healthcosts.net
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$108.00
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.
$180.00
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.
$14.31 with UPMC Health Plan vs $102.42 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $14.31 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $14.94 | ↓ -86% |
| United Healthcare Community Plan for Families | PA Medicaid | $14.96 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $16.69 | ↓ -85% |
| Geisinger | Medicaid | $18.08 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $35.27 | ↓ -67% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $43.55 | ↓ -60% |
| AmeriHealth Caritas | Medicare | $43.99 | ↓ -59% |
| UPMC Health Plan | Managed Medicare | $43.99 | ↓ -59% |
| United Healthcare | Medicare | $43.99 | ↓ -59% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $44.87 | ↓ -58% |
| Highmark BCBS of PA | Medicare Advantage | $45.08 | ↓ -58% |
| Highmark Wholecare (prev Gateway) | Medicare | $47.50 | ↓ -56% |
| Geisinger | Commercial | $51.59 | ↓ -52% |
| Aetna of PA | TPA/Carrier | $52.40 | ↓ -51% |
| United Healthcare | Commercial | $56.46 | ↓ -48% |
| UPMC Health Plan | Commercial | $61.35 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $65.24 | ↓ -40% |
| Multiplan | PPO (Includes PHCS as a Payer) | $65.50 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $82.58 | ↓ -24% |
| Galaxy Health Plan | Commercial | $85.15 | ↓ -21% |
| Humana | Commercial | $98.25 | ↓ -9% |
| UPMC Health Plan | CHIP | $102.42 | ↓ -5% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Injection therapeutic/prophylactic/diagnostic each addl sequential IV push new substance/drug at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $203.40 | $14.31 – $305.10 |
| UPMC Muncy | Muncy | $147.00 | $14.31 – $196.00 |
| UPMC Northwest | Seneca | $144.60 | $14.31 – $204.85 |
| UPMC Passavant-McCandless | Pittsburgh | $298.20 | $14.31 – $422.45 |
| UPMC Presbyterian | Pittsburgh | $438.00 | $14.31 – $620.50 |
| UPMC St. Margaret | Pittsburgh | $238.80 | $14.31 – $338.30 |
| UPMC Wellsboro | Wellsboro | $177.60 | $14.31 – $199.80 |
| UPMC Williamsport | Williamsport | $147.00 | $14.31 – $196.00 |