Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$876.60
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.
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What you pay up front if you don't use insurance.
$1,461.00
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.
$292.38 with United Healthcare Community Plan for Families vs $3,298.34 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $292.38 | ↓ -67% |
| Highmark BCBS of PA | Medicare Advantage | $379.50 | ↓ -57% |
| UPMC Work Partners | Workers Comp | $411.91 | ↓ -53% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $412.61 | ↓ -53% |
| United Healthcare | Medicare | $416.78 | ↓ -52% |
| AmeriHealth Caritas | Medicare | $416.78 | ↓ -52% |
| UPMC Health Plan | Managed Medicare | $416.78 | ↓ -52% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $425.12 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicare | $450.08 | ↓ -49% |
| United Healthcare | Commercial | $509.89 | ↓ -42% |
| Geisinger | Commercial | $575.34 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $584.40 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $618.13 | ↓ -29% |
| Multiplan | PPO (Includes PHCS as a Payer) | $730.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $782.38 | ↓ -11% |
| Geisinger | Medicaid | $803.55 | ↓ -8% |
| Galaxy Health Plan | Commercial | $949.65 | ↑ +8% |
| Humana | Commercial | $1,095.75 | ↑ +25% |
| UPMC Health Plan | Commercial | $2,275.21 | ↑ +160% |
| UPMC Health Plan | CHIP | $3,298.34 | ↑ +276% |
Visitor-reported prices
Comments
Infectious agent nucleic acid multiplex amplified probe gi pathogen 12-25 targets at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $438.00 | $365.00 – $584.00 |
| UPMC Carlisle | Carlisle | $876.60 | $200.16 – $1,241.85 |
| UPMC Community Osteopathic | Harrisburg | $876.60 | $292.20 – $3,298.34 |
| UPMC East | Monroeville | $454.20 | $249.81 – $605.60 |
| UPMC Hamot | Erie | $462.00 | $383.38 – $450.12 |
| UPMC Northwest | Seneca | $454.20 | $377.98 – $450.12 |
| UPMC Hanover | Hanover | $876.60 | $316.19 – $3,298.34 |
| UPMC Horizon-Greenville | Greenville | $454.20 | $373.14 – $619.90 |