healthcosts.net
Marker biop eviva buckle ss at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$1,213.20
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.
$2,022.00
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.
$3.20 with Highmark Wholecare (prev Gateway) vs $194.38 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $3.20 | ↓ -100% |
| Geisinger | Medicaid | $5.28 | ↓ -100% |
| Geisinger | Commercial | $6.30 | ↓ -99% |
| Aetna of PA | TPA/Carrier | $6.40 | ↓ -99% |
| Highmark BCBS of PA | Medicare Advantage | $7.92 | ↓ -99% |
| Highmark Wholecare (prev Gateway) | Medicare | $8.00 | ↓ -99% |
| Multiplan | PPO (Includes PHCS as a Payer) | $8.00 | ↓ -99% |
| Galaxy Health Plan | Commercial | $10.40 | ↓ -99% |
| Humana | Commercial | $12.00 | ↓ -99% |
| UPMC Health Plan | Commercial | $116.42 | ↓ -90% |
| UPMC Health Plan | CHIP | $194.38 | ↓ -84% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Marker biop eviva buckle ss at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $149.40 | $0.25 – $153.49 |
| UPMC Muncy | Muncy | $216.60 | $54.15 – $324.90 |
| UPMC Northwest | Seneca | $400.80 | $13.25 – $235.21 |
| UPMC Passavant-McCandless | Pittsburgh | $2,036.40 | $13.25 – $282.06 |
| UPMC Presbyterian | Pittsburgh | $3,051.60 | $7.38 – $314.27 |
| UPMC St. Margaret | Pittsburgh | $429.60 | $13.25 – $238.51 |
| UPMC Wellsboro | Wellsboro | $404.80 | $91.08 – $455.40 |
| UPMC Williamsport | Williamsport | $2,182.80 | $97.47 – $324.90 |