Insertion of new/replacement ppm w/transvenous electrode(s) ventricular 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.
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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.
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The hospital's undiscounted list price — almost no one pays this.
$507.30 with UPMC Health Plan vs $30,616.00 with United Healthcare — 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 Health Plan | Managed Medicaid | $507.30 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $530.36 | ↓ -95% |
| Aetna | Medicaid | $553.42 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $640.99 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $683.93 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $695.46 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $719.95 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $785.94 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $901.00 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $1,866.23 | ↓ -82% |
| Univera | Univera_Medicare_Hamot_2024 | $2,594.70 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,722.58 | ↓ -74% |
| Aetna | Commercial | $4,324.50 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $4,356.08 | ↓ -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% |
| Cigna | EBR | $6,919.20 | ↓ -33% |
| Cigna | Commercial | $6,919.20 | ↓ -33% |
| UPMC Health Plan | Commercial | $7,103.40 | ↓ -32% |
| 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% |
| AmeriHealth Caritas | Medicare | $12,436.43 | ↑ +20% |
| Cigna | Medicare | $12,436.43 | ↑ +20% |
| InterGroup | Beech Street | $13,838.40 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $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
Insertion of new/replacement ppm w/transvenous electrode(s) ventricular at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $4,138.20 | $461.18 – $5,517.60 |
| UPMC Carlisle | Carlisle | $24,630.00 | $585.70 – $34,892.50 |
| UPMC Cole | Coudersport | $990.00 | $457.38 – $1,954.88 |
| UPMC Community Osteopathic | Harrisburg | $24,630.00 | $585.70 – $34,892.50 |
| UPMC East | Monroeville | $3,774.00 | $507.30 – $10,476.31 |
| UPMC Hanover | Hanover | $24,630.00 | $585.70 – $15,996.05 |
| UPMC Jameson | New Castle | $17,091.00 | $507.30 – $13,469.54 |
| UPMC Lititz | Lititz | $24,630.00 | $511.65 – $1,828.26 |