Ghs refill of implantable pump at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$726.60
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.
$1,211.00
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.
$22.60 with Highmark BCBS of PA vs $968.80 with InterGroup — 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 | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $22.60 | ↓ -97% |
| Highmark BCBS of PA | UPMC Emergent | $36.16 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $42.01 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $52.21 | ↓ -93% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $54.58 | ↓ -92% |
| Aetna | Medicaid | $56.95 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $65.96 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $70.38 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $71.57 | ↓ -90% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $74.09 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $80.88 | ↓ -89% |
| UPMC Health Plan | Commercial | $82.77 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $101.57 | ↓ -86% |
| Univera | Univera_Medicare_Hamot_2024 | $181.65 | ↓ -75% |
| BCBS of Western NY | Commercial | $202.69 | ↓ -72% |
| Aetna | Commercial | $302.75 | ↓ -58% |
| Cigna | New Business ASO | $363.30 | ↓ -50% |
| Cigna | NBR ASO/FI | $363.30 | ↓ -50% |
| Fidelis | Medicare | $364.97 | ↓ -50% |
| Aetna | Medicare | $372.27 | ↓ -49% |
| UPMC Health Plan | Partners/Select | $372.56 | ↓ -49% |
| Wellcare | Medicare Advantage | $375.92 | ↓ -48% |
| BCBS of Western NY | Medicare Advantage | $383.22 | ↓ -47% |
| United Healthcare | Medicare | $390.52 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $394.13 | ↓ -46% |
| Cigna | Medicare | $394.17 | ↓ -46% |
| AmeriHealth Caritas | Medicare | $394.17 | ↓ -46% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $394.17 | ↓ -46% |
| Univera | Commercial | $399.63 | ↓ -45% |
| Independent Health | Medicare Advantage | $459.65 | ↓ -37% |
| Cigna | Commercial | $484.40 | ↓ -33% |
| Cigna | EBR | $484.40 | ↓ -33% |
| United Healthcare | Commercial | $550.40 | ↓ -24% |
| Independent Health | Commercial | $612.14 | ↓ -16% |
| InterGroup | Health Coalition Partners/PPO | $787.15 | ↑ +8% |
| Aetna | AXA/MMO | $847.70 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $847.70 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $968.80 | ↑ +33% |
| InterGroup | Beech Street | $968.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ghs refill of implantable pump at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $77.40 | $17.19 – $101.57 |
| UPMC Community Osteopathic | Harrisburg | $774.60 | $60.27 – $1,097.35 |
| UPMC Hanover | Hanover | $774.60 | $60.27 – $506.98 |
| UPMC Magee | Pittsburgh | $361.20 | $42.41 – $341.53 |
| UPMC Memorial | York | $774.60 | $34.24 – $508.90 |
| UPMC Mercy | Pittsburgh | $370.80 | $42.01 – $347.85 |
| UPMC Passavant-McCandless | Pittsburgh | $253.20 | $42.41 – $347.85 |
| UPMC Somerset | Somerset | $774.60 | $41.58 – $316.23 |