Complx repair sal addl 5 cm/> 13122 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$498.60
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.
?
What you pay up front if you don't use insurance.
$831.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$124.65 with Univera vs $3,547.20 with BCBS of Western NY — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $124.65 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $176.83 | ↓ -65% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $207.39 | ↓ -58% |
| Aetna | Commercial | $207.75 | ↓ -58% |
| Cigna | New Business ASO | $249.30 | ↓ -50% |
| Cigna | NBR ASO/FI | $249.30 | ↓ -50% |
| Univera | Commercial | $274.23 | ↓ -45% |
| Cigna | Commercial | $332.40 | ↓ -33% |
| Aetna | Medicare | $332.40 | ↓ -33% |
| Cigna | EBR | $332.40 | ↓ -33% |
| United Healthcare | Commercial | $340.00 | ↓ -32% |
| Highmark Wholecare (prev Gateway) | Medicare | $415.50 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $457.05 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $457.05 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $540.15 | ↑ +8% |
| Aetna | AXA/MMO | $581.70 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $581.70 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $626.67 | ↑ +26% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $664.80 | ↑ +33% |
| InterGroup | Beech Street | $664.80 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $1,002.66 | ↑ +101% |
| UPMC Health Plan | Commercial | $1,625.03 | ↑ +226% |
| BCBS of Western NY | Commercial | $3,547.20 | ↑ +611% |
Visitor-reported prices
Comments
Complx repair sal addl 5 cm/> 13122 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $418.20 | $176.83 – $1,308.89 |
| UPMC Carlisle | Carlisle | $828.60 | $95.43 – $1,173.85 |
| UPMC Cole | Coudersport | $486.60 | $66.25 – $1,470.59 |
| UPMC Community Osteopathic | Harrisburg | $828.60 | $95.43 – $1,308.89 |
| UPMC East | Monroeville | $1,062.00 | $176.83 – $1,416.00 |
| UPMC Northwest | Seneca | $1,128.00 | $176.83 – $618.31 |
| UPMC Hanover | Hanover | $828.60 | $95.43 – $1,308.89 |
| UPMC Horizon-Greenville | Greenville | $872.40 | $176.83 – $710.02 |