Ins pm gen exist dual lead at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$36,471.60
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.
$60,786.00
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.
$484.74 with Highmark BCBS of PA vs $48,628.80 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 | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $484.74 | ↓ -99% |
| UPMC Work Partners | Workers Comp | $561.11 | ↓ -98% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,464.75 | ↓ -96% |
| Highmark BCBS of PA | UPMC Emergent | $2,343.58 | ↓ -94% |
| BCBS of Western NY | Commercial | $2,794.87 | ↓ -92% |
| Univera | Univera_Medicare_Hamot_2024 | $9,117.90 | ↓ -75% |
| Aetna | Commercial | $15,196.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $18,235.80 | ↓ -50% |
| Cigna | New Business ASO | $18,235.80 | ↓ -50% |
| Univera | Commercial | $20,059.38 | ↓ -45% |
| UPMC Health Plan | Commercial | $22,369.25 | ↓ -39% |
| Cigna | EBR | $24,314.40 | ↓ -33% |
| Cigna | Commercial | $24,314.40 | ↓ -33% |
| Fidelis | Medicare | $24,697.99 | ↓ -32% |
| Aetna | Medicare | $25,191.95 | ↓ -31% |
| UPMC Health Plan | Partners/Select | $25,211.71 | ↓ -31% |
| Wellcare | Medicare Advantage | $25,438.93 | ↓ -30% |
| BCBS of Western NY | Medicare Advantage | $25,932.89 | ↓ -29% |
| United Healthcare | Medicare | $26,426.85 | ↓ -28% |
| Highmark Wholecare (prev Gateway) | Medicare | $26,671.36 | ↓ -27% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $26,673.83 | ↓ -27% |
| AmeriHealth Caritas | Medicare | $26,673.83 | ↓ -27% |
| Cigna | Medicare | $26,673.83 | ↓ -27% |
| United Healthcare | Commercial | $27,121.00 | ↓ -26% |
| Independent Health | Medicare Advantage | $31,124.41 | ↓ -15% |
| Geisinger | Medicaid/CHIP | $33,432.30 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $33,432.30 | ↓ -8% |
| Independent Health | Commercial | $39,044.35 | ↑ +7% |
| InterGroup | Health Coalition Partners/PPO | $39,510.90 | ↑ +8% |
| Aetna | AXA/MMO | $42,550.20 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $42,550.20 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $48,628.80 | ↑ +33% |
| InterGroup | Beech Street | $48,628.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins pm gen exist dual lead at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,124.80 | $484.74 – $23,111.73 |
| Uniontown Hospital | Uniontown | $7,666.00 | $205.80 – $44,779.58 |
| UPMC East | Monroeville | not published | $489.35 – $23,539.72 |
| UPMC Presbyterian | Pittsburgh | not published | $489.35 – $23,539.72 |