healthcosts.net
Lower Back (Lumbar Spine) X-ray at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$438.00
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.
$730.00
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.
$25.96 with BCBS of Western NY vs $584.00 with InterGroup — 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 | $25.96 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $35.78 | ↓ -92% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $37.41 | ↓ -91% |
| Aetna | Medicaid | $39.04 | ↓ -91% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $42.70 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $45.21 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $48.24 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $49.06 | ↓ -89% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $50.78 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $55.44 | ↓ -87% |
| UPMC Health Plan | Commercial | $61.69 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $92.28 | ↓ -79% |
| Univera | Univera_Medicare_Hamot_2024 | $109.50 | ↓ -75% |
| Fidelis | Medicare | $117.01 | ↓ -73% |
| Aetna | Medicare | $119.35 | ↓ -73% |
| UPMC Health Plan | Partners/Select | $119.44 | ↓ -73% |
| Wellcare | Medicare Advantage | $120.52 | ↓ -72% |
| BCBS of Western NY | Medicare Advantage | $122.86 | ↓ -72% |
| United Healthcare | Medicare | $125.20 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $126.36 | ↓ -71% |
| AmeriHealth Caritas | Medicare | $126.37 | ↓ -71% |
| Cigna | Medicare | $126.37 | ↓ -71% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $126.37 | ↓ -71% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $129.02 | ↓ -71% |
| Independent Health | Medicare Advantage | $166.40 | ↓ -62% |
| Aetna | Commercial | $182.50 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $206.43 | ↓ -53% |
| Cigna | NBR ASO/FI | $219.00 | ↓ -50% |
| Cigna | New Business ASO | $219.00 | ↓ -50% |
| Independent Health | Commercial | $221.61 | ↓ -49% |
| Univera | Commercial | $240.90 | ↓ -45% |
| Cigna | EBR | $292.00 | ↓ -33% |
| Cigna | Commercial | $292.00 | ↓ -33% |
| United Healthcare | Commercial | $331.79 | ↓ -24% |
| InterGroup | Health Coalition Partners/PPO | $474.50 | ↑ +8% |
| Aetna | AXA/MMO | $511.00 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $511.00 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $584.00 | ↑ +33% |
| InterGroup | Beech Street | $584.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lower Back (Lumbar Spine) X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $33.98 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $34.28 – $594.15 |
| UPMC Carlisle | Carlisle | $262.80 | $29.48 – $372.30 |
| UPMC Altoona | Altoona | $208.80 | $22.50 – $278.40 |
| UPMC Bedford | Everett | $115.80 | $34.16 – $173.70 |
| UPMC Cole | Coudersport | $171.00 | $34.16 – $228.00 |
| UPMC Community Osteopathic | Harrisburg | $272.40 | $29.48 – $372.30 |
| UPMC Hanover | Hanover | $262.80 | $29.48 – $381.06 |