Biopsy/removal lymph nodes 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.
$171.60 with UPMC Health Plan vs $5,882.41 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 | $171.60 | — |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $179.40 | — |
| Aetna | Medicaid | $187.20 | — |
| Geisinger | Medicaid/CHIP | $216.82 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $231.35 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $235.25 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $243.53 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $265.86 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $729.80 | — |
| UPMC Work Partners | Workers Comp | $749.16 | — |
| United Healthcare | Commercial | $1,754.00 | — |
| BCBS of Western NY | Commercial | $2,177.52 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,205.27 | — |
| UPMC Health Plan | Commercial | $2,875.60 | — |
| Highmark BCBS of PA | UPMC Emergent | $3,528.40 | — |
| Fidelis | Medicare | $4,213.43 | — |
| Aetna | Medicare | $4,297.70 | — |
| UPMC Health Plan | Partners/Select | $4,301.07 | — |
| Wellcare | Medicare Advantage | $4,339.83 | — |
| BCBS of Western NY | Medicare Advantage | $4,424.10 | — |
| United Healthcare | Medicare | $4,508.37 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $4,550.08 | — |
| AmeriHealth Caritas | Medicare | $4,550.50 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4,550.50 | — |
| Cigna | Medicare | $4,550.50 | — |
| Independent Health | Medicare Advantage | $5,309.76 | — |
| Independent Health | Commercial | $5,882.41 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy/removal lymph nodes at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $754.80 | $163.80 – $1,041.88 |
| Uniontown Hospital | Uniontown | $5,149.00 | $171.60 – $7,882.34 |
| UPMC Altoona | Altoona | not published | $156.00 – $3,942.82 |
| UPMC Carlisle | Carlisle | not published | $198.12 – $5,861.07 |
| UPMC Community Osteopathic | Harrisburg | not published | $210.60 – $7,348.95 |
| UPMC East | Monroeville | not published | $171.60 – $4,015.84 |
| UPMC Northwest | Seneca | not published | $171.60 – $3,833.30 |
| UPMC Hanover | Hanover | not published | $198.12 – $5,852.98 |