healthcosts.net
Porfimer sodium injection at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$13,787.40
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.
?
What you pay up front if you don't use insurance.
$22,979.00
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.
$4,735.11 with Highmark BCBS of PA vs $45,481.59 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 | $4,735.11 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $7,737.03 | ↓ -44% |
| UPMC Health Plan | CHIP | $8,042.65 | ↓ -42% |
| Geisinger | Commercial | $9,049.13 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $9,191.60 | ↓ -33% |
| UPMC Health Plan | Commercial | $10,340.55 | ↓ -25% |
| Multiplan | PPO (Includes PHCS as a Payer) | $11,489.50 | ↓ -17% |
| Geisinger | Medicaid | $12,638.45 | ↓ -8% |
| Galaxy Health Plan | Commercial | $14,936.35 | ↑ +8% |
| Humana | Commercial | $17,234.25 | ↑ +25% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $23,986.14 | ↑ +74% |
| AmeriHealth Caritas | Medicare | $24,228.42 | ↑ +76% |
| UPMC Health Plan | Managed Medicare | $24,228.42 | ↑ +76% |
| United Healthcare | Medicare | $24,228.42 | ↑ +76% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $24,712.99 | ↑ +79% |
| Highmark Wholecare (prev Gateway) | Medicare | $26,164.27 | ↑ +90% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $35,933.17 | ↑ +161% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $45,481.59 | ↑ +230% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Porfimer sodium injection at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $90,741.60 | $4,783.49 – $102,084.30 |
| UPMC Passavant-McCandless | Pittsburgh | $105,045.60 | $4,829.04 – $113,936.55 |
| UPMC Presbyterian | Pittsburgh | $105,045.60 | $4,829.04 – $148,814.60 |
| UPMC Western Psychiatric | Pittsburgh | $105,045.60 | $4,732.02 – $148,814.60 |