Bx breast add lesion mr imag at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$3,243.60
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.
$5,406.00
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.
$78.83 with UPMC Health Plan vs $4,324.80 with Multiplan — 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 | $78.83 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $82.41 | ↓ -97% |
| Aetna | Medicaid | $85.99 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $99.60 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $106.27 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $108.06 | ↓ -97% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $111.87 | ↓ -97% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $122.12 | ↓ -96% |
| United Healthcare | Commercial | $340.00 | ↓ -90% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $559.11 | ↓ -83% |
| Univera | Univera_Medicare_Hamot_2024 | $810.90 | ↓ -75% |
| UPMC Health Plan | Commercial | $857.95 | ↓ -74% |
| UPMC Work Partners | Workers Comp | $1,064.82 | ↓ -67% |
| Aetna | Commercial | $1,351.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $1,621.80 | ↓ -50% |
| Cigna | New Business ASO | $1,621.80 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,689.48 | ↓ -48% |
| Univera | Commercial | $1,783.98 | ↓ -45% |
| Cigna | Commercial | $2,162.40 | ↓ -33% |
| Aetna | Medicare | $2,162.40 | ↓ -33% |
| Cigna | EBR | $2,162.40 | ↓ -33% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $2,703.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $2,703.14 | ↓ -17% |
| InterGroup | Health Coalition Partners/PPO | $3,513.90 | ↑ +8% |
| Aetna | AXA/MMO | $3,784.20 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,784.20 | ↑ +17% |
| InterGroup | Beech Street | $4,324.80 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $4,324.80 | ↑ +33% |
Visitor-reported prices
Comments
Bx breast add lesion mr imag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,042.80 | $91.01 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $1,042.80 | $93.87 – $2,307.90 |
| UPMC Hanover | Hanover | $1,042.80 | $91.01 – $1,114.34 |
| UPMC Kane | Kane | $1,858.80 | $78.83 – $2,491.15 |
| UPMC Lititz | Lititz | $1,042.80 | $78.08 – $1,114.34 |
| UPMC Magee | Pittsburgh | $5,692.20 | $78.83 – $1,064.82 |
| UPMC Memorial | York | $1,042.80 | $78.08 – $1,114.34 |
| UPMC Passavant-McCandless | Pittsburgh | $6,352.80 | $78.83 – $1,238.16 |