Arthrodesis pantalar at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
not published by hospital
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.
not published by hospital
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.
$489.50 with UPMC Health Plan vs $37,468.97 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 Health Plan | Managed Medicaid | $489.50 | — |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $511.75 | — |
| Aetna | Medicaid | $534.00 | — |
| Geisinger | Medicaid/CHIP | $618.51 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $659.93 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $671.06 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $694.69 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $758.37 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,030.96 | — |
| UPMC Work Partners | Workers Comp | $2,503.55 | — |
| United Healthcare | Commercial | $2,849.00 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $3,115.30 | — |
| BCBS of Western NY | Commercial | $3,547.20 | — |
| UPMC Health Plan | Commercial | $4,057.82 | — |
| Highmark BCBS of PA | UPMC Emergent | $4,984.44 | — |
| Fidelis | Medicare | $20,234.94 | — |
| Aetna | Medicare | $20,639.64 | — |
| UPMC Health Plan | Partners/Select | $20,655.83 | — |
| Wellcare | Medicare Advantage | $20,841.99 | — |
| BCBS of Western NY | Medicare Advantage | $21,246.69 | — |
| United Healthcare | Medicare | $21,651.39 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $21,851.71 | — |
| AmeriHealth Caritas | Medicare | $21,853.74 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $21,853.74 | — |
| Cigna | Medicare | $21,853.74 | — |
| Independent Health | Medicare Advantage | $25,500.07 | — |
| Independent Health | Commercial | $37,468.97 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Arthrodesis pantalar at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $2,287.80 | $467.25 – $3,050.40 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | not published | $970.00 – $1,101.92 |