Cltx thigh fx w/mnpj at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$4,668.60
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.
$7,781.00
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.
$731.33 with UPMC Work Partners vs $6,224.80 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $731.33 | ↓ -84% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $837.97 | ↓ -82% |
| Univera | Univera_Medicare_Hamot_2024 | $1,167.15 | ↓ -75% |
| Aetna | Commercial | $1,945.25 | ↓ -58% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -53% |
| Cigna | NBR ASO/FI | $2,334.30 | ↓ -50% |
| Cigna | New Business ASO | $2,334.30 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,532.11 | ↓ -46% |
| Univera | Commercial | $2,567.73 | ↓ -45% |
| United Healthcare | Commercial | $2,608.00 | ↓ -44% |
| UPMC Health Plan | Commercial | $2,863.41 | ↓ -39% |
| Cigna | EBR | $3,112.40 | ↓ -33% |
| Aetna | Medicare | $3,112.40 | ↓ -33% |
| Cigna | Commercial | $3,112.40 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,890.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $4,051.34 | ↓ -13% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4,279.55 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $4,279.55 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $5,057.65 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $5,446.70 | ↑ +17% |
| Aetna | AXA/MMO | $5,446.70 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $6,224.80 | ↑ +33% |
| InterGroup | Beech Street | $6,224.80 | ↑ +33% |
Visitor-reported prices
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Cltx thigh fx w/mnpj at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,389.80 | $731.33 – $7,186.40 |
| UPMC Mercy | Pittsburgh | $4,240.80 | $835.43 – $837.97 |
| UPMC Presbyterian | Pittsburgh | $6,871.80 | $432.78 – $971.43 |
| UPMC Williamsport | Williamsport | $5,389.80 | $461.63 – $807.86 |