healthcosts.net
Piflu f-18, dia 1 millicurie at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$1,252.20
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.
?
What you pay up front if you don't use insurance.
$2,087.00
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.
$218.81 with Highmark BCBS of PA vs $1,565.25 with Humana — 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 | $218.81 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $329.12 | ↓ -74% |
| AmeriHealth Caritas | Medicare | $332.44 | ↓ -73% |
| UPMC Health Plan | Managed Medicare | $332.44 | ↓ -73% |
| United Healthcare | Medicare | $332.44 | ↓ -73% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $339.09 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicare | $359.00 | ↓ -71% |
| UPMC Health Plan | Commercial | $482.74 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $493.04 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $624.06 | ↓ -50% |
| UPMC Health Plan | CHIP | $805.95 | ↓ -36% |
| Geisinger | Commercial | $821.86 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $834.80 | ↓ -33% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,043.50 | ↓ -17% |
| Geisinger | Medicaid | $1,147.85 | ↓ -8% |
| Galaxy Health Plan | Commercial | $1,356.55 | ↑ +8% |
| Humana | Commercial | $1,565.25 | ↑ +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
Comments
Piflu f-18, dia 1 millicurie at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Northwest | Seneca | $1,033.80 | $301.49 – $4,714.77 |
| UPMC Passavant-McCandless | Pittsburgh | $1,305.00 | $223.15 – $1,848.75 |
| UPMC Presbyterian | Pittsburgh | $1,641.60 | $223.15 – $2,325.60 |
| UPMC Williamsport | Williamsport | $1,119.00 | $335.70 – $1,678.50 |
| UPMC Mercy | Pittsburgh | not published | $221.05 – $11,751.03 |
| UPMC St. Margaret | Pittsburgh | not published | $223.15 – $11,098.19 |