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Metabolic Blood Panel (Comprehensive) at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$68.40
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.
$114.00
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.
$10.43 with UPMC Work Partners vs $72.07 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $10.43 | ↓ -85% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $10.45 | ↓ -85% |
| AmeriHealth Caritas | Medicare | $10.56 | ↓ -85% |
| UPMC Health Plan | Managed Medicare | $10.56 | ↓ -85% |
| United Healthcare | Medicare | $10.56 | ↓ -85% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $10.77 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicare | $11.40 | ↓ -83% |
| CBHNP | Commercial | $11.69 | ↓ -83% |
| CCBHN | Commercial | $11.69 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $12.86 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $13.42 | ↓ -80% |
| United Healthcare Community Plan for Families | PA Medicaid | $13.44 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicaid | $15.00 | ↓ -78% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $15.66 | ↓ -77% |
| Geisinger | Medicaid | $16.25 | ↓ -76% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $19.82 | ↓ -71% |
| United Healthcare | Commercial | $25.48 | ↓ -63% |
| Highmark BCBS of PA | Medicare Advantage | $27.78 | ↓ -59% |
| Geisinger | Commercial | $28.75 | ↓ -58% |
| Aetna of PA | TPA/Carrier | $29.20 | ↓ -57% |
| Multiplan | PPO (Includes PHCS as a Payer) | $36.50 | ↓ -47% |
| Galaxy Health Plan | Commercial | $47.45 | ↓ -31% |
| UPMC Health Plan | Commercial | $49.72 | ↓ -27% |
| Humana | Commercial | $54.75 | ↓ -20% |
| UPMC Health Plan | CHIP | $72.07 | ↑ +5% |
Visitor-reported prices
Comments
Metabolic Blood Panel (Comprehensive) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $282.00 | $9.81 – $376.55 |
| UPMC Altoona | Altoona | $156.00 | $10.43 – $208.00 |
| UPMC Bedford | Everett | $66.60 | $3.81 – $99.90 |
| UPMC Cole | Coudersport | $100.80 | $6.86 – $134.40 |
| UPMC East | Monroeville | $216.00 | $10.43 – $288.00 |
| UPMC Hamot | Erie | $451.80 | $10.43 – $527.10 |
| UPMC Hanover | Hanover | $68.40 | $10.39 – $99.18 |
| UPMC Carlisle | Carlisle | $68.40 | $10.39 – $96.90 |