healthcosts.net
Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$96.00
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.
$160.00
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.
$9.68 with Highmark BCBS of PA vs $103.50 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 |
|---|---|---|---|
| Highmark BCBS of PA | Medicare Advantage | $9.68 | ↓ -90% |
| UPMC Health Plan | CHIP | $25.22 | ↓ -74% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $29.71 | ↓ -69% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $30.01 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $30.01 | ↓ -69% |
| Geisinger | Medicaid | $30.01 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicaid | $30.01 | ↓ -69% |
| UPMC Health Plan | Managed Medicare | $30.01 | ↓ -69% |
| United Healthcare | Medicare | $30.01 | ↓ -69% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $30.61 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $32.41 | ↓ -66% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $44.51 | ↓ -54% |
| UPMC Work Partners | Workers Comp | $46.46 | ↓ -52% |
| Geisinger | Commercial | $54.34 | ↓ -43% |
| Aetna of PA | TPA/Carrier | $55.20 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $56.33 | ↓ -41% |
| Multiplan | PPO (Includes PHCS as a Payer) | $69.00 | ↓ -28% |
| UPMC Health Plan | Commercial | $85.63 | ↓ -11% |
| Galaxy Health Plan | Commercial | $89.70 | ↓ -7% |
| Humana | Commercial | $103.50 | ↑ +8% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
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Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $204.00 | $7.81 – $32.41 |
| UPMC Muncy | Muncy | $1,494.00 | $12.00 – $72.00 |
| UPMC Northwest | Seneca | $96.00 | $4.69 – $32.41 |
| UPMC Passavant-McCandless | Pittsburgh | $507.60 | $9.87 – $33.01 |
| UPMC Presbyterian | Pittsburgh | $1,641.00 | $9.87 – $58.65 |
| UPMC St. Margaret | Pittsburgh | $225.60 | $1.76 – $32.41 |
| UPMC Wellsboro | Wellsboro | $1,494.00 | $14.40 – $72.00 |
| UPMC Williamsport | Williamsport | $1,422.60 | $21.70 – $72.00 |