Ghs central line insert < age 5, failed at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$3,229.80
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.
$5,383.00
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.
$129.62 with UPMC Health Plan vs $5,633.03 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $129.62 | ↓ -96% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $135.28 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicaid | $151.19 | ↓ -95% |
| Geisinger | Medicaid | $163.79 | ↓ -95% |
| Highmark BCBS of PA | Medicare Advantage | $578.48 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $596.90 | ↓ -82% |
| United Healthcare Community Plan for Families | PA Medicaid | $892.40 | ↓ -72% |
| Geisinger | Commercial | $2,119.83 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $2,153.20 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,220.00 | ↓ -31% |
| UPMC Health Plan | CHIP | $2,300.42 | ↓ -29% |
| United Healthcare | Commercial | $2,320.07 | ↓ -28% |
| Multiplan | PPO (Includes PHCS as a Payer) | $2,691.50 | ↓ -17% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $2,970.75 | ↓ -8% |
| UPMC Health Plan | Managed Medicare | $3,000.76 | ↓ -7% |
| United Healthcare | Medicare | $3,000.76 | ↓ -7% |
| AmeriHealth Caritas | Medicare | $3,000.76 | ↓ -7% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $3,060.78 | ↓ -5% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,240.52 | ↑ +0% |
| Galaxy Health Plan | Commercial | $3,498.95 | ↑ +8% |
| Humana | Commercial | $4,037.25 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $4,450.43 | ↑ +38% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $5,633.03 | ↑ +74% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs central line insert < age 5, failed at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,098.60 | $117.84 – $1,464.80 |
| UPMC Carlisle | Carlisle | $3,229.80 | $149.66 – $4,817.54 |
| UPMC Community Osteopathic | Harrisburg | $3,229.80 | $149.66 – $4,575.55 |
| UPMC Hamot | Erie | $3,239.40 | $129.62 – $4,364.40 |
| UPMC Northwest | Seneca | $3,106.20 | $129.62 – $3,150.80 |
| UPMC Hanover | Hanover | $3,229.80 | $149.66 – $4,810.90 |
| UPMC Jameson | New Castle | $2,715.60 | $129.62 – $4,051.03 |
| UPMC Lititz | Lititz | $3,229.80 | $149.66 – $4,836.88 |