healthcosts.net
Colonoscopy (with biopsy) at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$3,099.00
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.
$5,165.00
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.
$247.96 with UPMC Health Plan vs $4,132.00 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 Health Plan | Managed Medicaid | $247.96 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $259.23 | ↓ -92% |
| Aetna | Medicaid | $270.50 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $313.31 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $334.30 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $339.93 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $351.90 | ↓ -89% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $384.16 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $729.80 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $774.75 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $878.80 | ↓ -72% |
| Aetna | Commercial | $1,291.25 | ↓ -58% |
| Fidelis | Medicare | $1,297.37 | ↓ -58% |
| Aetna | Medicare | $1,323.32 | ↓ -57% |
| UPMC Health Plan | Partners/Select | $1,324.36 | ↓ -57% |
| Wellcare | Medicare Advantage | $1,336.29 | ↓ -57% |
| BCBS of Western NY | Medicare Advantage | $1,362.24 | ↓ -56% |
| United Healthcare | Medicare | $1,388.19 | ↓ -55% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,401.03 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $1,401.16 | ↓ -55% |
| Cigna | Medicare | $1,401.16 | ↓ -55% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,401.16 | ↓ -55% |
| United Healthcare | Commercial | $1,535.00 | ↓ -50% |
| Cigna | NBR ASO/FI | $1,549.50 | ↓ -50% |
| Cigna | New Business ASO | $1,549.50 | ↓ -50% |
| Independent Health | Medicare Advantage | $1,634.95 | ↓ -47% |
| Univera | Commercial | $1,704.45 | ↓ -45% |
| Independent Health | Commercial | $1,852.97 | ↓ -40% |
| Cigna | EBR | $2,066.00 | ↓ -33% |
| Cigna | Commercial | $2,066.00 | ↓ -33% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -30% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,205.27 | ↓ -29% |
| UPMC Health Plan | Commercial | $2,854.25 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $3,357.25 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $3,528.40 | ↑ +14% |
| Aetna | AXA/MMO | $3,615.50 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,615.50 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $4,132.00 | ↑ +33% |
| InterGroup | Beech Street | $4,132.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy (with biopsy) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,214.00 | $247.96 – $3,136.50 |
| UPMC East | Monroeville | $3,055.20 | $247.96 – $4,073.60 |
| UPMC Altoona | Altoona | $1,764.60 | $225.42 – $2,352.80 |
| UPMC Bedford | Everett | $1,656.60 | $236.69 – $2,484.90 |
| UPMC Cole | Coudersport | $727.20 | $236.69 – $1,041.88 |
| UPMC Horizon-Greenville | Greenville | $2,476.20 | $247.96 – $3,507.95 |
| UPMC Jameson | New Castle | $2,476.20 | $247.96 – $3,631.76 |
| UPMC Kane | Kane | $1,398.60 | $247.96 – $1,864.80 |