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Leg Vein Ultrasound (DVT study, both legs) at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$819.60
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.
$1,366.00
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.
$53.16 with Geisinger vs $479.25 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 |
|---|---|---|---|
| Geisinger | Commercial | $53.16 | ↓ -94% |
| Aetna of PA | TPA/Carrier | $54.00 | ↓ -93% |
| United Healthcare | Commercial | $58.19 | ↓ -93% |
| Multiplan | PPO (Includes PHCS as a Payer) | $67.50 | ↓ -92% |
| Galaxy Health Plan | Commercial | $87.75 | ↓ -89% |
| Humana | Commercial | $101.25 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $131.33 | ↓ -84% |
| Highmark BCBS of PA | Medicare Advantage | $156.36 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $161.33 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $168.37 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $188.16 | ↓ -77% |
| Geisinger | Medicaid | $203.84 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $228.15 | ↓ -72% |
| AmeriHealth Caritas | Medicare | $230.45 | ↓ -72% |
| UPMC Health Plan | Managed Medicare | $230.45 | ↓ -72% |
| United Healthcare | Medicare | $230.45 | ↓ -72% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $235.06 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $248.86 | ↓ -70% |
| UPMC Health Plan | Commercial | $287.05 | ↓ -65% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $341.78 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $416.37 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $432.60 | ↓ -47% |
| UPMC Health Plan | CHIP | $479.25 | ↓ -42% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Leg Vein Ultrasound (DVT study, both legs) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $817.80 | $159.46 – $1,090.40 |
| UPMC Passavant-McCandless | Pittsburgh | $2,092.20 | $159.46 – $2,963.95 |
| UPMC Hamot | Erie | $1,021.80 | $84.33 – $1,192.10 |
| UPMC Carlisle | Carlisle | $819.60 | $149.60 – $1,161.10 |
| UPMC Altoona | Altoona | $1,053.00 | $114.20 – $1,404.00 |
| UPMC Bedford | Everett | $466.80 | $83.15 – $700.20 |
| UPMC Cole | Coudersport | $495.00 | $153.99 – $660.00 |
| UPMC Community Osteopathic | Harrisburg | $819.60 | $27.00 – $479.25 |