Culture body fluid at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$105.00
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.
$175.00
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.
$6.90 with Health Partners Plans (Jefferson Health Plan) vs $140.00 with Multiplan — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $6.90 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $7.59 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $7.93 | ↓ -92% |
| Aetna | Medicaid | $8.28 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $8.52 | ↓ -92% |
| Fidelis | Medicare | $8.62 | ↓ -92% |
| Aetna | Medicare | $8.79 | ↓ -92% |
| UPMC Health Plan | Partners/Select | $8.80 | ↓ -92% |
| Independent Health | Medicare Advantage | $8.88 | ↓ -92% |
| Independent Health | Commercial | $8.88 | ↓ -92% |
| Wellcare | Medicare Advantage | $8.88 | ↓ -92% |
| BCBS of Western NY | Medicare Advantage | $9.05 | ↓ -91% |
| United Healthcare | Medicare | $9.22 | ↓ -91% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $9.31 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicare | $9.31 | ↓ -91% |
| AmeriHealth Caritas | Medicare | $9.31 | ↓ -91% |
| Cigna | Medicare | $9.31 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $9.59 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $10.23 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $10.77 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $11.76 | ↓ -89% |
| BCBS of Western NY | Commercial | $11.79 | ↓ -89% |
| United Healthcare | Commercial | $11.84 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $16.64 | ↓ -84% |
| UPMC Health Plan | Commercial | $19.60 | ↓ -81% |
| Univera | Univera_Medicare_Hamot_2024 | $26.25 | ↓ -75% |
| Aetna | Commercial | $43.75 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $50.27 | ↓ -52% |
| Cigna | NBR ASO/FI | $52.50 | ↓ -50% |
| Cigna | New Business ASO | $52.50 | ↓ -50% |
| Univera | Commercial | $57.75 | ↓ -45% |
| Cigna | Commercial | $70.00 | ↓ -33% |
| Cigna | EBR | $70.00 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $80.43 | ↓ -23% |
| InterGroup | Health Coalition Partners/PPO | $113.75 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $122.50 | ↑ +17% |
| Aetna | AXA/MMO | $122.50 | ↑ +17% |
| InterGroup | Beech Street | $140.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $140.00 | ↑ +33% |
Visitor-reported prices
Comments
Culture body fluid at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $108.00 | $6.90 – $144.00 |
| UPMC Bedford | Everett | $66.60 | $3.11 – $99.90 |
| UPMC Carlisle | Carlisle | $48.00 | $6.90 – $68.00 |
| UPMC Cole | Coudersport | $61.20 | $5.60 – $81.60 |
| UPMC Community Osteopathic | Harrisburg | $48.00 | $6.90 – $66.30 |
| UPMC East | Monroeville | $128.40 | $6.90 – $171.20 |
| UPMC Northwest | Seneca | $84.60 | $7.59 – $9.31 |
| UPMC Hanover | Hanover | $48.00 | $6.90 – $13.79 |