Inj., brexanolone, 1 mg at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$187.80
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.
$313.00
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.
$46.95 with Univera vs $250.40 with Multiplan — 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 | $46.95 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $63.40 | ↓ -66% |
| Independent Health | Commercial | $75.99 | ↓ -60% |
| Independent Health | Medicare Advantage | $75.99 | ↓ -60% |
| Aetna | Commercial | $78.25 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $84.93 | ↓ -55% |
| UPMC Work Partners | Workers Comp | $88.64 | ↓ -53% |
| Cigna | New Business ASO | $93.90 | ↓ -50% |
| Cigna | NBR ASO/FI | $93.90 | ↓ -50% |
| Univera | Commercial | $103.29 | ↓ -45% |
| BCBS of Western NY | Commercial | $109.55 | ↓ -42% |
| UPMC Health Plan | Commercial | $115.18 | ↓ -39% |
| Aetna | Medicare | $125.20 | ↓ -33% |
| Cigna | EBR | $125.20 | ↓ -33% |
| Cigna | Commercial | $125.20 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $135.89 | ↓ -28% |
| United Healthcare | Commercial | $142.26 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $156.50 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $172.15 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $172.15 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $203.45 | ↑ +8% |
| Aetna | AXA/MMO | $219.10 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $219.10 | ↑ +17% |
| InterGroup | Beech Street | $250.40 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $250.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Inj., brexanolone, 1 mg at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $172.20 | $63.40 – $268.20 |
| UPMC East | Monroeville | $178.80 | $35.64 – $238.40 |
| UPMC Northwest | Seneca | $171.00 | $164.56 – $164.56 |
| UPMC Horizon-Greenville | Greenville | $180.60 | $89.40 – $161.59 |
| UPMC Jameson | New Castle | $180.60 | $64.52 – $75.99 |
| UPMC St. Margaret | Pittsburgh | $171.00 | $64.01 – $64.01 |
| UPMC Williamsport | Williamsport | $172.80 | not published |