App high cost ss t/a/l >100sq cm 1st 100sq cm at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$2,618.40
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.
$4,364.00
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.
$420.87 with UPMC Work Partners vs $5,566.27 with Independent Health — 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 | $420.87 | ↓ -84% |
| Univera | Univera_Medicare_Hamot_2024 | $654.60 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $782.70 | ↓ -70% |
| Aetna | Commercial | $1,091.00 | ↓ -58% |
| UPMC Health Plan | Commercial | $1,280.25 | ↓ -51% |
| Cigna | NBR ASO/FI | $1,309.20 | ↓ -50% |
| Cigna | New Business ASO | $1,309.20 | ↓ -50% |
| Univera | Commercial | $1,440.12 | ↓ -45% |
| Cigna | EBR | $1,745.60 | ↓ -33% |
| Cigna | Commercial | $1,745.60 | ↓ -33% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -17% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,365.12 | ↓ -10% |
| Geisinger | Medicaid/CHIP | $2,400.20 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,400.20 | ↓ -8% |
| United Healthcare | Commercial | $2,608.00 | ↓ -0% |
| InterGroup | Health Coalition Partners/PPO | $2,836.60 | ↑ +8% |
| Aetna | AXA/MMO | $3,054.80 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,054.80 | ↑ +17% |
| InterGroup | Beech Street | $3,491.20 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $3,491.20 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $3,784.16 | ↑ +45% |
| Fidelis | Medicare | $4,028.24 | ↑ +54% |
| Aetna | Medicare | $4,108.80 | ↑ +57% |
| UPMC Health Plan | Partners/Select | $4,112.03 | ↑ +57% |
| Wellcare | Medicare Advantage | $4,149.09 | ↑ +58% |
| BCBS of Western NY | Medicare Advantage | $4,229.65 | ↑ +62% |
| United Healthcare | Medicare | $4,310.22 | ↑ +65% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,350.10 | ↑ +66% |
| Cigna | Medicare | $4,350.50 | ↑ +66% |
| AmeriHealth Caritas | Medicare | $4,350.50 | ↑ +66% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4,350.50 | ↑ +66% |
| Independent Health | Medicare Advantage | $5,076.39 | ↑ +94% |
| Independent Health | Commercial | $5,566.27 | ↑ +113% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
App high cost ss t/a/l >100sq cm 1st 100sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,513.80 | $440.44 – $6,394.55 |
| UPMC Hanover | Hanover | $4,513.80 | $440.44 – $5,595.71 |
| UPMC Horizon-Greenville | Greenville | $3,868.20 | $420.87 – $3,769.52 |
| UPMC Jameson | New Castle | $3,441.60 | $420.87 – $4,711.90 |
| UPMC Lititz | Lititz | $4,513.80 | $440.44 – $5,625.95 |
| UPMC Magee | Pittsburgh | $3,461.40 | $420.87 – $3,839.33 |
| UPMC McKeesport | Mckeesport | $3,120.60 | $369.97 – $3,839.33 |
| UPMC Passavant-McCandless | Pittsburgh | $3,154.80 | $420.87 – $3,839.33 |