Clsd tx bimalleol ank fx without manip 27808 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$3,021.60
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.
$5,036.00
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.
$263.94 with Fidelis vs $4,028.80 with InterGroup — 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 |
|---|---|---|---|
| Fidelis | Medicare | $263.94 | ↓ -91% |
| Aetna | Medicare | $269.22 | ↓ -91% |
| UPMC Health Plan | Partners/Select | $269.43 | ↓ -91% |
| Wellcare | Medicare Advantage | $271.86 | ↓ -91% |
| BCBS of Western NY | Medicare Advantage | $277.14 | ↓ -91% |
| United Healthcare | Medicare | $282.42 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $285.03 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $285.06 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $285.06 | ↓ -91% |
| Cigna | Medicare | $285.06 | ↓ -91% |
| Independent Health | Medicare Advantage | $332.62 | ↓ -89% |
| United Healthcare | Commercial | $340.00 | ↓ -89% |
| Independent Health | Commercial | $354.21 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $545.04 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $581.04 | ↓ -81% |
| Univera | Univera_Medicare_Hamot_2024 | $755.40 | ↓ -75% |
| Aetna | Commercial | $1,259.00 | ↓ -58% |
| Cigna | New Business ASO | $1,510.80 | ↓ -50% |
| Cigna | NBR ASO/FI | $1,510.80 | ↓ -50% |
| BCBS of Western NY | Commercial | $1,572.66 | ↓ -48% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,646.96 | ↓ -45% |
| Univera | Commercial | $1,661.88 | ↓ -45% |
| Cigna | EBR | $2,014.40 | ↓ -33% |
| Cigna | Commercial | $2,014.40 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,126.52 | ↓ -30% |
| Highmark BCBS of PA | UPMC Emergent | $2,635.11 | ↓ -13% |
| Geisinger | Medicaid/CHIP | $2,769.80 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,769.80 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $3,273.40 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,525.20 | ↑ +17% |
| Aetna | AXA/MMO | $3,525.20 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $4,028.80 | ↑ +33% |
| InterGroup | Beech Street | $4,028.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Clsd tx bimalleol ank fx without manip 27808 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,435.60 | $233.23 – $4,580.80 |
| UPMC Bedford | Everett | $1,594.20 | $82.51 – $2,391.30 |
| UPMC Carlisle | Carlisle | $1,212.00 | $126.21 – $1,717.00 |
| UPMC Cole | Coudersport | $1,266.00 | $73.46 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $1,212.00 | $233.61 – $1,717.00 |
| UPMC Hanover | Hanover | $1,212.00 | $226.87 – $1,712.82 |
| UPMC Horizon-Greenville | Greenville | $2,431.20 | $204.76 – $587.66 |
| UPMC Lititz | Lititz | $1,212.00 | $228.10 – $1,712.82 |