healthcosts.net
Infectious agent nucleic acid amplified probe sars-cov-2/inf a & b at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$84.60
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.
?
What you pay up front if you don't use insurance.
$141.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$49.21 with United Healthcare vs $267.75 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | Commercial | $49.21 | ↓ -42% |
| Geisinger | Commercial | $55.53 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $56.40 | ↓ -33% |
| Multiplan | PPO (Includes PHCS as a Payer) | $70.50 | ↓ -17% |
| Galaxy Health Plan | Commercial | $91.65 | ↑ +8% |
| Humana | Commercial | $105.75 | ↑ +25% |
| UPMC Health Plan | Managed Medicaid | $124.15 | ↑ +47% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $129.56 | ↑ +53% |
| United Healthcare Community Plan for Families | PA Medicaid | $129.79 | ↑ +53% |
| UPMC Work Partners | Workers Comp | $140.96 | ↑ +67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $141.20 | ↑ +67% |
| AmeriHealth Caritas | Medicare | $142.63 | ↑ +69% |
| UPMC Health Plan | Managed Medicare | $142.63 | ↑ +69% |
| United Healthcare | Medicare | $142.63 | ↑ +69% |
| Highmark Wholecare (prev Gateway) | Medicaid | $144.80 | ↑ +71% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $145.48 | ↑ +72% |
| Highmark Wholecare (prev Gateway) | Medicare | $154.03 | ↑ +82% |
| Geisinger | Medicaid | $156.86 | ↑ +85% |
| UPMC Health Plan | Commercial | $177.69 | ↑ +110% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $211.53 | ↑ +150% |
| Highmark BCBS of PA | Medicare Advantage | $226.32 | ↑ +168% |
| UPMC Health Plan | CHIP | $257.60 | ↑ +204% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $267.75 | ↑ +216% |