Ercp lesion ablate w/dilate 43278 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$4,209.00
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.
$7,015.00
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.
$647.45 with UPMC Work Partners vs $5,612.00 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 Work Partners | Workers Comp | $647.45 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $729.80 | ↓ -83% |
| Univera | Univera_Medicare_Hamot_2024 | $1,052.25 | ↓ -75% |
| Aetna | Commercial | $1,753.75 | ↓ -58% |
| United Healthcare | Commercial | $1,754.00 | ↓ -58% |
| Cigna | NBR ASO/FI | $2,104.50 | ↓ -50% |
| Cigna | New Business ASO | $2,104.50 | ↓ -50% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -48% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,205.27 | ↓ -48% |
| Univera | Commercial | $2,314.95 | ↓ -45% |
| UPMC Health Plan | Commercial | $2,581.52 | ↓ -39% |
| Cigna | EBR | $2,806.00 | ↓ -33% |
| Cigna | Commercial | $2,806.00 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $3,528.40 | ↓ -16% |
| Geisinger | Medicaid/CHIP | $3,858.25 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $3,858.25 | ↓ -8% |
| Fidelis | Medicare | $4,186.20 | ↓ -1% |
| Aetna | Medicare | $4,269.92 | ↑ +1% |
| UPMC Health Plan | Partners/Select | $4,273.27 | ↑ +2% |
| Wellcare | Medicare Advantage | $4,311.79 | ↑ +2% |
| BCBS of Western NY | Medicare Advantage | $4,395.51 | ↑ +4% |
| United Healthcare | Medicare | $4,479.23 | ↑ +6% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,520.68 | ↑ +7% |
| AmeriHealth Caritas | Medicare | $4,521.10 | ↑ +7% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4,521.10 | ↑ +7% |
| Cigna | Medicare | $4,521.10 | ↑ +7% |
| InterGroup | Health Coalition Partners/PPO | $4,559.75 | ↑ +8% |
| Aetna | AXA/MMO | $4,910.50 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $4,910.50 | ↑ +17% |
| Independent Health | Medicare Advantage | $5,275.45 | ↑ +25% |
| Independent Health | Commercial | $5,579.35 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $5,612.00 | ↑ +33% |
| InterGroup | Beech Street | $5,612.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ercp lesion ablate w/dilate 43278 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,311.80 | $707.40 – $3,989.88 |
| UPMC Passavant-McCandless | Pittsburgh | $3,928.80 | $647.45 – $3,989.88 |
| UPMC Presbyterian | Pittsburgh | $5,574.60 | $707.40 – $3,989.88 |
| UPMC Wellsboro | Wellsboro | $7,896.80 | $647.45 – $993.28 |
| UPMC Williamsport | Williamsport | $6,529.80 | $647.45 – $3,917.33 |
| UPMC Community Osteopathic | Harrisburg | not published | $677.57 – $7,348.95 |
| UPMC East | Monroeville | not published | $647.45 – $3,989.88 |