UPMC · Somerset, PA
33
In-network payers
160
Disclosed rate categories
111
Beds
4
Care quality
Upmc Somerset is a 111-bed voluntary non-profit - private hospital in Somerset, PA, affiliated with UPMC. Below you'll find publicly disclosed negotiated rates and facility details, including 33 in-network payers and 160 disclosed rate categories.
CCN (Medicare provider number)
390039
NPI
1912900168
Type
Short Term Acute Care Hospital
Ownership
Voluntary Non-Profit - Private
Beds
111
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Upmc Somerset most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
CT imaging
CPT 74177
$259 - $1,316
from 4 insurers · median $949
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 460
$21,225 - $32,290
from 2 insurers · median $26,758
Hospital reports orthopedic surgery services to CMS
Cardiology and vascular testing
CPT 93306
$184 - $1,216
from 4 insurers · median $1,004
Common here, based on CMS Medicare volume
CT imaging
CPT 70450
$103 - $753
from 4 insurers · median $448
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 473
$7,906 - $21,736
from 4 insurers · median $17,565
Hospital reports orthopedic surgery services to CMS
CT imaging
CPT 74176
$178 - $1,442
from 4 insurers · median $870
Common here, based on CMS Medicare volume
Digestive procedures
CPT 43239
$1,474 - $1,624
from 3 insurers · median $1,518
Common here, based on CMS Medicare volume
Medicine & Surgery · Inpatient
MS-DRG 470
$7,906 - $16,607
from 4 insurers · median $13,608
Hospital reports orthopedic surgery services to CMS
Mammography
CPT 77067
$112 - $208
from 4 insurers · median $176
Common here, based on CMS Medicare volume
MRI imaging
CPT 70553
$330 - $2,260
from 4 insurers · median $1,368
Common here, based on CMS Medicare volume
Medicine & Surgery
CPT 47562
$6,134 - $9,617
from 3 insurers · median $6,563
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$983 - $2,352
from 3 insurers · median $1,052
Common here, based on CMS Medicare volume
Gynecology
CPT 58571
$20,539
negotiated rate
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 743
$6,795 - $10,037
from 4 insurers · median $8,879
Hospital reports inpatient surgical services to CMS
CT imaging
CPT 71260
$96 - $675
from 4 insurers · median $482
Common here, based on CMS Medicare volume
X-ray and bone density
CPT 71046
$25 - $160
from 4 insurers · median $116
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78815
$1,000 - $4,173
from 4 insurers · median $1,949
Common here, based on CMS Medicare volume
Nuclear imaging
CPT 78452
$391 - $2,572
from 4 insurers · median $1,263
Common here, based on CMS Medicare volume
MRI imaging
CPT 72148
$198 - $1,311
from 4 insurers · median $810
Common here, based on CMS Medicare volume
Digestive procedures
CPT 49650
$11,510
negotiated rate
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,621
negotiated rate
Common here, based on CMS Medicare volume
MRI imaging
CPT 73721
$208 - $1,311
from 4 insurers · median $810
Common here, based on CMS Medicare volume
MRI imaging
CPT 74183
$352 - $1,280
from 4 insurers · median $925
Common here, based on CMS Medicare volume
Ultrasound
CPT 76830
$68 - $319
from 4 insurers · median $245
Common here, based on CMS Medicare volume
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 21 | 298% | 9 | 10 |
| Insurer B* | 20 | 286% | 12 | 5 |
| Insurer C* | 23 | 188% | 7 | 10 |
| Insurer D* | 18 | 73% | 0 | 18 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 17 are common here based on CMS Medicare volume, and 7 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Upmc Somerset.
225 South Center Avenue, Somerset, PA 15501
(814) 443-5000
The nearest hospitals of similar type and size. Their rates are compared with Upmc Somerset for the same insurers and services above.
Excela Latrobe Hospital
Rates about the same as Upmc Somerset (24 services)
Penn Highlands Connellsville
Rates about the same as Upmc Somerset (24 services)
Upmc Western Maryland
▲ Rates typically 141% higher than Upmc Somerset (14 services)
Uniontown Hospital
Rates about the same as Upmc Somerset (24 services)
Indiana Regional Medical Center
▲ Rates typically 45% higher than Upmc Somerset (24 services)
Monongahela Valley Hospital
▲ Rates typically 33% higher than Upmc Somerset (23 services)
Upmc Carlisle
Upmc Passavant - Cranberry
Upmc Mckeesport
Upmc Altoona
About Upmc Somerset's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Upmc Somerset range from $330 to $2,260 across 4 insurers. UnitedHealthcare's rate is $2,051. The median at nearby comparable hospitals is $696. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Upmc Somerset range from $259 to $1,316 across 4 insurers. Aetna's rate is $259. The median at nearby comparable hospitals is $676. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Upmc Somerset range from $983 to $2,352 across 3 insurers. Blue Cross Blue Shield's rate is $2,352. The median at nearby comparable hospitals is $2,358. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Upmc Somerset range from $112 to $208 across 4 insurers. UnitedHealthcare's rate is $185. The median at nearby comparable hospitals is $154. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Upmc Somerset range from $7,906 to $16,607 across 4 insurers. Cigna's rate is $10,823. The median at nearby comparable hospitals is $23,598. What a patient pays depends on their plan's deductible, coinsurance and network status.
Upmc Somerset has 111 beds. Facility type: Short Term Acute Care Hospital.
Upmc Somerset is located at 225 South Center Avenue, Somerset, PA 15501. Its main phone number is (814) 443-5000.
Upmc Somerset's CMS Certification Number (CCN), also called its Medicare provider number, is 390039.
The National Provider Identifier (NPI) on file for Upmc Somerset is 1912900168.
Upmc Somerset is affiliated with UPMC.
Upmc Somerset lists 33 in-network payers, including Aetna, Ameri Health, Aspirus Health Plan, Avera Health Plans, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
160 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers