Coombs direct at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$130.80
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.
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What you pay up front if you don't use insurance.
$218.00
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.
$5.32 with UPMC Work Partners vs $174.40 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 | $5.32 | ↓ -96% |
| Fidelis | Medicare | $5.39 | ↓ -96% |
| Aetna | Medicare | $5.50 | ↓ -96% |
| UPMC Health Plan | Partners/Select | $5.50 | ↓ -96% |
| Wellcare | Medicare Advantage | $5.55 | ↓ -96% |
| BCBS of Western NY | Medicare Advantage | $5.66 | ↓ -96% |
| United Healthcare | Medicare | $5.77 | ↓ -96% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $5.82 | ↓ -96% |
| Highmark Wholecare (prev Gateway) | Medicare | $5.82 | ↓ -96% |
| AmeriHealth Caritas | Medicare | $5.82 | ↓ -96% |
| Cigna | Medicare | $5.82 | ↓ -96% |
| BCBS of Western NY | Commercial | $7.37 | ↓ -94% |
| United Healthcare | Commercial | $7.39 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $7.43 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $8.17 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $8.54 | ↓ -93% |
| Aetna | Medicaid | $8.92 | ↓ -93% |
| UPMC Health Plan | Commercial | $10.04 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $10.33 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $10.37 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $11.02 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $11.60 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $12.66 | ↓ -90% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $31.34 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $32.70 | ↓ -75% |
| Independent Health | Medicare Advantage | $49.63 | ↓ -62% |
| Highmark BCBS of PA | UPMC Emergent | $50.15 | ↓ -62% |
| Aetna | Commercial | $54.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $65.40 | ↓ -50% |
| Cigna | New Business ASO | $65.40 | ↓ -50% |
| Independent Health | Commercial | $66.10 | ↓ -49% |
| Univera | Commercial | $71.94 | ↓ -45% |
| Cigna | Commercial | $87.20 | ↓ -33% |
| Cigna | EBR | $87.20 | ↓ -33% |
| InterGroup | Health Coalition Partners/PPO | $141.70 | ↑ +8% |
| Aetna | AXA/MMO | $152.60 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $152.60 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $174.40 | ↑ +33% |
| InterGroup | Beech Street | $174.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Coombs direct at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $46.80 | $5.32 – $62.40 |
| UPMC Bedford | Everett | $41.40 | $1.94 – $62.10 |
| UPMC Carlisle | Carlisle | $48.00 | $5.34 – $68.00 |
| UPMC Cole | Coudersport | $41.40 | $3.50 – $55.20 |
| UPMC Community Osteopathic | Harrisburg | $75.00 | $5.34 – $68.00 |
| UPMC East | Monroeville | $80.40 | $5.32 – $107.20 |
| UPMC Northwest | Seneca | $37.20 | $4.89 – $8.54 |
| UPMC Hanover | Hanover | $48.00 | $5.34 – $10.12 |