Injection therapeutic/prophylactic/diagnostic subcutaneous/im at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$94.80
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.
$158.00
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.
$13.36 with Fidelis vs $126.40 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 |
|---|---|---|---|
| Fidelis | Child Health Plus/Family Health Plus/Medicaid | $13.36 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $13.97 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $14.61 | ↓ -85% |
| Aetna | Medicaid | $15.24 | ↓ -84% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $17.34 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $17.65 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $18.83 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $19.15 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $19.83 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $21.64 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $23.70 | ↓ -75% |
| Highmark BCBS of PA | UPMC Emergent | $27.74 | ↓ -71% |
| UPMC Health Plan | Commercial | $28.52 | ↓ -70% |
| Molina Healthcare of NY | CHIP (For Kids)/Essential Plan/Medicaid | $30.06 | ↓ -68% |
| Fidelis | Essential Plan | $30.06 | ↓ -68% |
| UPMC Work Partners | Workers Comp | $31.10 | ↓ -67% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $32.23 | ↓ -66% |
| BCBS of Western NY | Commercial | $35.94 | ↓ -62% |
| Aetna | Commercial | $39.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $47.40 | ↓ -50% |
| Cigna | New Business ASO | $47.40 | ↓ -50% |
| Univera | Commercial | $52.14 | ↓ -45% |
| Cigna | Commercial | $63.20 | ↓ -33% |
| Aetna | Medicare | $63.20 | ↓ -33% |
| Cigna | EBR | $63.20 | ↓ -33% |
| United Healthcare | Commercial | $71.81 | ↓ -24% |
| Fidelis | Medicare | $78.31 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $79.00 | ↓ -17% |
| UPMC Health Plan | Partners/Select | $79.94 | ↓ -16% |
| Wellcare | Medicare Advantage | $80.66 | ↓ -15% |
| BCBS of Western NY | Medicare Advantage | $82.23 | ↓ -13% |
| United Healthcare | Medicare | $83.79 | ↓ -12% |
| Cigna | Medicare | $84.57 | ↓ -11% |
| AmeriHealth Caritas | Medicare | $84.57 | ↓ -11% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $84.57 | ↓ -11% |
| InterGroup | Health Coalition Partners/PPO | $102.70 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $110.60 | ↑ +17% |
| Aetna | AXA/MMO | $110.60 | ↑ +17% |
| InterGroup | Beech Street | $126.40 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $126.40 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Injection therapeutic/prophylactic/diagnostic subcutaneous/im at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $163.20 | $12.70 – $217.60 |
| UPMC Bedford | Everett | $84.60 | $13.34 – $126.90 |
| UPMC Carlisle | Carlisle | $171.60 | $16.13 – $243.10 |
| UPMC Cole | Coudersport | $141.00 | $13.34 – $48.80 |
| UPMC Community Osteopathic | Harrisburg | $171.60 | $16.13 – $175.95 |
| UPMC East | Monroeville | $183.60 | $13.97 – $244.80 |
| UPMC Northwest | Seneca | $121.20 | $13.97 – $71.24 |
| UPMC Hanover | Hanover | $171.60 | $16.13 – $108.78 |