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Lower Back (Lumbar Spine) MRI (with and without contrast) at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$2,536.20
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.
$4,227.00
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.
$281.64 with BCBS of Western NY vs $5,814.46 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 |
|---|---|---|---|
| BCBS of Western NY | Commercial | $281.64 | ↓ -89% |
| UPMC Health Plan | Managed Medicaid | $372.90 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $389.85 | ↓ -85% |
| Fidelis | Medicare | $392.96 | ↓ -85% |
| Aetna | Medicare | $400.82 | ↓ -84% |
| UPMC Health Plan | Partners/Select | $401.13 | ↓ -84% |
| Wellcare | Medicare Advantage | $404.75 | ↓ -84% |
| Aetna | Medicaid | $406.80 | ↓ -84% |
| BCBS of Western NY | Medicare Advantage | $412.61 | ↓ -84% |
| United Healthcare | Medicare | $420.47 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $424.36 | ↓ -83% |
| AmeriHealth Caritas | Medicare | $424.40 | ↓ -83% |
| Cigna | Medicare | $424.40 | ↓ -83% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $424.40 | ↓ -83% |
| Geisinger | Medicaid/CHIP | $471.18 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $502.74 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $511.21 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $529.21 | ↓ -79% |
| Independent Health | Medicare Advantage | $566.90 | ↓ -78% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $577.72 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $634.05 | ↓ -75% |
| Independent Health | Commercial | $755.01 | ↓ -70% |
| Aetna | Commercial | $1,056.75 | ↓ -58% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $1,202.64 | ↓ -53% |
| Cigna | NBR ASO/FI | $1,268.10 | ↓ -50% |
| Cigna | New Business ASO | $1,268.10 | ↓ -50% |
| Univera | Commercial | $1,394.91 | ↓ -45% |
| United Healthcare | Commercial | $1,478.00 | ↓ -42% |
| Cigna | EBR | $1,690.80 | ↓ -33% |
| Cigna | Commercial | $1,690.80 | ↓ -33% |
| UPMC Health Plan | Commercial | $1,894.95 | ↓ -25% |
| UPMC Work Partners | Workers Comp | $2,610.88 | ↑ +3% |
| InterGroup | Health Coalition Partners/PPO | $2,747.55 | ↑ +8% |
| Aetna | AXA/MMO | $2,958.90 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $2,958.90 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $3,381.60 | ↑ +33% |
| InterGroup | Beech Street | $3,381.60 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $3,634.07 | ↑ +43% |
| Highmark BCBS of PA | UPMC Emergent | $5,814.46 | ↑ +129% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Lower Back (Lumbar Spine) MRI (with and without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,999.40 | $316.41 – $8,499.15 |
| UPMC East | Monroeville | $6,218.40 | $341.40 – $8,291.20 |
| UPMC Carlisle | Carlisle | $2,713.80 | $338.22 – $3,844.55 |
| UPMC Bedford | Everett | $2,884.20 | $122.85 – $4,326.30 |
| UPMC Altoona | Altoona | $2,604.00 | $269.00 – $3,472.00 |
| UPMC Cole | Coudersport | $1,907.40 | $355.95 – $2,543.20 |
| UPMC Community Osteopathic | Harrisburg | $2,713.80 | $347.79 – $3,844.55 |
| UPMC Hanover | Hanover | $2,713.80 | $337.76 – $3,935.01 |