Intracranial complete study at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$1,173.60
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.
$1,956.00
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.
$167.79 with Highmark BCBS of PA vs $1,564.80 with Multiplan — 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 | $167.79 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $180.66 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $188.88 | ↓ -84% |
| Aetna | Medicaid | $197.09 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $228.28 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $243.57 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $247.67 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $256.40 | ↓ -78% |
| UPMC Health Plan | Commercial | $263.00 | ↓ -78% |
| Fidelis | Medicare | $265.97 | ↓ -77% |
| Aetna | Medicare | $271.29 | ↓ -77% |
| UPMC Health Plan | Partners/Select | $271.50 | ↓ -77% |
| Wellcare | Medicare Advantage | $273.95 | ↓ -77% |
| BCBS of Western NY | Medicare Advantage | $279.27 | ↓ -76% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $279.90 | ↓ -76% |
| United Healthcare | Medicare | $284.59 | ↓ -76% |
| Highmark Wholecare (prev Gateway) | Medicare | $287.22 | ↓ -76% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $287.25 | ↓ -76% |
| AmeriHealth Caritas | Medicare | $287.25 | ↓ -76% |
| Cigna | Medicare | $287.25 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $293.40 | ↓ -75% |
| Independent Health | Medicare Advantage | $345.98 | ↓ -71% |
| Independent Health | Commercial | $460.77 | ↓ -61% |
| Aetna | Commercial | $489.00 | ↓ -58% |
| UPMC Work Partners | Workers Comp | $493.75 | ↓ -58% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $507.03 | ↓ -57% |
| Cigna | NBR ASO/FI | $586.80 | ↓ -50% |
| Cigna | New Business ASO | $586.80 | ↓ -50% |
| BCBS of Western NY | Commercial | $636.43 | ↓ -46% |
| Univera | Commercial | $645.48 | ↓ -45% |
| Cigna | Commercial | $782.40 | ↓ -33% |
| Cigna | EBR | $782.40 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $811.24 | ↓ -31% |
| United Healthcare | Commercial | $889.00 | ↓ -24% |
| InterGroup | Health Coalition Partners/PPO | $1,271.40 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,369.20 | ↑ +17% |
| Aetna | AXA/MMO | $1,369.20 | ↑ +17% |
| InterGroup | Beech Street | $1,564.80 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $1,564.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Intracranial complete study at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $769.80 | $119.34 – $1,026.40 |
| UPMC Community Osteopathic | Harrisburg | $481.20 | $151.56 – $1,049.13 |
| UPMC Magee | Pittsburgh | $889.20 | $169.39 – $493.75 |
| UPMC Muncy | Muncy | $1,981.20 | $152.76 – $528.20 |
| UPMC Passavant-McCandless | Pittsburgh | $1,169.40 | $169.39 – $574.13 |
| UPMC Somerset | Somerset | $481.20 | $131.27 – $306.13 |