Consultation/report referred slides prepared elsewhere at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$342.00
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.
$570.00
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.
$12.71 with United Healthcare vs $456.00 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 |
|---|---|---|---|
| United Healthcare | Commercial | $12.71 | ↓ -96% |
| Fidelis | Medicare | $43.19 | ↓ -87% |
| Aetna | Medicare | $44.05 | ↓ -87% |
| UPMC Health Plan | Partners/Select | $44.09 | ↓ -87% |
| Wellcare | Medicare Advantage | $44.49 | ↓ -87% |
| BCBS of Western NY | Medicare Advantage | $45.35 | ↓ -87% |
| United Healthcare | Medicare | $46.21 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicare | $46.64 | ↓ -86% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $46.65 | ↓ -86% |
| AmeriHealth Caritas | Medicare | $46.65 | ↓ -86% |
| Cigna | Medicare | $46.65 | ↓ -86% |
| Independent Health | Medicare Advantage | $49.63 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $59.93 | ↓ -82% |
| Independent Health | Commercial | $66.10 | ↓ -81% |
| UPMC Health Plan | Commercial | $81.26 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $85.50 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $137.12 | ↓ -60% |
| Aetna | Commercial | $142.50 | ↓ -58% |
| Cigna | New Business ASO | $171.00 | ↓ -50% |
| Cigna | NBR ASO/FI | $171.00 | ↓ -50% |
| BCBS of Western NY | Commercial | $174.72 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $181.09 | ↓ -47% |
| Univera | Commercial | $188.10 | ↓ -45% |
| Cigna | Commercial | $228.00 | ↓ -33% |
| Cigna | EBR | $228.00 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $289.73 | ↓ -15% |
| Geisinger | Medicaid/CHIP | $313.50 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $313.50 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $370.50 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $399.00 | ↑ +17% |
| Aetna | AXA/MMO | $399.00 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $456.00 | ↑ +33% |
| InterGroup | Beech Street | $456.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Consultation/report referred slides prepared elsewhere at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $298.20 | $38.16 – $397.60 |
| UPMC Carlisle | Carlisle | $78.60 | $17.95 – $139.15 |
| UPMC Cole | Coudersport | $336.60 | $53.00 – $448.80 |
| UPMC Community Osteopathic | Harrisburg | $163.20 | $26.20 – $162.74 |
| UPMC Hanover | Hanover | $78.60 | $37.12 – $162.74 |
| UPMC Horizon-Greenville | Greenville | $204.00 | $33.50 – $131.19 |
| UPMC Kane | Kane | $210.00 | $12.71 – $407.30 |
| UPMC Lititz | Lititz | $78.60 | $37.32 – $162.74 |