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Venous mech thrombectomy at UPMC Somerset
225 South Center Avenue, Somerset, PA · UPMC · · NPI 1912900168
$17,446.80
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.
$29,078.00
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.
$892.40 with United Healthcare Community Plan for Families vs $21,602.25 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 | $892.40 | ↓ -95% |
| UPMC Work Partners | Workers Comp | $4,574.16 | ↓ -74% |
| UPMC Health Plan | Commercial | $5,012.52 | ↓ -71% |
| Highmark BCBS of PA | Medicare Advantage | $5,015.34 | ↓ -71% |
| UPMC Health Plan | CHIP | $8,368.64 | ↓ -52% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage/Together Blue Medicare Advantage | $10,703.75 | ↓ -39% |
| AmeriHealth Caritas | Medicare | $10,811.87 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $10,811.87 | ↓ -38% |
| United Healthcare | Medicare | $10,811.87 | ↓ -38% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $11,028.11 | ↓ -37% |
| Geisinger | Commercial | $11,342.62 | ↓ -35% |
| Aetna of PA | TPA/Carrier | $11,521.20 | ↓ -34% |
| Highmark Wholecare (prev Gateway) | Medicare | $11,675.74 | ↓ -33% |
| United Healthcare | Commercial | $12,414.09 | ↓ -29% |
| Multiplan | PPO (Includes PHCS as a Payer) | $14,401.50 | ↓ -17% |
| Geisinger | Medicaid | $15,841.65 | ↓ -9% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity/Managed Care - Social Mission | $16,035.08 | ↓ -8% |
| Galaxy Health Plan | Commercial | $18,721.95 | ↑ +7% |
| Highmark BCBS of PA | Commercial - Indemnity/Managed Care | $20,296.04 | ↑ +16% |
| Humana | Commercial | $21,602.25 | ↑ +24% |
Visitor-reported prices
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Venous mech thrombectomy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $26,215.20 | $4,574.16 – $37,138.20 |
| UPMC Mercy | Pittsburgh | $12,268.80 | $4,626.06 – $18,403.20 |
| UPMC Presbyterian | Pittsburgh | $32,551.20 | $931.20 – $46,114.20 |
| UPMC Williamsport | Williamsport | $5,352.00 | $993.28 – $11,675.74 |