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Screening Mammogram at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$399.60
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.
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What you pay up front if you don't use insurance.
$666.00
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.
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The hospital's undiscounted list price — almost no one pays this.
$60.33 with Highmark BCBS of PA vs $551.43 with UPMC Health Plan — same scan, same building. Share
Negotiated rates by payer
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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 →
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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 | $60.33 | ↓ -85% |
| Geisinger | Commercial | $76.40 | ↓ -81% |
| Aetna of PA | TPA/Carrier | $77.60 | ↓ -81% |
| United Healthcare | Commercial | $83.61 | ↓ -79% |
| United Healthcare Community Plan for Families | PA Medicaid | $86.27 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicare | $97.00 | ↓ -76% |
| Multiplan | PPO (Includes PHCS as a Payer) | $97.00 | ↓ -76% |
| UPMC Health Plan | Managed Medicaid | $115.17 | ↓ -71% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $120.20 | ↓ -70% |
| Galaxy Health Plan | Commercial | $126.10 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicaid | $134.33 | ↓ -66% |
| Humana | Commercial | $145.50 | ↓ -64% |
| Geisinger | Medicaid | $145.52 | ↓ -64% |
| UPMC Health Plan | Commercial | $414.77 | ↑ +4% |
| UPMC Health Plan | CHIP | $551.43 | ↑ +38% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Screening Mammogram at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $345.00 | $60.95 – $460.00 |
| UPMC Bedford | Everett | $205.20 | $85.50 – $307.80 |
| UPMC Cole | Coudersport | $381.00 | $109.94 – $508.00 |
| UPMC Hamot | Erie | $205.20 | $51.30 – $239.40 |
| UPMC Carlisle | Carlisle | $257.40 | $58.77 – $506.81 |
| UPMC Community Osteopathic | Harrisburg | $399.60 | $38.80 – $551.43 |
| UPMC Hanover | Hanover | $257.40 | $81.51 – $506.81 |
| UPMC Horizon-Greenville | Greenville | $205.20 | $49.00 – $290.70 |