Hospitals / PA

UPMC Somerset Pricing Analysis

Source: Hospital MRF file & CMS Medicare PFS 2026

Fairness Grade

C

Average Cost

Price Multiplier

47x

the federal fair-price benchmark

Procedures Priced

2,337

80 comparable to federal rates

What does this mean for your bill? This hospital charges 47x or more above the government benchmark — among the most expensive. For example, a procedure the government prices at $100 would cost about $4,700 at this hospital's list price. If you're uninsured or out-of-network, you may be able to negotiate down significantly.

Check a specific procedure price

Use our price checker to look up any of 7,700+ procedures and see what Medicare considers a fair price.

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Biggest Overcharges at This Hospital

These are the procedures where UPMC Somersetcharges the most compared to the federal fair-price benchmark. “They Charge” is what appears on your bill. “Gov. Benchmark” is what the government determines the doctor's work is worth.

ProcedureCodeThey ChargeGov. BenchmarkYou Overpay
INSERT SGL/DUAL ICD GEN W/ EXIST DUAL LE33230$40,440$333+$40,107
REMOVE&REPLACE PER PULSE GEN W DUAL LEAD33263$44,742$342+$44,400
REM & REPL CARDIO DEFIB PULSE GEN MULT33264$56,442$355+$56,087
INSERT SGL/DUAL ICD GEN W/ EXIST SGL LEA33240$40,440$320+$40,119
REMOVE&REPLACE PERM PULSE GEN W SNG LEAD33262$40,440$329+$40,110
CT HEAD W/O CONT ACUTE STROKE70450$7,964$107+$7,858
INSERTION SUBQ DEFIBIRLLATOR ICD33270$56,442$493+$55,949
APPENDECTOMY; WHEN DONE FOR INDICATED PURPOSE AT TIME OF OTHER MAJOR PROCEDURE (NOT AS SEPARATE PROCEDURE) (LIST SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)44955$5,444$75+$5,369
LV PACING ADD ON33225$21,495$394+$21,101
SIGMOIDOSCOPY, FLEXIBLE; WITH PLACEMENT OF ENDOSCOPIC STENT (INCLUDES PRE- AND POST-DILATION AND GUIDE WIRE PASSAGE, WHEN PERFORMED)45347$9,778$137+$9,641
INSERTION LV LEAD TO EXISTING DEVICE33224$22,692$442+$22,250
INC & PLACEMENT OF PULSE GEN OR RECVR63685$53,274$319+$52,955
CHROMOTUBATION OF OVIDUCT, INCLUDING MATERIALS58350$8,533$143+$8,390
CATH TEMP PACEMAKER INSERTION33210$14,575$141+$14,435
INSERTION SGL/DUAL ICD33249$56,442$798+$55,644
NASAL/SINUS ENDOSCOPY, SURGICAL, WITH MAXILLARY ANTROSTOMY; WITH REMOVAL OF TISSUE FROM MAXILLARY SINUS31267$11,742$224+$11,518
IMPLANTATION OF PROGRAMMABLE PUMP62362$30,597$372+$30,225
CATH PERC CORONARY THROMBECTOMY92973$3,148$82+$3,066

About UPMC Somerset Pricing

UPMC Somerset in , PA charges 47x or more above the government benchmark — among the most expensive across 80procedures we could compare. This data comes directly from the hospital's own published price file — they're required by federal law to share it.

What this means for your bill

If you're uninsured, out-of-network, or have a high-deductible plan, these prices directly affect what you pay. If you have in-network insurance, your insurer has likely negotiated much lower rates — but you may still owe a percentage of the hospital's high list price for your coinsurance or deductible.

Can I negotiate?

Yes. Most hospitals will reduce bills when patients present evidence. Our bill checker compares your specific charges to fair-price benchmarks and generates a dispute letter you can send to the billing department.

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