Cyclophosphamide 25 mg capsule at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$20.20
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.
$25.25
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.
$0.69 with UPMC Health Plan vs $20.00 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $0.69 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $1.00 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $1.10 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1.10 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $1.10 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $1.14 | ↓ -94% |
| Aetna | Medicaid | $1.19 | ↓ -94% |
| United Healthcare | Commercial | $1.68 | ↓ -92% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $3.39 | ↓ -83% |
| Univera | Univera_Medicare_Hamot_2024 | $3.75 | ↓ -81% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $3.75 | ↓ -81% |
| Highmark BCBS of PA | UPMC Emergent | $5.42 | ↓ -73% |
| Aetna | Commercial | $6.25 | ↓ -69% |
| UPMC Work Partners | Workers Comp | $7.08 | ↓ -65% |
| Cigna | NBR ASO/FI | $7.50 | ↓ -63% |
| Cigna | New Business ASO | $7.50 | ↓ -63% |
| Univera | Commercial | $8.25 | ↓ -59% |
| BCBS of Western NY | Commercial | $8.75 | ↓ -57% |
| UPMC Health Plan | Commercial | $9.20 | ↓ -54% |
| Cigna | EBR | $10.00 | ↓ -50% |
| Cigna | Commercial | $10.00 | ↓ -50% |
| Aetna | Medicare | $10.00 | ↓ -50% |
| Highmark Wholecare (prev Gateway) | Medicare | $12.50 | ↓ -38% |
| InterGroup | Health Coalition Partners/PPO | $16.25 | ↓ -20% |
| Multiplan | PPO (Includes PHCS as a Payer) | $17.50 | ↓ -13% |
| Aetna | AXA/MMO | $17.50 | ↓ -13% |
| InterGroup | Beech Street | $20.00 | ↓ -1% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $20.00 | ↓ -1% |
Visitor-reported prices
Comments
Cyclophosphamide 25 mg capsule at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $18.60 | $0.69 – $4.80 |
| UPMC Carlisle | Carlisle | $7.80 | $0.41 – $2.55 |
| UPMC Community Osteopathic | Harrisburg | $7.80 | $0.60 – $6.25 |
| UPMC East | Monroeville | $19.00 | $0.69 – $18.40 |
| UPMC Hanover | Hanover | $7.80 | $0.87 – $1.21 |
| UPMC Lititz | Lititz | $7.80 | $0.87 – $1.21 |
| UPMC Magee | Pittsburgh | $67.20 | $0.69 – $3.79 |
| UPMC Memorial | York | $7.80 | $0.87 – $3.06 |