Biopsy skin incisional single lesion at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$857.40
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.
?
What you pay up front if you don't use insurance.
$1,429.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$54.13 with UPMC Health Plan vs $6,879.78 with BCBS of Western NY — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $54.13 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $56.59 | ↓ -93% |
| Aetna | Medicaid | $59.05 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $68.40 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $72.98 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $74.21 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $76.82 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $83.86 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $89.48 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $177.50 | ↓ -79% |
| Univera | Univera_Medicare_Hamot_2024 | $214.35 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $270.39 | ↓ -68% |
| Aetna | Commercial | $357.25 | ↓ -58% |
| Cigna | NBR ASO/FI | $428.70 | ↓ -50% |
| Cigna | New Business ASO | $428.70 | ↓ -50% |
| Highmark BCBS of PA | UPMC Emergent | $432.62 | ↓ -50% |
| Univera | Commercial | $471.57 | ↓ -45% |
| Cigna | EBR | $571.60 | ↓ -33% |
| Cigna | Commercial | $571.60 | ↓ -33% |
| Fidelis | Medicare | $673.54 | ↓ -21% |
| Aetna | Medicare | $687.01 | ↓ -20% |
| UPMC Health Plan | Partners/Select | $687.55 | ↓ -20% |
| Wellcare | Medicare Advantage | $693.75 | ↓ -19% |
| BCBS of Western NY | Medicare Advantage | $707.22 | ↓ -18% |
| United Healthcare | Medicare | $720.69 | ↓ -16% |
| Highmark Wholecare (prev Gateway) | Medicare | $727.36 | ↓ -15% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $727.42 | ↓ -15% |
| AmeriHealth Caritas | Medicare | $727.42 | ↓ -15% |
| Cigna | Medicare | $727.42 | ↓ -15% |
| Independent Health | Medicare Advantage | $848.80 | ↓ -1% |
| InterGroup | Health Coalition Partners/PPO | $928.85 | ↑ +8% |
| Independent Health | Commercial | $994.07 | ↑ +16% |
| Aetna | AXA/MMO | $1,000.30 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,000.30 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,058.60 | ↑ +23% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $1,143.20 | ↑ +33% |
| InterGroup | Beech Street | $1,143.20 | ↑ +33% |
| United Healthcare | Commercial | $1,147.00 | ↑ +34% |
| BCBS of Western NY | Commercial | $6,879.78 | ↑ +702% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy skin incisional single lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $613.80 | $49.21 – $818.40 |
| UPMC Bedford | Everett | $588.60 | $51.67 – $882.90 |
| UPMC Carlisle | Carlisle | $1,227.00 | $62.50 – $1,738.25 |
| UPMC Cole | Coudersport | $87.60 | $40.47 – $2,325.85 |
| UPMC East | Monroeville | $823.80 | $54.13 – $1,098.40 |
| UPMC Hanover | Hanover | $1,227.00 | $62.50 – $1,016.56 |
| UPMC Jameson | New Castle | $394.80 | $54.13 – $892.40 |
| UPMC Lititz | Lititz | $1,227.00 | $62.50 – $1,016.56 |