Pinworm exam at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$238.80
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.
$398.00
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.
$2.99 with United Healthcare Community Plan for Families vs $30.00 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $2.99 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $4.22 | ↓ -98% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $4.23 | ↓ -98% |
| UPMC Health Plan | Managed Medicare | $4.27 | ↓ -98% |
| AmeriHealth Caritas | Medicare | $4.27 | ↓ -98% |
| United Healthcare | Medicare | $4.27 | ↓ -98% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $4.36 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.61 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $6.33 | ↓ -97% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $8.02 | ↓ -97% |
| Highmark BCBS of PA | Medicare Advantage | $11.22 | ↓ -95% |
| United Healthcare | Commercial | $13.96 | ↓ -94% |
| Geisinger | Commercial | $15.75 | ↓ -93% |
| Aetna of PA | TPA/Carrier | $16.00 | ↓ -93% |
| UPMC Health Plan | Commercial | $18.93 | ↓ -92% |
| Multiplan | PPO (Includes PHCS as a Payer) | $20.00 | ↓ -92% |
| Geisinger | Medicaid | $22.00 | ↓ -91% |
| Galaxy Health Plan | Commercial | $26.00 | ↓ -89% |
| UPMC Health Plan | CHIP | $27.44 | ↓ -89% |
| Humana | Commercial | $30.00 | ↓ -87% |
Visitor-reported prices
Comments
Pinworm exam at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $45.00 | $4.22 – $60.00 |
| UPMC Bedford | Everett | $73.80 | $1.54 – $110.70 |
| UPMC Carlisle | Carlisle | $238.80 | $2.35 – $34.00 |
| UPMC Cole | Coudersport | $43.20 | $2.78 – $57.60 |
| UPMC Community Osteopathic | Harrisburg | $238.80 | $3.41 – $34.00 |
| UPMC Northwest | Seneca | $58.80 | $3.87 – $4.61 |
| UPMC Hanover | Hanover | $238.80 | $3.41 – $27.44 |
| UPMC Horizon-Greenville | Greenville | $39.00 | $3.82 – $8.01 |