Exc ben+marg excep skin tag snhfg >4cm 11426 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
not published by hospital
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.
not published by hospital
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.
$133.10 with UPMC Health Plan vs $4,420.18 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $133.10 | — |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $139.15 | — |
| Aetna | Medicaid | $145.20 | — |
| Geisinger | Medicaid/CHIP | $168.18 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $179.44 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $182.47 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $188.89 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $206.21 | — |
| UPMC Work Partners | Workers Comp | $566.35 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $729.80 | — |
| United Healthcare | Commercial | $1,754.00 | — |
| BCBS of Western NY | Commercial | $2,177.52 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,205.27 | — |
| UPMC Health Plan | Commercial | $2,876.50 | — |
| Fidelis | Medicare | $3,149.17 | — |
| Aetna | Medicare | $3,212.15 | — |
| UPMC Health Plan | Partners/Select | $3,214.67 | — |
| Wellcare | Medicare Advantage | $3,243.65 | — |
| BCBS of Western NY | Medicare Advantage | $3,306.63 | — |
| United Healthcare | Medicare | $3,369.61 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $3,400.79 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,401.10 | — |
| Cigna | Medicare | $3,401.10 | — |
| AmeriHealth Caritas | Medicare | $3,401.10 | — |
| Highmark BCBS of PA | UPMC Emergent | $3,528.40 | — |
| Independent Health | Medicare Advantage | $3,968.58 | — |
| Independent Health | Commercial | $4,420.18 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc ben+marg excep skin tag snhfg >4cm 11426 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $465.00 | $127.05 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $718.80 | $163.35 – $5,805.45 |
| UPMC Presbyterian | Pittsburgh | $5,502.00 | $133.10 – $3,001.48 |
| UPMC Somerset | Somerset | $718.80 | $133.10 – $2,728.62 |
| UPMC St. Margaret | Pittsburgh | $3,706.20 | $133.10 – $736.75 |
| Uniontown Hospital | Uniontown | $995.00 | $133.10 – $5,847.63 |
| UPMC Altoona | Altoona | not published | $121.00 – $2,946.91 |
| UPMC Bedford | Everett | not published | $127.05 – $2,946.91 |