healthcosts.net
Established Patient Office Visit (level 1) at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$118.20
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.
$197.00
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.
$20.20 with Fidelis vs $161.47 with Independent Health — 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 |
|---|---|---|---|
| Fidelis | Child Health Plus/Family Health Plus/Medicaid | $20.20 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $22.00 | ↓ -81% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $23.00 | ↓ -81% |
| Aetna | Medicaid | $24.00 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $27.80 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $29.55 | ↓ -75% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.66 | ↓ -75% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $30.16 | ↓ -74% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.22 | ↓ -74% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $33.72 | ↓ -71% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $34.08 | ↓ -71% |
| UPMC Work Partners | Workers Comp | $41.25 | ↓ -65% |
| BCBS of Western NY | Commercial | $43.75 | ↓ -63% |
| Fidelis | Essential Plan | $45.45 | ↓ -62% |
| Molina Healthcare of NY | CHIP (For Kids)/Essential Plan/Medicaid | $45.45 | ↓ -62% |
| Aetna | Commercial | $49.25 | ↓ -58% |
| Cigna | NBR ASO/FI | $59.10 | ↓ -50% |
| Cigna | New Business ASO | $59.10 | ↓ -50% |
| Cigna | Commercial | $63.91 | ↓ -46% |
| Univera | Commercial | $65.01 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $75.69 | ↓ -36% |
| Aetna | Medicare | $78.80 | ↓ -33% |
| Cigna | EBR | $78.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $98.50 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $121.10 | ↑ +2% |
| InterGroup | Health Coalition Partners/PPO | $128.05 | ↑ +8% |
| Aetna | AXA/MMO | $137.90 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $137.90 | ↑ +17% |
| Independent Health | Medicare Advantage | $151.40 | ↑ +28% |
| InterGroup | Beech Street | $157.60 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $157.60 | ↑ +33% |
| Independent Health | Commercial | $161.47 | ↑ +37% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $108.60 | $22.00 – $153.85 |
| UPMC Altoona | Altoona | $174.60 | $6.00 – $232.80 |
| UPMC Bedford | Everett | $83.40 | $21.00 – $125.10 |
| UPMC Cole | Coudersport | $84.00 | $19.64 – $70.40 |
| UPMC Community Osteopathic | Harrisburg | $97.80 | $8.20 – $180.41 |
| UPMC Hanover | Hanover | $24.60 | $7.79 – $38.11 |
| UPMC Horizon-Greenville | Greenville | $141.00 | $21.00 – $199.75 |
| UPMC Jameson | New Castle | $141.00 | $10.18 – $150.48 |