healthcosts.net
Sarscov coronavirus ag ia at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$84.60
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.
$141.00
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.
$34.92 with UPMC Work Partners vs $105.75 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $34.92 | ↓ -59% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $34.98 | ↓ -59% |
| AmeriHealth Caritas | Medicare | $35.33 | ↓ -58% |
| UPMC Health Plan | Managed Medicare | $35.33 | ↓ -58% |
| United Healthcare | Medicare | $35.33 | ↓ -58% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $36.04 | ↓ -57% |
| Highmark Wholecare (prev Gateway) | Medicare | $38.15 | ↓ -55% |
| UPMC Health Plan | Managed Medicaid | $38.43 | ↓ -55% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.11 | ↓ -53% |
| United Healthcare Community Plan for Families | PA Medicaid | $40.18 | ↓ -53% |
| UPMC Health Plan | Commercial | $42.49 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicaid | $44.83 | ↓ -47% |
| Geisinger | Medicaid | $48.56 | ↓ -43% |
| United Healthcare | Commercial | $49.21 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $52.40 | ↓ -38% |
| Geisinger | Commercial | $55.53 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $56.40 | ↓ -33% |
| UPMC Health Plan | CHIP | $61.60 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $66.32 | ↓ -22% |
| Multiplan | PPO (Includes PHCS as a Payer) | $70.50 | ↓ -17% |
| Highmark BCBS of PA | Medicare Advantage | $83.22 | ↓ -2% |
| Galaxy Health Plan | Commercial | $91.65 | ↑ +8% |
| Humana | Commercial | $105.75 | ↑ +25% |
Visitor-reported prices
Comments
Sarscov coronavirus ag ia at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $34.80 | $16.18 – $84.07 |
| UPMC Muncy | Muncy | $34.80 | $8.70 – $46.40 |
| UPMC Northwest | Seneca | $34.80 | $23.20 – $49.30 |
| UPMC Passavant-McCandless | Pittsburgh | $39.00 | $19.72 – $84.87 |
| UPMC Presbyterian | Pittsburgh | $34.80 | $14.50 – $84.87 |
| UPMC St. Margaret | Pittsburgh | $34.80 | $14.62 – $84.87 |
| UPMC Wellsboro | Wellsboro | $46.40 | $10.44 – $52.69 |
| UPMC Western Psychiatric | Pittsburgh | $34.80 | $17.23 – $83.17 |