Administration vaccine pneumococcal at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$12.00
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.
$20.00
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.
$3.00 with Univera vs $54.83 with AmeriHealth Caritas — 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $3.00 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $4.05 | ↓ -66% |
| Aetna | Commercial | $5.00 | ↓ -58% |
| Cigna | New Business ASO | $6.00 | ↓ -50% |
| Cigna | NBR ASO/FI | $6.00 | ↓ -50% |
| Highmark BCBS of PA | UPMC Emergent | $6.48 | ↓ -46% |
| Univera | Commercial | $6.60 | ↓ -45% |
| UPMC Health Plan | Commercial | $7.36 | ↓ -39% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $7.53 | ↓ -37% |
| Cigna | Commercial | $8.00 | ↓ -33% |
| Cigna | EBR | $8.00 | ↓ -33% |
| Aetna | Medicare | $8.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $10.00 | ↓ -17% |
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -8% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $11.50 | ↓ -4% |
| Aetna | Medicaid | $12.00 | ↑ +0% |
| InterGroup | Health Coalition Partners/PPO | $13.00 | ↑ +8% |
| Fidelis | Child Health Plus/Family Health Plus/Medicaid | $13.36 | ↑ +11% |
| Geisinger | Medicaid/CHIP | $13.90 | ↑ +16% |
| Aetna | AXA/MMO | $14.00 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $14.00 | ↑ +17% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.83 | ↑ +24% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $15.08 | ↑ +26% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.61 | ↑ +30% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $16.00 | ↑ +33% |
| InterGroup | Beech Street | $16.00 | ↑ +33% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $17.04 | ↑ +42% |
| Molina Healthcare of NY | CHIP (For Kids)/Essential Plan/Medicaid | $30.06 | ↑ +151% |
| Fidelis | Essential Plan | $30.06 | ↑ +151% |
| BCBS of Western NY | Commercial | $40.51 | ↑ +238% |
| Fidelis | Medicare | $50.77 | ↑ +323% |
| UPMC Health Plan | Partners/Select | $51.83 | ↑ +332% |
| Wellcare | Medicare Advantage | $52.29 | ↑ +336% |
| BCBS of Western NY | Medicare Advantage | $53.31 | ↑ +344% |
| United Healthcare | Medicare | $54.32 | ↑ +353% |
| Cigna | Medicare | $54.83 | ↑ +357% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $54.83 | ↑ +357% |
| AmeriHealth Caritas | Medicare | $54.83 | ↑ +357% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Administration vaccine pneumococcal at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $12.00 | $7.53 – $17.04 |
| UPMC Bedford | Everett | $12.00 | $8.00 – $20.88 |
| UPMC Carlisle | Carlisle | $72.60 | $12.70 – $102.85 |
| UPMC Cole | Coudersport | $86.40 | $9.70 – $28.00 |
| UPMC Community Osteopathic | Harrisburg | $72.60 | $7.20 – $48.57 |
| UPMC East | Monroeville | $12.00 | $6.60 – $46.19 |
| UPMC Northwest | Seneca | $12.00 | $11.00 – $46.19 |
| UPMC Hanover | Hanover | $72.60 | $12.70 – $70.53 |