healthcosts.net
Removal/replacement ppm generator dual lead system at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$19,161.00
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.
$31,935.00
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.
$443.40 with Highmark BCBS of PA vs $26,238.52 with UPMC Health Plan — 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 | $443.40 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $518.50 | ↓ -97% |
| United Healthcare Community Plan for Families | PA Medicaid | $892.40 | ↓ -95% |
| Geisinger | Commercial | $12,576.00 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $12,774.00 | ↓ -33% |
| United Healthcare | Commercial | $13,763.99 | ↓ -28% |
| UPMC Health Plan | Commercial | $15,715.94 | ↓ -18% |
| Highmark Wholecare (prev Gateway) | Medicare | $15,967.50 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $15,967.50 | ↓ -17% |
| Geisinger | Medicaid | $17,564.25 | ↓ -8% |
| Galaxy Health Plan | Commercial | $20,757.75 | ↑ +8% |
| Humana | Commercial | $23,951.25 | ↑ +25% |
| UPMC Health Plan | CHIP | $26,238.52 | ↑ +37% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Removal/replacement ppm generator dual lead system at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $33,155.40 | $452.20 – $46,970.15 |
| UPMC Mercy | Pittsburgh | $29,639.40 | $447.93 – $44,459.10 |
| UPMC Presbyterian | Pittsburgh | $40,853.40 | $452.20 – $57,875.65 |
| UPMC Williamsport | Williamsport | $5,997.00 | $518.50 – $10,774.64 |
| UPMC Northwest | Seneca | not published | $518.50 – $10,775.64 |