Aspiration peritonsillar abscess at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$297.00
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.
$495.00
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.
$18.59 with Highmark BCBS of PA vs $396.00 with InterGroup — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.59 | ↓ -94% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $56.17 | ↓ -81% |
| UPMC Health Plan | Commercial | $61.88 | ↓ -79% |
| Univera | Univera_Medicare_Hamot_2024 | $74.25 | ↓ -75% |
| Highmark BCBS of PA | UPMC Emergent | $89.87 | ↓ -70% |
| Aetna | Commercial | $123.75 | ↓ -58% |
| Cigna | NBR ASO/FI | $148.50 | ↓ -50% |
| Cigna | New Business ASO | $148.50 | ↓ -50% |
| Univera | Commercial | $163.35 | ↓ -45% |
| BCBS of Western NY | Commercial | $173.25 | ↓ -42% |
| Cigna | Commercial | $198.00 | ↓ -33% |
| Cigna | EBR | $198.00 | ↓ -33% |
| Fidelis | Medicare | $255.52 | ↓ -14% |
| Aetna | Medicare | $260.63 | ↓ -12% |
| UPMC Health Plan | Partners/Select | $260.83 | ↓ -12% |
| Wellcare | Medicare Advantage | $263.19 | ↓ -11% |
| BCBS of Western NY | Medicare Advantage | $268.30 | ↓ -10% |
| Geisinger | Medicaid/CHIP | $272.25 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $272.25 | ↓ -8% |
| United Healthcare | Medicare | $273.41 | ↓ -8% |
| Highmark Wholecare (prev Gateway) | Medicare | $275.94 | ↓ -7% |
| AmeriHealth Caritas | Medicare | $275.96 | ↓ -7% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $275.96 | ↓ -7% |
| Cigna | Medicare | $275.96 | ↓ -7% |
| InterGroup | Health Coalition Partners/PPO | $321.75 | ↑ +8% |
| Independent Health | Medicare Advantage | $322.01 | ↑ +8% |
| United Healthcare | Commercial | $340.00 | ↑ +14% |
| Multiplan | PPO (Includes PHCS as a Payer) | $346.50 | ↑ +17% |
| Aetna | AXA/MMO | $346.50 | ↑ +17% |
| Independent Health | Commercial | $355.61 | ↑ +20% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $396.00 | ↑ +33% |
| InterGroup | Beech Street | $396.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
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Aspiration peritonsillar abscess at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $120.00 | $18.59 – $239.10 |
| UPMC Bedford | Everett | $124.20 | $36.86 – $239.10 |
| UPMC East | Monroeville | $76.80 | $18.77 – $239.10 |
| UPMC Northwest | Seneca | $109.20 | $35.92 – $239.10 |
| UPMC Horizon-Greenville | Greenville | $817.20 | $27.92 – $239.10 |
| UPMC Jameson | New Castle | $817.20 | $18.92 – $298.88 |
| UPMC Magee | Pittsburgh | $146.40 | $18.77 – $243.53 |
| UPMC McKeesport | Mckeesport | $911.40 | $18.77 – $243.53 |