healthcosts.net
ER Visit (level 4) at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$1,581.00
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.
$2,635.00
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.
$104.86 with UPMC Health Plan vs $2,108.00 with InterGroup — 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 | $104.86 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $109.63 | ↓ -93% |
| Aetna | Medicaid | $114.40 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $132.50 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $141.37 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $141.98 | ↓ -91% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $143.76 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $148.82 | ↓ -91% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $162.46 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $173.95 | ↓ -89% |
| Univera | Univera_Medicare_Hamot_2024 | $395.25 | ↓ -75% |
| Fidelis | Medicare | $468.54 | ↓ -70% |
| Aetna | Medicare | $477.91 | ↓ -70% |
| UPMC Health Plan | Partners/Select | $478.29 | ↓ -70% |
| Wellcare | Medicare Advantage | $482.60 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $491.59 | ↓ -69% |
| BCBS of Western NY | Medicare Advantage | $491.97 | ↓ -69% |
| United Healthcare | Medicare | $501.34 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicare | $505.98 | ↓ -68% |
| AmeriHealth Caritas | Medicare | $506.02 | ↓ -68% |
| Cigna | Medicare | $506.02 | ↓ -68% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $506.02 | ↓ -68% |
| Aetna | Commercial | $658.75 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $786.55 | ↓ -50% |
| Cigna | NBR ASO/FI | $790.50 | ↓ -50% |
| Cigna | New Business ASO | $790.50 | ↓ -50% |
| Univera | Commercial | $869.55 | ↓ -45% |
| UPMC Health Plan | Commercial | $969.68 | ↓ -39% |
| Cigna | EBR | $1,054.00 | ↓ -33% |
| Cigna | Commercial | $1,054.00 | ↓ -33% |
| BCBS of Western NY | Commercial | $1,313.40 | ↓ -17% |
| Independent Health | Medicare Advantage | $1,315.00 | ↓ -17% |
| United Healthcare | Commercial | $1,354.00 | ↓ -14% |
| Independent Health | Commercial | $1,648.00 | ↑ +4% |
| InterGroup | Health Coalition Partners/PPO | $1,712.75 | ↑ +8% |
| Aetna | AXA/MMO | $1,844.50 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,844.50 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $2,108.00 | ↑ +33% |
| InterGroup | Beech Street | $2,108.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 4) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $1,146.00 | $104.86 – $1,623.50 |
| UPMC Cole | Coudersport | $357.00 | $56.38 – $432.27 |
| UPMC East | Monroeville | $1,120.20 | $104.86 – $1,493.60 |
| UPMC Altoona | Altoona | $1,012.20 | $123.00 – $1,349.60 |
| UPMC Carlisle | Carlisle | $1,320.00 | $65.00 – $1,870.00 |
| UPMC Bedford | Everett | $645.60 | $100.10 – $968.40 |
| UPMC Community Osteopathic | Harrisburg | $1,320.00 | $65.00 – $448.50 |
| UPMC Hanover | Hanover | $1,320.00 | $104.86 – $1,914.00 |