CMS Price Transparency Data

New patient office visit (30-44 min)

Facility: UPMC Somerset

Billing Code: 99203 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$101
about 0.9× the $118 Medicare rate · typically $66–$125
modeled estimate · not a bill or quote
What this hospital charges insurers
$75
Below the fair price — a good deal
about $26 under the fair price · 0.6× Medicare
Medicare pays $118 Fair price $101 This hospital $75 Cash price $160 Hospital's list price $267

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $75

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a New patient office visit (30-44 min) is about $101 (about 0.9× the $118 Medicare rate). UPMC Somerset charges insurers about $75, or about $160 in cash — below the fair price — a good deal. Located in Somerset, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $62 53%
Blue Cross Blue Shieldmajor $25 - $368 21%
Aetnamajor $78 - $294 66%
Humanamajor $147 - $551 125%
AmeriHealth $62 53%
Geisinger $75 - $289 64%
UPMC Health Plan $60 - $289 51%
Excludes 2 rental-network / third-party entries (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 225 South Center Avenue, Somerset, PA 15501
  • CMS Rating: ★★★★☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals