Emg 2 ext w-w/o paraspinal area 95861 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$260.40
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.
$434.00
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.
$41.25 with UPMC Health Plan vs $498.41 with Highmark BCBS of PA — 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 | $41.25 | ↓ -84% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $43.12 | ↓ -83% |
| Aetna | Medicaid | $45.00 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $52.12 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicaid | $55.61 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $56.55 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $58.54 | ↓ -78% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $63.91 | ↓ -75% |
| Univera | Univera_Medicare_Hamot_2024 | $65.10 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $103.09 | ↓ -60% |
| Aetna | Commercial | $108.50 | ↓ -58% |
| Cigna | New Business ASO | $130.20 | ↓ -50% |
| Cigna | NBR ASO/FI | $130.20 | ↓ -50% |
| Fidelis | Medicare | $141.83 | ↓ -46% |
| Univera | Commercial | $143.22 | ↓ -45% |
| Aetna | Medicare | $144.67 | ↓ -44% |
| UPMC Health Plan | Partners/Select | $144.78 | ↓ -44% |
| Wellcare | Medicare Advantage | $146.08 | ↓ -44% |
| BCBS of Western NY | Medicare Advantage | $148.92 | ↓ -43% |
| United Healthcare | Medicare | $151.76 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $153.16 | ↓ -41% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $153.18 | ↓ -41% |
| AmeriHealth Caritas | Medicare | $153.18 | ↓ -41% |
| Cigna | Medicare | $153.18 | ↓ -41% |
| Independent Health | Medicare Advantage | $161.87 | ↓ -38% |
| UPMC Health Plan | Commercial | $163.73 | ↓ -37% |
| Cigna | EBR | $173.60 | ↓ -33% |
| Cigna | Commercial | $173.60 | ↓ -33% |
| United Healthcare | Commercial | $197.25 | ↓ -24% |
| Independent Health | Commercial | $215.57 | ↓ -17% |
| InterGroup | Health Coalition Partners/PPO | $282.10 | ↑ +8% |
| Aetna | AXA/MMO | $303.80 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $303.80 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $311.51 | ↑ +20% |
| UPMC Work Partners | Workers Comp | $331.42 | ↑ +27% |
| InterGroup | Beech Street | $347.20 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $347.20 | ↑ +33% |
| BCBS of Western NY | Commercial | $385.96 | ↑ +48% |
| Highmark BCBS of PA | UPMC Emergent | $498.41 | ↑ +91% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Emg 2 ext w-w/o paraspinal area 95861 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $462.60 | $22.50 – $616.80 |
| UPMC Carlisle | Carlisle | $247.80 | $29.48 – $351.05 |
| UPMC Cole | Coudersport | $160.20 | $33.54 – $308.08 |
| UPMC Community Osteopathic | Harrisburg | $247.80 | $29.48 – $351.05 |
| UPMC East | Monroeville | $615.00 | $41.25 – $820.00 |
| UPMC Northwest | Seneca | $464.40 | $41.25 – $312.08 |
| UPMC Hanover | Hanover | $247.80 | $29.48 – $326.59 |
| UPMC Lititz | Lititz | $247.80 | $29.48 – $322.41 |