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Icd reliance df4 ib 64cm at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$18,804.00
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.
$31,340.00
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.
$4,575.73 with Highmark BCBS of PA vs $23,505.00 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $4,575.73 | ↓ -76% |
| Highmark Wholecare (prev Gateway) | Medicaid | $6,268.00 | ↓ -67% |
| Geisinger | Medicaid | $10,342.20 | ↓ -45% |
| Geisinger | Commercial | $12,341.69 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $12,536.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $12,914.24 | ↓ -31% |
| Highmark Wholecare (prev Gateway) | Medicare | $15,670.00 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $15,670.00 | ↓ -17% |
| Galaxy Health Plan | Commercial | $20,371.00 | ↑ +8% |
| UPMC Health Plan | CHIP | $21,560.95 | ↑ +15% |
| Humana | Commercial | $23,505.00 | ↑ +25% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Icd reliance df4 ib 64cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $15,159.00 | $4,622.48 – $22,738.50 |
| UPMC Passavant-McCandless | Pittsburgh | $24,073.20 | $4,666.50 – $32,172.50 |
| UPMC Presbyterian | Pittsburgh | $68,619.60 | $1,124.04 – $34,860.21 |
| UPMC Williamsport | Williamsport | $14,973.00 | $4,991.00 – $22,459.50 |