healthcosts.net
Cystine urine quantitative at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$116.40
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
?
What you pay up front if you don't use insurance.
$194.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
?
The hospital's undiscounted list price — almost no one pays this.
$22.71 with UPMC Work Partners vs $102.82 with UPMC Health Plan — same scan, same building. Share
Negotiated rates by payer
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $22.71 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $22.75 | ↓ -80% |
| AmeriHealth Caritas | Medicare | $22.98 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $22.98 | ↓ -80% |
| United Healthcare | Medicare | $22.98 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $23.44 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicare | $24.82 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $25.51 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $26.62 | ↓ -77% |
| United Healthcare Community Plan for Families | PA Medicaid | $26.67 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.75 | ↓ -74% |
| Highmark BCBS of PA | Medicare Advantage | $32.09 | ↓ -72% |
| Geisinger | Medicaid | $32.23 | ↓ -72% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $34.08 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $43.14 | ↓ -63% |
| United Healthcare | Commercial | $43.62 | ↓ -63% |
| Geisinger | Commercial | $49.23 | ↓ -58% |
| Aetna of PA | TPA/Carrier | $50.00 | ↓ -57% |
| Multiplan | PPO (Includes PHCS as a Payer) | $62.50 | ↓ -46% |
| UPMC Health Plan | Commercial | $70.92 | ↓ -39% |
| Galaxy Health Plan | Commercial | $81.25 | ↓ -30% |
| Humana | Commercial | $93.75 | ↓ -19% |
| UPMC Health Plan | CHIP | $102.82 | ↓ -12% |
Visitor-reported prices
Comments
Cystine urine quantitative at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $464.40 | $21.36 – $657.90 |
| UPMC Mercy | Pittsburgh | $178.20 | $19.16 – $267.30 |
| UPMC Northwest | Seneca | $125.40 | $20.84 – $177.65 |
| UPMC Presbyterian | Pittsburgh | $463.80 | $22.71 – $657.05 |
| UPMC St. Margaret | Pittsburgh | $125.40 | $19.84 – $177.65 |
| UPMC Williamsport | Williamsport | $116.40 | $22.71 – $155.20 |