Diffusing capacity at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$298.80
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.
$498.00
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.
$36.25 with Highmark BCBS of PA vs $398.40 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $36.25 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $43.49 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $45.47 | ↓ -85% |
| Aetna | Medicaid | $47.45 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $54.96 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $58.64 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $59.63 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $61.73 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $67.38 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $72.88 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $74.70 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $109.53 | ↓ -63% |
| Aetna | Commercial | $124.50 | ↓ -58% |
| BCBS of Western NY | Commercial | $148.64 | ↓ -50% |
| Cigna | NBR ASO/FI | $149.40 | ↓ -50% |
| Cigna | New Business ASO | $149.40 | ↓ -50% |
| UPMC Health Plan | Commercial | $152.63 | ↓ -49% |
| Univera | Commercial | $164.34 | ↓ -45% |
| Highmark BCBS of PA | UPMC Emergent | $175.24 | ↓ -41% |
| Cigna | EBR | $199.20 | ↓ -33% |
| Cigna | Commercial | $199.20 | ↓ -33% |
| Aetna | Medicare | $199.20 | ↓ -33% |
| United Healthcare | Commercial | $226.34 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $249.00 | ↓ -17% |
| InterGroup | Health Coalition Partners/PPO | $323.70 | ↑ +8% |
| Aetna | AXA/MMO | $348.60 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $348.60 | ↑ +17% |
| InterGroup | Beech Street | $398.40 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $398.40 | ↑ +33% |
Visitor-reported prices
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Diffusing capacity at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $339.60 | $33.12 – $452.80 |
| UPMC Bedford | Everett | $190.20 | $41.52 – $285.30 |
| UPMC Carlisle | Carlisle | $970.20 | $43.39 – $1,374.45 |
| UPMC Cole | Coudersport | $136.20 | $41.52 – $181.60 |
| UPMC Community Osteopathic | Harrisburg | $970.20 | $43.39 – $305.65 |
| UPMC East | Monroeville | $360.00 | $36.59 – $480.00 |
| UPMC Northwest | Seneca | $145.80 | $43.49 – $94.07 |
| UPMC Hanover | Hanover | $970.20 | $43.39 – $613.00 |