Athrectomy tib/pero/unilat/ini ves 37229 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$38,325.60
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.
$63,876.00
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.
$669.43 with UPMC Health Plan vs $92,133.66 with Highmark BCBS of PA — 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 | $669.43 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $699.86 | ↓ -98% |
| Aetna | Medicaid | $730.28 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $845.85 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $902.51 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $917.72 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $950.04 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,037.12 | ↓ -97% |
| BCBS of Western NY | Commercial | $2,794.87 | ↓ -93% |
| United Healthcare | Commercial | $3,411.00 | ↓ -91% |
| Univera | Univera_Medicare_Hamot_2024 | $9,581.40 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $15,644.10 | ↓ -59% |
| Aetna | Commercial | $15,969.00 | ↓ -58% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $19,056.62 | ↓ -50% |
| Cigna | New Business ASO | $19,162.80 | ↓ -50% |
| Cigna | NBR ASO/FI | $19,162.80 | ↓ -50% |
| Fidelis | Medicare | $19,758.14 | ↓ -48% |
| Aetna | Medicare | $20,153.30 | ↓ -47% |
| UPMC Health Plan | Partners/Select | $20,169.11 | ↓ -47% |
| Wellcare | Medicare Advantage | $20,350.88 | ↓ -47% |
| BCBS of Western NY | Medicare Advantage | $20,746.05 | ↓ -46% |
| Univera | Commercial | $21,079.08 | ↓ -45% |
| United Healthcare | Medicare | $21,141.21 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicare | $21,336.82 | ↓ -44% |
| Cigna | Medicare | $21,338.79 | ↓ -44% |
| AmeriHealth Caritas | Medicare | $21,338.79 | ↓ -44% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $21,338.79 | ↓ -44% |
| Independent Health | Medicare Advantage | $24,899.21 | ↓ -35% |
| Cigna | EBR | $25,550.40 | ↓ -33% |
| Cigna | Commercial | $25,550.40 | ↓ -33% |
| Independent Health | Commercial | $29,392.54 | ↓ -23% |
| UPMC Health Plan | Commercial | $31,744.95 | ↓ -17% |
| InterGroup | Health Coalition Partners/PPO | $41,519.40 | ↑ +8% |
| Aetna | AXA/MMO | $44,713.20 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $44,713.20 | ↑ +17% |
| InterGroup | Beech Street | $51,100.80 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $51,100.80 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $57,584.05 | ↑ +50% |
| Highmark BCBS of PA | UPMC Emergent | $92,133.66 | ↑ +140% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Athrectomy tib/pero/unilat/ini ves 37229 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $41,476.20 | $15,644.10 – $55,301.60 |
| UPMC Carlisle | Carlisle | $24,161.40 | $1,016.56 – $34,228.65 |
| UPMC Community Osteopathic | Harrisburg | $24,161.40 | $1,016.56 – $34,228.65 |
| UPMC East | Monroeville | $79,783.20 | $14,606.80 – $106,377.60 |
| UPMC Hanover | Hanover | $24,161.40 | $1,016.56 – $27,446.48 |
| UPMC Jameson | New Castle | $83,793.60 | $892.40 – $23,111.43 |
| UPMC Lititz | Lititz | $24,161.40 | $1,016.56 – $27,594.74 |
| UPMC Memorial | York | $24,161.40 | $1,016.56 – $27,549.92 |