Ins pm gen w/exist mlt leads at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$2,586.00
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.
$4,310.00
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.
$450.02 with Highmark BCBS of PA vs $31,949.62 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $450.02 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $520.93 | ↓ -80% |
| Univera | Univera_Medicare_Hamot_2024 | $646.50 | ↓ -75% |
| Aetna | Commercial | $1,077.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $1,293.00 | ↓ -50% |
| Cigna | New Business ASO | $1,293.00 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,359.83 | ↓ -47% |
| Univera | Commercial | $1,422.30 | ↓ -45% |
| UPMC Health Plan | Commercial | $1,586.08 | ↓ -39% |
| Cigna | EBR | $1,724.00 | ↓ -33% |
| Cigna | Commercial | $1,724.00 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $2,175.70 | ↓ -16% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,370.50 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $2,370.50 | ↓ -8% |
| BCBS of Western NY | Commercial | $2,794.87 | ↑ +8% |
| InterGroup | Health Coalition Partners/PPO | $2,801.50 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,017.00 | ↑ +17% |
| Aetna | AXA/MMO | $3,017.00 | ↑ +17% |
| United Healthcare | Commercial | $3,411.00 | ↑ +32% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $3,448.00 | ↑ +33% |
| InterGroup | Beech Street | $3,448.00 | ↑ +33% |
| Fidelis | Medicare | $20,984.38 | ↑ +711% |
| Aetna | Medicare | $21,404.07 | ↑ +728% |
| UPMC Health Plan | Partners/Select | $21,420.86 | ↑ +728% |
| Wellcare | Medicare Advantage | $21,613.91 | ↑ +736% |
| BCBS of Western NY | Medicare Advantage | $22,033.60 | ↑ +752% |
| United Healthcare | Medicare | $22,453.29 | ↑ +768% |
| Highmark Wholecare (prev Gateway) | Medicare | $22,661.03 | ↑ +776% |
| Cigna | Medicare | $22,663.13 | ↑ +776% |
| AmeriHealth Caritas | Medicare | $22,663.13 | ↑ +776% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $22,663.13 | ↑ +776% |
| Independent Health | Medicare Advantage | $26,444.52 | ↑ +923% |
| Independent Health | Commercial | $31,949.62 | ↑ +1135% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins pm gen w/exist mlt leads at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $41,511.60 | $545.16 – $58,808.10 |
| UPMC Community Osteopathic | Harrisburg | $41,511.60 | $545.16 – $58,808.10 |
| UPMC Hanover | Hanover | $41,511.60 | $545.16 – $29,149.89 |
| UPMC Lititz | Lititz | $41,511.60 | $545.16 – $29,307.34 |
| UPMC Memorial | York | $41,511.60 | $366.78 – $29,259.74 |
| UPMC Presbyterian | Pittsburgh | $40,853.40 | $454.30 – $20,000.27 |
| UPMC Somerset | Somerset | $41,511.60 | $445.46 – $19,634.81 |
| UPMC Williamsport | Williamsport | $3,785.40 | $520.93 – $19,636.62 |