Clsd tx/fx/phalanx/phalang/manip 28515 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$405.00
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.
$675.00
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.
$73.15 with UPMC Health Plan vs $540.00 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 | $73.15 | ↓ -82% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $76.47 | ↓ -81% |
| Aetna | Medicaid | $79.80 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $92.43 | ↓ -77% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $92.94 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $98.62 | ↓ -76% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $100.28 | ↓ -75% |
| Univera | Univera_Medicare_Hamot_2024 | $101.25 | ↓ -75% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $103.81 | ↓ -74% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $113.33 | ↓ -72% |
| Aetna | Commercial | $168.75 | ↓ -58% |
| Cigna | New Business ASO | $202.50 | ↓ -50% |
| Cigna | NBR ASO/FI | $202.50 | ↓ -50% |
| Univera | Commercial | $222.75 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $250.11 | ↓ -38% |
| Fidelis | Medicare | $263.94 | ↓ -35% |
| Aetna | Medicare | $269.22 | ↓ -34% |
| UPMC Health Plan | Partners/Select | $269.43 | ↓ -33% |
| Cigna | Commercial | $270.00 | ↓ -33% |
| Cigna | EBR | $270.00 | ↓ -33% |
| Wellcare | Medicare Advantage | $271.86 | ↓ -33% |
| BCBS of Western NY | Medicare Advantage | $277.14 | ↓ -32% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $280.84 | ↓ -31% |
| United Healthcare | Medicare | $282.42 | ↓ -30% |
| Highmark Wholecare (prev Gateway) | Medicare | $285.03 | ↓ -30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $285.06 | ↓ -30% |
| AmeriHealth Caritas | Medicare | $285.06 | ↓ -30% |
| Cigna | Medicare | $285.06 | ↓ -30% |
| Independent Health | Medicare Advantage | $332.62 | ↓ -18% |
| United Healthcare | Commercial | $340.00 | ↓ -16% |
| Independent Health | Commercial | $354.21 | ↓ -13% |
| UPMC Health Plan | Commercial | $373.56 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $438.75 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $449.34 | ↑ +11% |
| Multiplan | PPO (Includes PHCS as a Payer) | $472.50 | ↑ +17% |
| Aetna | AXA/MMO | $472.50 | ↑ +17% |
| BCBS of Western NY | Commercial | $494.99 | ↑ +22% |
| InterGroup | Beech Street | $540.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $540.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx/fx/phalanx/phalang/manip 28515 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $408.60 | $66.50 – $544.80 |
| UPMC Bedford | Everett | $210.00 | $69.83 – $315.00 |
| UPMC Carlisle | Carlisle | $370.80 | $84.45 – $1,016.56 |
| UPMC Cole | Coudersport | $512.40 | $37.14 – $237.10 |
| UPMC Community Osteopathic | Harrisburg | $370.80 | $84.45 – $1,016.56 |
| UPMC East | Monroeville | $388.80 | $73.15 – $518.40 |
| UPMC Northwest | Seneca | $556.80 | $73.15 – $258.05 |
| UPMC Hanover | Hanover | $370.80 | $84.45 – $1,016.56 |