Exchange biliary drg cath at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$3,045.00
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.
$5,075.00
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.
$132.20 with UPMC Health Plan vs $6,060.59 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 | $132.20 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $138.21 | ↓ -95% |
| Aetna | Medicaid | $144.22 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $167.04 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $178.23 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $181.23 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $187.61 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $204.81 | ↓ -93% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $544.74 | ↓ -82% |
| Univera | Univera_Medicare_Hamot_2024 | $761.25 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $1,043.33 | ↓ -66% |
| Aetna | Commercial | $1,268.75 | ↓ -58% |
| Cigna | New Business ASO | $1,522.50 | ↓ -50% |
| Cigna | NBR ASO/FI | $1,522.50 | ↓ -50% |
| BCBS of Western NY | Commercial | $1,572.66 | ↓ -48% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,646.06 | ↓ -46% |
| Univera | Commercial | $1,674.75 | ↓ -45% |
| Cigna | Commercial | $2,030.00 | ↓ -33% |
| Cigna | EBR | $2,030.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $2,571.63 | ↓ -16% |
| United Healthcare | Commercial | $2,608.00 | ↓ -14% |
| Highmark BCBS of PA | UPMC Emergent | $2,633.67 | ↓ -14% |
| InterGroup | Health Coalition Partners/PPO | $3,298.75 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,552.50 | ↑ +17% |
| Aetna | AXA/MMO | $3,552.50 | ↑ +17% |
| Fidelis | Medicare | $3,883.10 | ↑ +28% |
| Aetna | Medicare | $3,960.76 | ↑ +30% |
| UPMC Health Plan | Partners/Select | $3,963.87 | ↑ +30% |
| Wellcare | Medicare Advantage | $3,999.59 | ↑ +31% |
| InterGroup | Beech Street | $4,060.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $4,060.00 | ↑ +33% |
| BCBS of Western NY | Medicare Advantage | $4,077.26 | ↑ +34% |
| United Healthcare | Medicare | $4,154.92 | ↑ +36% |
| Highmark Wholecare (prev Gateway) | Medicare | $4,193.36 | ↑ +38% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $4,193.75 | ↑ +38% |
| Cigna | Medicare | $4,193.75 | ↑ +38% |
| AmeriHealth Caritas | Medicare | $4,193.75 | ↑ +38% |
| Independent Health | Medicare Advantage | $4,893.48 | ↑ +61% |
| Independent Health | Commercial | $6,060.59 | ↑ +99% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exchange biliary drg cath at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,273.40 | $120.18 – $3,031.20 |
| UPMC Carlisle | Carlisle | $7,502.40 | $152.63 – $10,628.40 |
| UPMC Community Osteopathic | Harrisburg | $7,502.40 | $162.24 – $10,628.40 |
| UPMC East | Monroeville | $3,058.80 | $132.20 – $4,078.40 |
| UPMC Northwest | Seneca | $3,855.00 | $132.20 – $3,532.77 |
| UPMC Hanover | Hanover | $7,502.40 | $152.63 – $5,394.10 |
| UPMC Jameson | New Castle | $2,373.00 | $132.20 – $4,542.13 |
| UPMC Lititz | Lititz | $7,502.40 | $152.63 – $5,423.23 |