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Pet fdg brain metoblic eval sb at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$5,639.40
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.
$9,399.00
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.
$705.26 with United Healthcare Community Plan for Families vs $7,049.25 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $705.26 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $751.40 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $784.19 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $876.40 | ↓ -84% |
| Geisinger | Medicaid | $949.43 | ↓ -83% |
| Highmark BCBS of PA | Medicare Advantage | $2,405.38 | ↓ -57% |
| UPMC Health Plan | Commercial | $3,549.03 | ↓ -37% |
| Geisinger | Commercial | $3,701.33 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $3,759.60 | ↓ -33% |
| United Healthcare | Commercial | $4,173.00 | ↓ -26% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,699.50 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $4,699.50 | ↓ -17% |
| UPMC Health Plan | CHIP | $4,718.45 | ↓ -16% |
| Galaxy Health Plan | Commercial | $6,109.35 | ↑ +8% |
| Humana | Commercial | $7,049.25 | ↑ +25% |
| 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
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Pet fdg brain metoblic eval sb at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $13,297.20 | $751.40 – $18,837.70 |
| UPMC Presbyterian | Pittsburgh | $13,366.80 | $735.92 – $18,936.30 |