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Lung function test (mbc/mvv) at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$155.40
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.
$259.00
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.
$6.21 with United Healthcare Community Plan for Families vs $106.31 with Highmark BCBS of PA — 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 | $6.21 | ↓ -96% |
| UPMC Health Plan | Managed Medicaid | $9.90 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $10.33 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $11.55 | ↓ -93% |
| Geisinger | Commercial | $12.21 | ↓ -92% |
| Aetna of PA | TPA/Carrier | $12.40 | ↓ -92% |
| Geisinger | Medicaid | $12.51 | ↓ -92% |
| United Healthcare | Commercial | $13.36 | ↓ -91% |
| Multiplan | PPO (Includes PHCS as a Payer) | $15.50 | ↓ -90% |
| Highmark BCBS of PA | Medicare Advantage | $18.14 | ↓ -88% |
| Galaxy Health Plan | Commercial | $20.15 | ↓ -87% |
| Humana | Commercial | $23.25 | ↓ -85% |
| UPMC Health Plan | Commercial | $39.21 | ↓ -75% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $56.06 | ↓ -64% |
| AmeriHealth Caritas | Medicare | $56.63 | ↓ -64% |
| UPMC Health Plan | Managed Medicare | $56.63 | ↓ -64% |
| United Healthcare | Medicare | $56.63 | ↓ -64% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $57.76 | ↓ -63% |
| Highmark Wholecare (prev Gateway) | Medicare | $61.15 | ↓ -61% |
| UPMC Health Plan | CHIP | $65.46 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $76.51 | ↓ -51% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $83.99 | ↓ -46% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $106.31 | ↓ -32% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Lung function test (mbc/mvv) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $79.80 | $9.90 – $119.70 |
| UPMC Northwest | Seneca | $115.80 | $9.90 – $164.05 |
| UPMC Passavant-McCandless | Pittsburgh | $109.80 | $9.90 – $155.55 |
| UPMC Presbyterian | Pittsburgh | $100.20 | $6.48 – $141.95 |
| UPMC St. Margaret | Pittsburgh | $69.60 | $9.90 – $98.60 |
| UPMC Wellsboro | Wellsboro | $109.60 | $6.91 – $123.30 |
| UPMC Williamsport | Williamsport | $133.20 | $6.91 – $177.60 |