Fine needle aspiration biopsy without img gdn; ea addtl 10004 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$176.40
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.
$294.00
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.
$32.06 with Highmark BCBS of PA vs $6,879.78 with BCBS of Western NY — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $32.06 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $39.07 | ↓ -78% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $40.85 | ↓ -77% |
| Aetna | Medicaid | $42.62 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $44.10 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $49.37 | ↓ -72% |
| Highmark Wholecare (prev Gateway) | Medicaid | $52.68 | ↓ -70% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $53.56 | ↓ -70% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $55.45 | ↓ -69% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $60.53 | ↓ -66% |
| UPMC Work Partners | Workers Comp | $63.59 | ↓ -64% |
| Aetna | Commercial | $73.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $88.20 | ↓ -50% |
| Cigna | New Business ASO | $88.20 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $96.89 | ↓ -45% |
| Univera | Commercial | $97.02 | ↓ -45% |
| UPMC Health Plan | Commercial | $108.19 | ↓ -39% |
| Aetna | Medicare | $117.60 | ↓ -33% |
| Cigna | EBR | $117.60 | ↓ -33% |
| Cigna | Commercial | $117.60 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $147.00 | ↓ -17% |
| Highmark BCBS of PA | UPMC Emergent | $155.02 | ↓ -12% |
| InterGroup | Health Coalition Partners/PPO | $191.10 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $205.80 | ↑ +17% |
| Aetna | AXA/MMO | $205.80 | ↑ +17% |
| InterGroup | Beech Street | $235.20 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $235.20 | ↑ +33% |
| United Healthcare | Commercial | $340.00 | ↑ +93% |
| BCBS of Western NY | Commercial | $6,879.78 | ↑ +3800% |
Visitor-reported prices
Comments
Fine needle aspiration biopsy without img gdn; ea addtl 10004 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $269.40 | $32.37 – $80.83 |
| Uniontown Hospital | Uniontown | $78.50 | $33.20 – $74.73 |