Ultrasound joint complete left at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$394.20
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.
$657.00
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.
$76.11 with United Healthcare Community Plan for Families vs $550.20 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $76.11 | ↓ -81% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $100.37 | ↓ -75% |
| UPMC Health Plan | Managed Medicare | $101.38 | ↓ -74% |
| United Healthcare | Medicare | $101.38 | ↓ -74% |
| AmeriHealth Caritas | Medicare | $101.38 | ↓ -74% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $103.41 | ↓ -74% |
| Highmark Wholecare (prev Gateway) | Medicare | $109.48 | ↓ -72% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $150.36 | ↓ -62% |
| Highmark BCBS of PA | Medicare Advantage | $152.20 | ↓ -61% |
| UPMC Work Partners | Workers Comp | $170.06 | ↓ -57% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $190.31 | ↓ -52% |
| Geisinger | Commercial | $258.73 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $262.80 | ↓ -33% |
| United Healthcare | Commercial | $283.17 | ↓ -28% |
| Multiplan | PPO (Includes PHCS as a Payer) | $328.50 | ↓ -17% |
| Geisinger | Medicaid | $361.35 | ↓ -8% |
| UPMC Health Plan | Commercial | $413.84 | ↑ +5% |
| Galaxy Health Plan | Commercial | $427.05 | ↑ +8% |
| Humana | Commercial | $492.75 | ↑ +25% |
| UPMC Health Plan | CHIP | $550.20 | ↑ +40% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Ultrasound joint complete left at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $626.40 | $36.58 – $939.60 |
| UPMC Carlisle | Carlisle | $394.20 | $55.95 – $558.45 |
| UPMC Cole | Coudersport | $333.60 | $59.18 – $444.80 |
| UPMC Community Osteopathic | Harrisburg | $394.20 | $86.70 – $558.45 |
| UPMC East | Monroeville | $1,414.20 | $101.65 – $1,885.60 |
| UPMC Northwest | Seneca | $625.80 | $91.94 – $170.06 |
| UPMC Hanover | Hanover | $394.20 | $86.70 – $550.20 |
| UPMC Horizon-Greenville | Greenville | $625.80 | $90.77 – $190.24 |