healthcosts.net
Inj w/fluor eval cv device at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$417.00
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.
?
What you pay up front if you don't use insurance.
$695.00
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.
$66.70 with United Healthcare Community Plan for Families vs $524.10 with UPMC Health Plan — 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 Community Plan for Families | PA Medicaid | $66.70 | ↓ -84% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $198.86 | ↓ -52% |
| AmeriHealth Caritas | Medicare | $200.87 | ↓ -52% |
| UPMC Health Plan | Managed Medicare | $200.87 | ↓ -52% |
| United Healthcare | Medicare | $200.87 | ↓ -52% |
| UPMC Work Partners | Workers Comp | $201.63 | ↓ -52% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $204.89 | ↓ -51% |
| Highmark Wholecare (prev Gateway) | Medicare | $216.92 | ↓ -48% |
| Highmark BCBS of PA | Medicare Advantage | $221.09 | ↓ -47% |
| Geisinger | Commercial | $273.69 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $278.00 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $297.91 | ↓ -29% |
| United Healthcare | Commercial | $299.55 | ↓ -28% |
| UPMC Health Plan | Commercial | $313.92 | ↓ -25% |
| Multiplan | PPO (Includes PHCS as a Payer) | $347.50 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $377.07 | ↓ -10% |
| Geisinger | Medicaid | $382.25 | ↓ -8% |
| Galaxy Health Plan | Commercial | $451.75 | ↑ +8% |
| Humana | Commercial | $521.25 | ↑ +25% |
| UPMC Health Plan | CHIP | $524.10 | ↑ +26% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Inj w/fluor eval cv device at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,433.40 | $186.67 – $2,030.65 |
| UPMC Mercy | Pittsburgh | $543.00 | $167.45 – $814.50 |
| UPMC Northwest | Seneca | $551.40 | $182.17 – $781.15 |
| UPMC Presbyterian | Pittsburgh | $866.40 | $69.60 – $1,227.40 |
| UPMC St. Margaret | Pittsburgh | $516.00 | $173.43 – $731.00 |
| UPMC Williamsport | Williamsport | $1,012.20 | $74.24 – $1,349.60 |