Biliary endoscopy thru skin at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$5,424.00
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.
$9,040.00
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.
$247.50 with UPMC Health Plan vs $14,436.44 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 | $247.50 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $258.75 | ↓ -95% |
| Aetna | Medicaid | $270.00 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $312.73 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $333.68 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $339.30 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $351.25 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $383.44 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $1,026.00 | ↓ -81% |
| Univera | Univera_Medicare_Hamot_2024 | $1,356.00 | ↓ -75% |
| UPMC Health Plan | Commercial | $2,181.38 | ↓ -60% |
| Aetna | Commercial | $2,260.00 | ↓ -58% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2,357.05 | ↓ -57% |
| Cigna | New Business ASO | $2,712.00 | ↓ -50% |
| Cigna | NBR ASO/FI | $2,712.00 | ↓ -50% |
| BCBS of Western NY | Commercial | $2,794.87 | ↓ -48% |
| United Healthcare | Commercial | $2,849.00 | ↓ -47% |
| Univera | Commercial | $2,983.20 | ↓ -45% |
| Cigna | EBR | $3,616.00 | ↓ -33% |
| Cigna | Commercial | $3,616.00 | ↓ -33% |
| InterGroup | Health Coalition Partners/PPO | $5,876.00 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $6,328.00 | ↑ +17% |
| Aetna | AXA/MMO | $6,328.00 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $7,122.38 | ↑ +31% |
| InterGroup | Beech Street | $7,232.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $7,232.00 | ↑ +33% |
| Independent Health | Commercial | $8,918.49 | ↑ +64% |
| Highmark BCBS of PA | UPMC Emergent | $11,395.71 | ↑ +110% |
| Fidelis | Medicare | $11,455.67 | ↑ +111% |
| Aetna | Medicare | $11,684.78 | ↑ +115% |
| UPMC Health Plan | Partners/Select | $11,693.95 | ↑ +116% |
| Wellcare | Medicare Advantage | $11,799.34 | ↑ +118% |
| BCBS of Western NY | Medicare Advantage | $12,028.45 | ↑ +122% |
| United Healthcare | Medicare | $12,257.57 | ↑ +126% |
| Highmark Wholecare (prev Gateway) | Medicare | $12,370.98 | ↑ +128% |
| AmeriHealth Caritas | Medicare | $12,372.12 | ↑ +128% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12,372.12 | ↑ +128% |
| Cigna | Medicare | $12,372.12 | ↑ +128% |
| Independent Health | Medicare Advantage | $14,436.44 | ↑ +166% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $18,827.40 | $285.75 – $26,672.15 |
| UPMC Community Osteopathic | Harrisburg | $18,827.40 | $294.75 – $26,672.15 |
| UPMC Hanover | Hanover | $18,827.40 | $285.75 – $15,913.34 |
| UPMC Lititz | Lititz | $18,827.40 | $285.75 – $15,999.30 |
| UPMC Magee | Pittsburgh | $12,186.60 | $247.50 – $10,719.92 |
| UPMC Memorial | York | $18,827.40 | $285.75 – $15,973.31 |
| UPMC Somerset | Somerset | $18,827.40 | $247.50 – $9,925.85 |
| UPMC Williamsport | Williamsport | $1,036.20 | $247.50 – $10,620.66 |