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Metabolic Blood Panel (Basic) at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$55.20
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.
$92.00
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.
$8.36 with UPMC Work Partners vs $57.75 with Humana — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $8.36 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $8.38 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $8.46 | ↓ -85% |
| UPMC Health Plan | Managed Medicare | $8.46 | ↓ -85% |
| United Healthcare | Medicare | $8.46 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $8.63 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $9.14 | ↓ -83% |
| CBHNP | Commercial | $9.36 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $10.30 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $10.75 | ↓ -81% |
| United Healthcare Community Plan for Families | PA Medicaid | $10.76 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $12.01 | ↓ -78% |
| CCBHN | Commercial | $12.50 | ↓ -77% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $12.55 | ↓ -77% |
| Geisinger | Medicaid | $13.01 | ↓ -76% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $15.88 | ↓ -71% |
| Highmark BCBS of PA | Medicare Advantage | $22.25 | ↓ -60% |
| United Healthcare | Commercial | $26.87 | ↓ -51% |
| Geisinger | Commercial | $30.32 | ↓ -45% |
| Aetna of PA | TPA/Carrier | $30.80 | ↓ -44% |
| UPMC Health Plan | Commercial | $37.90 | ↓ -31% |
| Multiplan | PPO (Includes PHCS as a Payer) | $38.50 | ↓ -30% |
| Galaxy Health Plan | Commercial | $50.05 | ↓ -9% |
| UPMC Health Plan | CHIP | $54.94 | ↓ -0% |
| Humana | Commercial | $57.75 | ↑ +5% |
Visitor-reported prices
Comments
Metabolic Blood Panel (Basic) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $55.20 | $8.38 – $78.20 |
| UPMC Altoona | Altoona | $108.60 | $8.36 – $144.80 |
| UPMC Bedford | Everett | $58.80 | $3.05 – $88.20 |
| UPMC Cole | Coudersport | $81.60 | $5.50 – $108.80 |
| UPMC Community Osteopathic | Harrisburg | $55.20 | $8.38 – $65.45 |
| UPMC East | Monroeville | $175.20 | $8.36 – $233.60 |
| UPMC Hamot | Erie | $534.60 | $8.36 – $623.70 |
| UPMC Hanover | Hanover | $55.20 | $8.38 – $80.04 |