Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$71.50 with UPMC Health Plan vs $6,879.78 with BCBS of Western NY — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $71.50 | — |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $74.75 | — |
| Aetna | Medicaid | $78.00 | — |
| Geisinger | Medicaid/CHIP | $90.34 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $96.39 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $98.02 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $101.47 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $110.77 | — |
| UPMC Work Partners | Workers Comp | $325.23 | — |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $545.04 | — |
| Fidelis | Medicare | $774.17 | — |
| Aetna | Medicare | $789.65 | — |
| UPMC Health Plan | Partners/Select | $790.27 | — |
| Wellcare | Medicare Advantage | $797.40 | — |
| BCBS of Western NY | Medicare Advantage | $812.88 | — |
| United Healthcare | Medicare | $828.36 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $836.03 | — |
| AmeriHealth Caritas | Medicare | $836.10 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $836.10 | — |
| Cigna | Medicare | $836.10 | — |
| Independent Health | Medicare Advantage | $975.61 | — |
| Independent Health | Commercial | $1,110.44 | — |
| United Healthcare | Commercial | $1,147.00 | — |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,646.96 | — |
| UPMC Health Plan | Commercial | $2,128.47 | — |
| Highmark BCBS of PA | UPMC Emergent | $2,635.11 | — |
| BCBS of Western NY | Commercial | $6,879.78 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc ben+marg excep skin tag tal 2.1-3/>cm 11403 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,651.80 | $82.55 – $2,340.05 |
| UPMC Cole | Coudersport | $1,266.00 | $35.48 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $1,651.80 | $82.55 – $2,340.05 |
| UPMC Hanover | Hanover | $1,651.80 | $82.55 – $1,075.42 |
| UPMC Kane | Kane | $1,045.20 | $71.50 – $827.51 |
| UPMC Lititz | Lititz | $1,651.80 | $82.55 – $1,081.23 |
| UPMC Magee | Pittsburgh | $2,584.20 | $71.50 – $724.45 |
| UPMC Memorial | York | $1,651.80 | $82.55 – $1,079.47 |