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Diabetes (HbA1c) Test at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$49.20
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.
$82.00
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.
$7.00 with CBHNP vs $67.98 with UPMC Health Plan — 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 |
|---|---|---|---|
| CBHNP | Commercial | $7.00 | ↓ -86% |
| CCBHN | Commercial | $7.00 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $7.70 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $8.04 | ↓ -84% |
| United Healthcare Community Plan for Families | PA Medicaid | $8.05 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicaid | $8.98 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $9.60 | ↓ -80% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $9.61 | ↓ -80% |
| AmeriHealth Caritas | Medicare | $9.71 | ↓ -80% |
| UPMC Health Plan | Managed Medicare | $9.71 | ↓ -80% |
| United Healthcare | Medicare | $9.71 | ↓ -80% |
| Geisinger | Medicaid | $9.73 | ↓ -80% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $9.90 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicare | $10.49 | ↓ -79% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $14.40 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $18.23 | ↓ -63% |
| Highmark BCBS of PA | Medicare Advantage | $20.39 | ↓ -59% |
| United Healthcare | Commercial | $26.87 | ↓ -45% |
| Geisinger | Commercial | $30.32 | ↓ -38% |
| Aetna of PA | TPA/Carrier | $30.80 | ↓ -37% |
| Multiplan | PPO (Includes PHCS as a Payer) | $38.50 | ↓ -22% |
| UPMC Health Plan | Commercial | $46.90 | ↓ -5% |
| Galaxy Health Plan | Commercial | $50.05 | ↑ +2% |
| Humana | Commercial | $57.75 | ↑ +17% |
| UPMC Health Plan | CHIP | $67.98 | ↑ +38% |
Visitor-reported prices
Comments
Diabetes (HbA1c) Test at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $158.40 | $7.00 – $211.20 |
| UPMC Passavant-McCandless | Pittsburgh | $236.40 | $7.70 – $334.90 |
| UPMC Hamot | Erie | $125.40 | $7.00 – $146.30 |
| UPMC Carlisle | Carlisle | $49.20 | $7.00 – $69.70 |
| UPMC Altoona | Altoona | $86.40 | $7.00 – $115.20 |
| UPMC Bedford | Everett | $66.60 | $3.50 – $99.90 |
| UPMC Cole | Coudersport | $75.00 | $6.31 – $100.00 |
| UPMC Community Osteopathic | Harrisburg | $49.20 | $7.00 – $67.98 |