App high cost ss t/a/l <100sq cm addl <25sq cm at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$168.60
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.
$281.00
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.
$38.50 with UPMC Work Partners vs $2,177.52 with BCBS of Western NY — 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 | $38.50 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $42.15 | ↓ -75% |
| Aetna | Commercial | $70.25 | ↓ -58% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $77.38 | ↓ -54% |
| Cigna | NBR ASO/FI | $84.30 | ↓ -50% |
| Cigna | New Business ASO | $84.30 | ↓ -50% |
| Univera | Commercial | $92.73 | ↓ -45% |
| Cigna | Commercial | $112.40 | ↓ -33% |
| Cigna | EBR | $112.40 | ↓ -33% |
| Aetna | Medicare | $112.40 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $140.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $154.55 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $154.55 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $182.65 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $196.70 | ↑ +17% |
| Aetna | AXA/MMO | $196.70 | ↑ +17% |
| InterGroup | Beech Street | $224.80 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $224.80 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $233.83 | ↑ +39% |
| United Healthcare | Commercial | $340.00 | ↑ +102% |
| Highmark BCBS of PA | UPMC Emergent | $374.12 | ↑ +122% |
| UPMC Health Plan | Commercial | $529.86 | ↑ +214% |
| BCBS of Western NY | Commercial | $2,177.52 | ↑ +1192% |
Visitor-reported prices
Comments
App high cost ss t/a/l <100sq cm addl <25sq cm at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,472.40 | $38.50 – $1,963.20 |
| UPMC Carlisle | Carlisle | $372.00 | $17.93 – $527.00 |
| UPMC Hanover | Hanover | $372.00 | $17.93 – $426.78 |
| UPMC Horizon-Greenville | Greenville | $345.00 | $38.50 – $231.51 |
| UPMC Jameson | New Castle | $345.00 | $15.37 – $426.78 |
| UPMC Lititz | Lititz | $372.00 | $15.37 – $426.78 |
| UPMC McKeesport | Mckeesport | $384.00 | $16.91 – $153.12 |
| UPMC Mercy | Pittsburgh | $384.00 | $42.90 – $268.13 |