Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$39,445.80
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.
$65,743.00
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.
$1,587.58 with Highmark BCBS of PA vs $54,885.71 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 | $1,587.58 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $3,429.22 | ↓ -91% |
| UPMC Health Plan | Commercial | $4,476.08 | ↓ -89% |
| BCBS of Western NY | Commercial | $4,694.96 | ↓ -88% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $4,797.25 | ↓ -88% |
| Highmark BCBS of PA | UPMC Emergent | $7,675.54 | ↓ -81% |
| Univera | Univera_Medicare_Hamot_2024 | $9,861.45 | ↓ -75% |
| Aetna | Commercial | $16,435.75 | ↓ -58% |
| Cigna | NBR ASO/FI | $19,722.90 | ↓ -50% |
| Cigna | New Business ASO | $19,722.90 | ↓ -50% |
| Univera | Commercial | $21,695.19 | ↓ -45% |
| Cigna | Commercial | $26,297.20 | ↓ -33% |
| Cigna | EBR | $26,297.20 | ↓ -33% |
| Fidelis | Medicare | $35,278.00 | ↓ -11% |
| Aetna | Medicare | $35,983.56 | ↓ -9% |
| UPMC Health Plan | Partners/Select | $36,011.78 | ↓ -9% |
| Geisinger | Medicaid/CHIP | $36,158.65 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $36,158.65 | ↓ -8% |
| Wellcare | Medicare Advantage | $36,336.34 | ↓ -8% |
| BCBS of Western NY | Medicare Advantage | $37,041.90 | ↓ -6% |
| United Healthcare | Medicare | $37,747.46 | ↓ -4% |
| Highmark Wholecare (prev Gateway) | Medicare | $38,096.71 | ↓ -3% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $38,100.24 | ↓ -3% |
| Cigna | Medicare | $38,100.24 | ↓ -3% |
| AmeriHealth Caritas | Medicare | $38,100.24 | ↓ -3% |
| InterGroup | Health Coalition Partners/PPO | $42,732.95 | ↑ +8% |
| United Healthcare | Commercial | $42,978.00 | ↑ +9% |
| Independent Health | Medicare Advantage | $44,457.34 | ↑ +13% |
| Aetna | AXA/MMO | $46,020.10 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $46,020.10 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $52,594.40 | ↑ +33% |
| InterGroup | Beech Street | $52,594.40 | ↑ +33% |
| Independent Health | Commercial | $54,885.71 | ↑ +39% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Insertion/replacement implantable defibrillator w/lead(s) single/dual chamber at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $6,433.20 | $1,587.58 – $33,012.22 |
| UPMC Carlisle | Carlisle | $48,933.60 | $1,016.56 – $69,322.60 |
| UPMC Community Osteopathic | Harrisburg | $48,933.60 | $1,016.56 – $69,322.60 |
| UPMC East | Monroeville | $73,004.40 | $1,602.70 – $97,339.20 |
| UPMC Hanover | Hanover | $48,933.60 | $1,016.56 – $49,005.49 |
| UPMC Lititz | Lititz | $48,933.60 | $1,016.56 – $49,270.19 |
| UPMC Memorial | York | $48,933.60 | $1,016.56 – $49,190.16 |
| UPMC Mercy | Pittsburgh | $41,292.60 | $1,587.58 – $33,623.56 |