Ghs layer closure 5.1 - 7.5 cm - 12053 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$880.20
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.
$1,467.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$52.25 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 | $52.25 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $54.62 | ↓ -94% |
| Aetna | Medicaid | $57.00 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $66.02 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $70.44 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $71.63 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.15 | ↓ -92% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $80.95 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $204.47 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $220.05 | ↓ -75% |
| United Healthcare | Commercial | $340.00 | ↓ -61% |
| Aetna | Commercial | $366.75 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $387.59 | ↓ -56% |
| Fidelis | Medicare | $439.61 | ↓ -50% |
| Cigna | New Business ASO | $440.10 | ↓ -50% |
| Cigna | NBR ASO/FI | $440.10 | ↓ -50% |
| Aetna | Medicare | $448.40 | ↓ -49% |
| UPMC Health Plan | Partners/Select | $448.75 | ↓ -49% |
| Wellcare | Medicare Advantage | $452.80 | ↓ -49% |
| BCBS of Western NY | Medicare Advantage | $461.59 | ↓ -48% |
| United Healthcare | Medicare | $470.38 | ↓ -47% |
| Highmark Wholecare (prev Gateway) | Medicare | $474.73 | ↓ -46% |
| AmeriHealth Caritas | Medicare | $474.78 | ↓ -46% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $474.78 | ↓ -46% |
| Cigna | Medicare | $474.78 | ↓ -46% |
| Univera | Commercial | $484.11 | ↓ -45% |
| Independent Health | Medicare Advantage | $554.00 | ↓ -37% |
| Cigna | EBR | $586.80 | ↓ -33% |
| Cigna | Commercial | $586.80 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $617.85 | ↓ -30% |
| Independent Health | Commercial | $638.36 | ↓ -27% |
| UPMC Health Plan | Commercial | $811.51 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $953.55 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $988.55 | ↑ +12% |
| Aetna | AXA/MMO | $1,026.90 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,026.90 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $1,173.60 | ↑ +33% |
| InterGroup | Beech Street | $1,173.60 | ↑ +33% |
| BCBS of Western NY | Commercial | $6,879.78 | ↑ +682% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs layer closure 5.1 - 7.5 cm - 12053 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $909.00 | $47.50 – $1,212.00 |
| UPMC Bedford | Everett | $428.40 | $49.88 – $642.60 |
| UPMC Carlisle | Carlisle | $819.00 | $60.33 – $1,160.25 |
| UPMC Cole | Coudersport | $1,084.80 | $49.88 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $819.00 | $60.33 – $1,160.25 |
| UPMC East | Monroeville | $1,037.40 | $52.25 – $1,383.20 |
| UPMC Northwest | Seneca | $695.40 | $52.25 – $408.14 |
| UPMC Hanover | Hanover | $819.00 | $60.33 – $1,016.56 |