Foam drg >16<=48 sq in without b at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$15.00
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.
$25.00
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.
$1.35 with Univera vs $170.75 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $1.35 | ↓ -91% |
| Aetna | Commercial | $2.25 | ↓ -85% |
| Cigna | NBR ASO/FI | $2.70 | ↓ -82% |
| Cigna | New Business ASO | $2.70 | ↓ -82% |
| Univera | Commercial | $2.97 | ↓ -80% |
| BCBS of Western NY | Commercial | $3.15 | ↓ -79% |
| UPMC Health Plan | Commercial | $3.31 | ↓ -78% |
| Aetna | Medicare | $3.60 | ↓ -76% |
| Cigna | Commercial | $3.60 | ↓ -76% |
| Cigna | EBR | $3.60 | ↓ -76% |
| United Healthcare | Commercial | $4.09 | ↓ -73% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.50 | ↓ -70% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4.95 | ↓ -67% |
| Geisinger | Medicaid/CHIP | $4.95 | ↓ -67% |
| InterGroup | Health Coalition Partners/PPO | $5.85 | ↓ -61% |
| Aetna | AXA/MMO | $6.30 | ↓ -58% |
| Multiplan | PPO (Includes PHCS as a Payer) | $6.30 | ↓ -58% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $7.20 | ↓ -52% |
| InterGroup | Beech Street | $7.20 | ↓ -52% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $35.32 | ↑ +135% |
| UPMC Work Partners | Workers Comp | $45.90 | ↑ +206% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $106.72 | ↑ +611% |
| Highmark BCBS of PA | UPMC Emergent | $170.75 | ↑ +1038% |
Visitor-reported prices
Comments
Foam drg >16<=48 sq in without b at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $14.40 | $6.00 – $111.44 |
| UPMC Mercy | Pittsburgh | $171.60 | $35.32 – $88.00 |
| UPMC Passavant-McCandless | Pittsburgh | $21.60 | $35.65 – $161.71 |
| UPMC Presbyterian | Pittsburgh | $102.00 | $21.53 – $180.18 |
| UPMC Williamsport | Williamsport | $21.60 | $22.96 – $50.70 |