Ins/rpl pm w/tv ld atrl at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$10,378.80
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.
?
What you pay up front if you don't use insurance.
$17,298.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$786.48 with Highmark BCBS of PA vs $30,616.00 with United Healthcare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $786.48 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $1,778.02 | ↓ -83% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,376.52 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $2,594.70 | ↓ -75% |
| Highmark BCBS of PA | UPMC Emergent | $3,802.40 | ↓ -63% |
| Aetna | Commercial | $4,324.50 | ↓ -58% |
| BCBS of Western NY | Commercial | $4,694.96 | ↓ -55% |
| Cigna | New Business ASO | $5,189.40 | ↓ -50% |
| Cigna | NBR ASO/FI | $5,189.40 | ↓ -50% |
| Univera | Commercial | $5,708.34 | ↓ -45% |
| UPMC Health Plan | Commercial | $6,365.66 | ↓ -39% |
| Cigna | Commercial | $6,919.20 | ↓ -33% |
| Cigna | EBR | $6,919.20 | ↓ -33% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $9,513.90 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $9,513.90 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $11,243.70 | ↑ +8% |
| Fidelis | Medicare | $11,515.21 | ↑ +11% |
| Aetna | Medicare | $11,745.51 | ↑ +13% |
| UPMC Health Plan | Partners/Select | $11,754.73 | ↑ +13% |
| Wellcare | Medicare Advantage | $11,860.67 | ↑ +14% |
| BCBS of Western NY | Medicare Advantage | $12,090.97 | ↑ +16% |
| Aetna | AXA/MMO | $12,108.60 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $12,108.60 | ↑ +17% |
| United Healthcare | Medicare | $12,321.27 | ↑ +19% |
| Highmark Wholecare (prev Gateway) | Medicare | $12,435.28 | ↑ +20% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $12,436.43 | ↑ +20% |
| Cigna | Medicare | $12,436.43 | ↑ +20% |
| AmeriHealth Caritas | Medicare | $12,436.43 | ↑ +20% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $13,838.40 | ↑ +33% |
| InterGroup | Beech Street | $13,838.40 | ↑ +33% |
| Independent Health | Medicare Advantage | $14,511.47 | ↑ +40% |
| Independent Health | Commercial | $17,673.52 | ↑ +70% |
| United Healthcare | Commercial | $30,616.00 | ↑ +195% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm w/tv ld atrl at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $25,170.00 | $1,016.56 – $35,657.50 |
| UPMC Community Osteopathic | Harrisburg | $25,170.00 | $1,016.56 – $35,657.50 |
| UPMC East | Monroeville | $3,294.60 | $793.97 – $10,775.64 |
| UPMC Lititz | Lititz | $25,170.00 | $486.93 – $1,754.22 |
| UPMC Memorial | York | $25,170.00 | $486.93 – $1,766.45 |
| UPMC Passavant-McCandless | Pittsburgh | $15,256.20 | $793.97 – $10,975.18 |
| UPMC Presbyterian | Pittsburgh | $17,949.60 | $793.97 – $10,975.18 |
| UPMC Somerset | Somerset | $25,170.00 | $778.52 – $1,676.25 |