App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$4,338.60
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.
$7,231.00
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.
$425.04 with UPMC Work Partners vs $5,784.80 with Multiplan — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $425.04 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $782.70 | ↓ -82% |
| Univera | Univera_Medicare_Hamot_2024 | $1,084.65 | ↓ -75% |
| United Healthcare | Commercial | $1,535.00 | ↓ -65% |
| Aetna | Commercial | $1,807.75 | ↓ -58% |
| Fidelis | Medicare | $2,012.74 | ↓ -54% |
| Aetna | Medicare | $2,052.99 | ↓ -53% |
| UPMC Health Plan | Partners/Select | $2,054.60 | ↓ -53% |
| Wellcare | Medicare Advantage | $2,073.12 | ↓ -52% |
| BCBS of Western NY | Medicare Advantage | $2,113.38 | ↓ -51% |
| United Healthcare | Medicare | $2,153.63 | ↓ -50% |
| Cigna | NBR ASO/FI | $2,169.30 | ↓ -50% |
| Cigna | New Business ASO | $2,169.30 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,173.56 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $2,173.76 | ↓ -50% |
| AmeriHealth Caritas | Medicare | $2,173.76 | ↓ -50% |
| Cigna | Medicare | $2,173.76 | ↓ -50% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,365.12 | ↓ -45% |
| Univera | Commercial | $2,386.23 | ↓ -45% |
| Independent Health | Medicare Advantage | $2,536.45 | ↓ -42% |
| UPMC Health Plan | Commercial | $2,661.01 | ↓ -39% |
| Cigna | EBR | $2,892.40 | ↓ -33% |
| Cigna | Commercial | $2,892.40 | ↓ -33% |
| Independent Health | Commercial | $2,953.12 | ↓ -32% |
| Highmark BCBS of PA | UPMC Emergent | $3,784.16 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $3,977.05 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,977.05 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $4,700.15 | ↑ +8% |
| Aetna | AXA/MMO | $5,061.70 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $5,061.70 | ↑ +17% |
| InterGroup | Beech Street | $5,784.80 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $5,784.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
App high cost ss f/n/g/h/f >100sq cm 1st 100sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,895.60 | $444.81 – $4,102.10 |
| UPMC Cole | Coudersport | $331.80 | $153.29 – $1,041.88 |
| UPMC Hanover | Hanover | $2,895.60 | $444.81 – $2,795.94 |
| UPMC Lititz | Lititz | $2,895.60 | $444.81 – $2,811.04 |
| UPMC McKeesport | Mckeesport | $3,798.60 | $425.04 – $1,918.35 |
| UPMC St. Margaret | Pittsburgh | $4,381.80 | $425.04 – $790.16 |
| UPMC Wellsboro | Wellsboro | $2,148.00 | $425.04 – $993.28 |
| Uniontown Hospital | Uniontown | $2,371.50 | $205.80 – $4,153.69 |