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Kidney (Retroperitoneal) Ultrasound (complete) at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$394.20
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.
$657.00
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.
$56.35 with United Healthcare Community Plan for Families vs $418.71 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 | $56.35 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $89.65 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $93.56 | ↓ -76% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $100.37 | ↓ -75% |
| AmeriHealth Caritas | Medicare | $101.38 | ↓ -74% |
| UPMC Health Plan | Managed Medicare | $101.38 | ↓ -74% |
| United Healthcare | Medicare | $101.38 | ↓ -74% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $103.41 | ↓ -74% |
| Highmark Wholecare (prev Gateway) | Medicaid | $104.56 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -72% |
| Geisinger | Commercial | $111.84 | ↓ -72% |
| Geisinger | Medicaid | $113.28 | ↓ -71% |
| Aetna of PA | TPA/Carrier | $113.60 | ↓ -71% |
| United Healthcare | Commercial | $122.40 | ↓ -69% |
| Highmark BCBS of PA | Medicare Advantage | $129.11 | ↓ -67% |
| Multiplan | PPO (Includes PHCS as a Payer) | $142.00 | ↓ -64% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $150.36 | ↓ -62% |
| Galaxy Health Plan | Commercial | $184.60 | ↓ -53% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $190.31 | ↓ -52% |
| Humana | Commercial | $213.00 | ↓ -46% |
| UPMC Work Partners | Workers Comp | $263.82 | ↓ -33% |
| UPMC Health Plan | Commercial | $314.94 | ↓ -20% |
| UPMC Health Plan | CHIP | $418.71 | ↑ +6% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Kidney (Retroperitoneal) Ultrasound (complete) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $1,200.60 | $89.65 – $1,600.80 |
| UPMC Passavant-McCandless | Pittsburgh | $1,469.40 | $89.65 – $2,081.65 |
| UPMC Hamot | Erie | $442.20 | $85.14 – $515.90 |
| UPMC Carlisle | Carlisle | $394.20 | $64.19 – $558.45 |
| UPMC Altoona | Altoona | $726.60 | $49.00 – $968.80 |
| UPMC Bedford | Everett | $808.80 | $36.58 – $1,213.20 |
| UPMC Cole | Coudersport | $405.00 | $85.58 – $540.00 |
| UPMC Community Osteopathic | Harrisburg | $394.20 | $56.80 – $418.71 |