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Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$123.00
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.
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What you pay up front if you don't use insurance.
$205.00
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.
$6.42 with United Healthcare Community Plan for Families vs $153.75 with Humana — 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 | $6.42 | ↓ -95% |
| Highmark BCBS of PA | Medicare Advantage | $18.40 | ↓ -85% |
| UPMC Health Plan | Commercial | $28.88 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $34.90 | ↓ -72% |
| UPMC Health Plan | CHIP | $48.22 | ↓ -61% |
| Geisinger | Commercial | $80.73 | ↓ -34% |
| Aetna of PA | TPA/Carrier | $82.00 | ↓ -33% |
| United Healthcare | Commercial | $88.36 | ↓ -28% |
| Highmark Wholecare (prev Gateway) | Medicare | $102.50 | ↓ -17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $102.50 | ↓ -17% |
| Geisinger | Medicaid | $112.75 | ↓ -8% |
| Galaxy Health Plan | Commercial | $133.25 | ↑ +8% |
| Humana | Commercial | $153.75 | ↑ +25% |
Visitor-reported prices
Comments
Venipuncture >= 3 years diagnostic/therapeutic (not to be used for routine venipuncture) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $102.00 | $18.77 – $144.50 |
| UPMC Mercy | Pittsburgh | $90.60 | $18.59 – $135.90 |
| UPMC Muncy | Muncy | $511.20 | $7.14 – $681.60 |
| UPMC Northwest | Seneca | $122.40 | $34.75 – $173.40 |
| UPMC Presbyterian | Pittsburgh | $102.00 | $6.70 – $144.50 |
| UPMC St. Margaret | Pittsburgh | $90.60 | $18.77 – $128.35 |
| UPMC Wellsboro | Wellsboro | $617.60 | $7.14 – $694.80 |
| UPMC Williamsport | Williamsport | $511.20 | $7.14 – $681.60 |