Decalcification at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$124.80
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.
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What you pay up front if you don't use insurance.
$208.00
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.
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The hospital's undiscounted list price — almost no one pays this.
$7.12 with United Healthcare Community Plan for Families vs $156.00 with Humana — same scan, same building. Share
Negotiated rates by payer
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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 →
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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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $7.12 | ↓ -94% |
| CBHNP | Commercial | $16.72 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $18.39 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $19.19 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $21.45 | ↓ -83% |
| Geisinger | Medicaid | $23.24 | ↓ -81% |
| Highmark BCBS of PA | Medicare Advantage | $31.83 | ↓ -74% |
| UPMC Health Plan | Commercial | $57.13 | ↓ -54% |
| United Healthcare | Commercial | $72.59 | ↓ -42% |
| Geisinger | Commercial | $81.91 | ↓ -34% |
| UPMC Health Plan | CHIP | $82.82 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $83.20 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $104.00 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $104.00 | ↓ -17% |
| Galaxy Health Plan | Commercial | $135.20 | ↑ +8% |
| UPMC Work Partners | Workers Comp | $141.08 | ↑ +13% |
| Humana | Commercial | $156.00 | ↑ +25% |
Visitor-reported prices
Comments
Decalcification at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $127.80 | $16.72 – $170.40 |
| UPMC Bedford | Everett | $83.40 | $16.72 – $141.08 |
| UPMC Carlisle | Carlisle | $124.80 | $8.11 – $176.80 |
| UPMC Cole | Coudersport | $80.40 | $17.56 – $141.08 |
| UPMC Community Osteopathic | Harrisburg | $124.80 | $8.11 – $176.80 |
| UPMC East | Monroeville | $250.20 | $16.72 – $333.60 |
| UPMC Hamot | Erie | $272.40 | $12.71 – $142.12 |
| UPMC Northwest | Seneca | $102.00 | $18.39 – $141.30 |