Consultation pathology during surgery at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$133.80
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.
$223.00
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.
$4.95 with UPMC Health Plan vs $178.40 with Multiplan — 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 |
|---|---|---|---|
| UPMC Health Plan | Commercial | $4.95 | ↓ -96% |
| United Healthcare | Commercial | $12.71 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $29.77 | ↓ -78% |
| UPMC Health Plan | Managed Medicaid | $32.75 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $33.45 | ↓ -75% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $34.24 | ↓ -74% |
| Aetna | Medicaid | $35.72 | ↓ -73% |
| Geisinger | Medicaid/CHIP | $41.38 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicaid | $44.15 | ↓ -67% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $46.47 | ↓ -65% |
| Independent Health | Medicare Advantage | $49.63 | ↓ -63% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $50.73 | ↓ -62% |
| Aetna | Commercial | $55.75 | ↓ -58% |
| Fidelis | Medicare | $65.36 | ↓ -51% |
| Independent Health | Commercial | $66.10 | ↓ -51% |
| Aetna | Medicare | $66.67 | ↓ -50% |
| UPMC Health Plan | Partners/Select | $66.72 | ↓ -50% |
| Cigna | NBR ASO/FI | $66.90 | ↓ -50% |
| Cigna | New Business ASO | $66.90 | ↓ -50% |
| Wellcare | Medicare Advantage | $67.32 | ↓ -50% |
| BCBS of Western NY | Medicare Advantage | $68.63 | ↓ -49% |
| United Healthcare | Medicare | $69.94 | ↓ -48% |
| Highmark Wholecare (prev Gateway) | Medicare | $70.58 | ↓ -47% |
| AmeriHealth Caritas | Medicare | $70.59 | ↓ -47% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $70.59 | ↓ -47% |
| Cigna | Medicare | $70.59 | ↓ -47% |
| Univera | Commercial | $73.59 | ↓ -45% |
| BCBS of Western NY | Commercial | $73.96 | ↓ -45% |
| Cigna | EBR | $89.20 | ↓ -33% |
| Cigna | Commercial | $89.20 | ↓ -33% |
| UPMC Work Partners | Workers Comp | $95.98 | ↓ -28% |
| InterGroup | Health Coalition Partners/PPO | $144.95 | ↑ +8% |
| Aetna | AXA/MMO | $156.10 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $156.10 | ↑ +17% |
| InterGroup | Beech Street | $178.40 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $178.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Consultation pathology during surgery at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $78.60 | $9.91 – $111.35 |
| UPMC Community Osteopathic | Harrisburg | $78.60 | $9.91 – $111.35 |
| UPMC East | Monroeville | $159.60 | $2.73 – $212.80 |
| UPMC Northwest | Seneca | $63.60 | $2.75 – $89.17 |
| UPMC Hanover | Hanover | $78.60 | $9.91 – $93.32 |
| UPMC Jameson | New Castle | $55.80 | $6.11 – $89.17 |
| UPMC Lititz | Lititz | $78.60 | $9.91 – $94.72 |
| UPMC Magee | Pittsburgh | $118.20 | $2.89 – $95.98 |