Ins lv lead exist pm/icd at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$12,843.00
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.
$21,405.00
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.
$918.74 with UPMC Work Partners vs $17,673.52 with Independent Health — 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $918.74 | ↓ -93% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $927.28 | ↓ -93% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,802.00 | ↓ -78% |
| Univera | Univera_Medicare_Hamot_2024 | $3,210.75 | ↓ -75% |
| United Healthcare | Commercial | $3,860.00 | ↓ -70% |
| Highmark BCBS of PA | UPMC Emergent | $4,483.16 | ↓ -65% |
| Aetna | Commercial | $5,351.25 | ↓ -58% |
| Cigna | New Business ASO | $6,421.50 | ↓ -50% |
| Cigna | NBR ASO/FI | $6,421.50 | ↓ -50% |
| Univera | Commercial | $7,063.65 | ↓ -45% |
| UPMC Health Plan | Commercial | $7,877.04 | ↓ -39% |
| Cigna | Commercial | $8,562.00 | ↓ -33% |
| Cigna | EBR | $8,562.00 | ↓ -33% |
| Fidelis | Medicare | $11,515.21 | ↓ -10% |
| Aetna | Medicare | $11,745.51 | ↓ -9% |
| UPMC Health Plan | Partners/Select | $11,754.73 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $11,772.75 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $11,772.75 | ↓ -8% |
| Wellcare | Medicare Advantage | $11,860.67 | ↓ -8% |
| BCBS of Western NY | Medicare Advantage | $12,090.97 | ↓ -6% |
| United Healthcare | Medicare | $12,321.27 | ↓ -4% |
| Highmark Wholecare (prev Gateway) | Medicare | $12,435.28 | ↓ -3% |
| AmeriHealth Caritas | Medicare | $12,436.43 | ↓ -3% |
| Cigna | Medicare | $12,436.43 | ↓ -3% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12,436.43 | ↓ -3% |
| InterGroup | Health Coalition Partners/PPO | $13,913.25 | ↑ +8% |
| Independent Health | Medicare Advantage | $14,511.47 | ↑ +13% |
| Multiplan | PPO (Includes PHCS as a Payer) | $14,983.50 | ↑ +17% |
| Aetna | AXA/MMO | $14,983.50 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $17,124.00 | ↑ +33% |
| InterGroup | Beech Street | $17,124.00 | ↑ +33% |
| Independent Health | Commercial | $17,673.52 | ↑ +38% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins lv lead exist pm/icd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,358.40 | $918.74 – $10,775.64 |
| UPMC Carlisle | Carlisle | $15,540.60 | $961.47 – $22,015.85 |
| UPMC Community Osteopathic | Harrisburg | $15,540.60 | $961.47 – $22,015.85 |
| UPMC East | Monroeville | $3,883.80 | $918.74 – $10,775.64 |
| UPMC Hanover | Hanover | $15,540.60 | $961.47 – $15,996.05 |
| UPMC Lititz | Lititz | $15,540.60 | $961.47 – $16,082.45 |
| UPMC Memorial | York | $15,540.60 | $755.77 – $16,056.32 |
| UPMC Mercy | Pittsburgh | $28,245.60 | $927.28 – $10,975.18 |