Ghs i and d abscess/hematoma scrotum at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$5,452.20
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.
$9,087.00
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.
$42.35 with UPMC Health Plan vs $6,815.25 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $42.35 | ↓ -99% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $44.20 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicaid | $49.40 | ↓ -99% |
| Geisinger | Medicaid | $53.51 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $345.72 | ↓ -94% |
| Highmark BCBS of PA | Medicare Advantage | $722.42 | ↓ -87% |
| United Healthcare Community Plan for Families | PA Medicaid | $892.40 | ↓ -84% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $1,933.48 | ↓ -65% |
| UPMC Health Plan | Managed Medicare | $1,953.01 | ↓ -64% |
| AmeriHealth Caritas | Medicare | $1,953.01 | ↓ -64% |
| United Healthcare | Medicare | $1,953.01 | ↓ -64% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $1,992.07 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,109.06 | ↓ -61% |
| UPMC Health Plan | CHIP | $2,297.12 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $2,896.51 | ↓ -47% |
| UPMC Health Plan | Commercial | $2,937.00 | ↓ -46% |
| Geisinger | Commercial | $3,578.46 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $3,634.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $3,666.19 | ↓ -33% |
| United Healthcare | Commercial | $3,916.50 | ↓ -28% |
| Multiplan | PPO (Includes PHCS as a Payer) | $4,543.50 | ↓ -17% |
| Galaxy Health Plan | Commercial | $5,906.55 | ↑ +8% |
| Humana | Commercial | $6,815.25 | ↑ +25% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs i and d abscess/hematoma scrotum at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $4,573.20 | $40.42 – $6,859.80 |
| UPMC Carlisle | Carlisle | $5,452.20 | $48.90 – $7,723.95 |
| UPMC Cole | Coudersport | $1,693.20 | $40.42 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $5,452.20 | $48.90 – $7,723.95 |
| UPMC East | Monroeville | $3,768.60 | $42.35 – $5,024.80 |
| UPMC Hamot | Erie | $4,273.20 | $42.35 – $2,840.52 |
| UPMC Northwest | Seneca | $4,869.60 | $42.35 – $2,050.66 |
| UPMC Hanover | Hanover | $5,452.20 | $48.90 – $3,131.10 |