CT heart w/evaluation of calcium without contrast at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$120.00
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.
$200.00
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.
$30.00 with Univera vs $693.00 with United Healthcare — 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $30.00 | ↓ -75% |
| Aetna | Commercial | $50.00 | ↓ -58% |
| Cigna | NBR ASO/FI | $60.00 | ↓ -50% |
| Cigna | New Business ASO | $60.00 | ↓ -50% |
| UPMC Health Plan | Managed Medicaid | $62.52 | ↓ -48% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $65.37 | ↓ -46% |
| Univera | Commercial | $66.00 | ↓ -45% |
| Aetna | Medicaid | $68.21 | ↓ -43% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $77.66 | ↓ -35% |
| Geisinger | Medicaid/CHIP | $79.00 | ↓ -34% |
| Cigna | EBR | $80.00 | ↓ -33% |
| Cigna | Commercial | $80.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicaid | $84.29 | ↓ -30% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $85.71 | ↓ -29% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $88.73 | ↓ -26% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $96.87 | ↓ -19% |
| Fidelis | Medicare | $96.88 | ↓ -19% |
| Aetna | Medicare | $98.82 | ↓ -18% |
| UPMC Health Plan | Partners/Select | $98.90 | ↓ -18% |
| Wellcare | Medicare Advantage | $99.79 | ↓ -17% |
| BCBS of Western NY | Medicare Advantage | $101.72 | ↓ -15% |
| United Healthcare | Medicare | $103.66 | ↓ -14% |
| Highmark Wholecare (prev Gateway) | Medicare | $104.62 | ↓ -13% |
| Cigna | Medicare | $104.63 | ↓ -13% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $104.63 | ↓ -13% |
| AmeriHealth Caritas | Medicare | $104.63 | ↓ -13% |
| UPMC Work Partners | Workers Comp | $107.43 | ↓ -10% |
| Independent Health | Medicare Advantage | $118.50 | ↓ -1% |
| InterGroup | Health Coalition Partners/PPO | $130.00 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $140.00 | ↑ +17% |
| Aetna | AXA/MMO | $140.00 | ↑ +17% |
| Independent Health | Commercial | $157.79 | ↑ +31% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $160.00 | ↑ +33% |
| InterGroup | Beech Street | $160.00 | ↑ +33% |
| UPMC Health Plan | Commercial | $164.85 | ↑ +37% |
| BCBS of Western NY | Commercial | $231.45 | ↑ +93% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $234.67 | ↑ +96% |
| Highmark BCBS of PA | UPMC Emergent | $375.47 | ↑ +213% |
| United Healthcare | Commercial | $693.00 | ↑ +478% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
CT heart w/evaluation of calcium without contrast at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $120.00 | $34.78 – $160.00 |
| UPMC Carlisle | Carlisle | $127.20 | $13.56 – $280.00 |
| UPMC Cole | Coudersport | $126.00 | $58.21 – $168.00 |
| UPMC Community Osteopathic | Harrisburg | $127.20 | $19.80 – $330.12 |
| UPMC Hanover | Hanover | $127.20 | $45.56 – $280.00 |
| UPMC Kane | Kane | $124.80 | $62.52 – $308.34 |
| UPMC Lititz | Lititz | $127.20 | $45.56 – $280.00 |
| UPMC Magee | Pittsburgh | $120.00 | $62.52 – $107.43 |