Foam drsg <=16 sq in without bdr at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$9.00
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.
$15.00
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.
$1.20 with Univera vs $64.17 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 | $1.20 | ↓ -87% |
| Aetna | Commercial | $2.00 | ↓ -78% |
| Cigna | NBR ASO/FI | $2.40 | ↓ -73% |
| Cigna | New Business ASO | $2.40 | ↓ -73% |
| Univera | Commercial | $2.64 | ↓ -71% |
| BCBS of Western NY | Commercial | $2.80 | ↓ -69% |
| UPMC Health Plan | Commercial | $2.94 | ↓ -67% |
| Aetna | Medicare | $3.20 | ↓ -64% |
| Cigna | Commercial | $3.20 | ↓ -64% |
| Cigna | EBR | $3.20 | ↓ -64% |
| United Healthcare | Commercial | $3.64 | ↓ -60% |
| Highmark Wholecare (prev Gateway) | Medicare | $4.00 | ↓ -56% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4.40 | ↓ -51% |
| Geisinger | Medicaid/CHIP | $4.40 | ↓ -51% |
| InterGroup | Health Coalition Partners/PPO | $5.20 | ↓ -42% |
| Aetna | AXA/MMO | $5.60 | ↓ -38% |
| Multiplan | PPO (Includes PHCS as a Payer) | $5.60 | ↓ -38% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $6.40 | ↓ -29% |
| InterGroup | Beech Street | $6.40 | ↓ -29% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $13.27 | ↑ +47% |
| UPMC Work Partners | Workers Comp | $17.26 | ↑ +92% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $40.10 | ↑ +346% |
| Highmark BCBS of PA | UPMC Emergent | $64.17 | ↑ +613% |
Visitor-reported prices
Comments
Foam drsg <=16 sq in without bdr at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4.20 | $3.50 – $41.83 |
| UPMC East | Monroeville | $118.20 | $1.75 – $41.83 |
| UPMC Jameson | New Castle | $6.00 | $6.40 – $41.83 |
| UPMC Magee | Pittsburgh | $8.40 | $7.04 – $41.83 |
| UPMC McKeesport | Mckeesport | $6.00 | $7.04 – $41.83 |
| UPMC Mercy | Pittsburgh | $64.20 | $13.27 – $33.03 |
| UPMC Passavant-McCandless | Pittsburgh | $8.40 | $13.40 – $60.70 |
| UPMC Presbyterian | Pittsburgh | $28.20 | $8.10 – $67.63 |