Kit lead specify 5-6-5 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$24,616.20
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.
$41,027.00
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.
$30.00 with Univera vs $10,412.02 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $30.00 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicaid | $32.00 | ↓ -100% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $38.00 | ↓ -100% |
| Aetna | Commercial | $50.00 | ↓ -100% |
| Cigna | New Business ASO | $60.00 | ↓ -100% |
| Cigna | NBR ASO/FI | $60.00 | ↓ -100% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $66.00 | ↓ -100% |
| Univera | Commercial | $66.00 | ↓ -100% |
| Geisinger | Medicaid/CHIP | $66.00 | ↓ -100% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $67.66 | ↓ -100% |
| BCBS of Western NY | Commercial | $70.00 | ↓ -100% |
| UPMC Health Plan | Commercial | $73.60 | ↓ -100% |
| Cigna | EBR | $80.00 | ↓ -100% |
| Cigna | Commercial | $80.00 | ↓ -100% |
| Aetna | Medicare | $80.00 | ↓ -100% |
| United Healthcare | Commercial | $90.90 | ↓ -100% |
| Highmark Wholecare (prev Gateway) | Medicare | $100.00 | ↓ -100% |
| InterGroup | Health Coalition Partners/PPO | $130.00 | ↓ -99% |
| Aetna | AXA/MMO | $140.00 | ↓ -99% |
| Multiplan | PPO (Includes PHCS as a Payer) | $140.00 | ↓ -99% |
| InterGroup | Beech Street | $160.00 | ↓ -99% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $160.00 | ↓ -99% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $2,153.59 | ↓ -91% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $6,507.57 | ↓ -74% |
| Highmark BCBS of PA | UPMC Emergent | $10,412.02 | ↓ -58% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $25,039.80 | $37.62 – $13,170.92 |
| UPMC Bedford | Everett | $7,272.00 | $38.00 – $13,170.92 |
| UPMC Cole | Coudersport | $18,036.00 | $5,711.40 – $24,048.00 |
| UPMC East | Monroeville | $21,221.40 | $133.00 – $13,170.92 |
| UPMC Northwest | Seneca | $7,816.20 | $5,589.39 – $15,937.99 |
| UPMC Horizon-Greenville | Greenville | $11,638.80 | $5,488.59 – $13,170.92 |
| UPMC Jameson | New Castle | $7,176.60 | $582.60 – $13,170.92 |
| UPMC Kane | Kane | $2,910.60 | $9,698.74 – $9,698.74 |