healthcosts.net
Perc drug-el cor stent sing at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$15,411.00
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.
?
What you pay up front if you don't use insurance.
$25,685.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$2,121.19 with Highmark BCBS of PA vs $20,296.04 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $2,121.19 | ↓ -86% |
| UPMC Health Plan | Commercial | $4,923.97 | ↓ -68% |
| United Healthcare Community Plan for Families | PA Medicaid | $7,446.64 | ↓ -52% |
| UPMC Health Plan | CHIP | $8,220.80 | ↓ -47% |
| Geisinger | Commercial | $10,114.75 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $10,274.00 | ↓ -33% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $10,703.75 | ↓ -31% |
| AmeriHealth Caritas | Medicare | $10,811.87 | ↓ -30% |
| UPMC Health Plan | Managed Medicare | $10,811.87 | ↓ -30% |
| United Healthcare | Medicare | $10,811.87 | ↓ -30% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,028.11 | ↓ -28% |
| United Healthcare | Commercial | $11,070.24 | ↓ -28% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,675.74 | ↓ -24% |
| Multiplan | PPO (Includes PHCS as a Payer) | $12,842.50 | ↓ -17% |
| Geisinger | Medicaid | $14,126.75 | ↓ -8% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $16,035.08 | ↑ +4% |
| Galaxy Health Plan | Commercial | $16,695.25 | ↑ +8% |
| Humana | Commercial | $19,263.75 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $20,296.04 | ↑ +32% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Perc drug-el cor stent sing at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $11,088.60 | $2,142.86 – $16,632.90 |
| UPMC Passavant-McCandless | Pittsburgh | $18,556.80 | $2,163.27 – $26,288.80 |
| UPMC Presbyterian | Pittsburgh | $23,282.40 | $2,163.27 – $32,983.40 |
| UPMC St. Margaret | Pittsburgh | $17,008.20 | $2,163.27 – $24,094.95 |
| UPMC Williamsport | Williamsport | $7,905.00 | $3,557.25 – $11,857.50 |