Lung function test (mbc/mvv) at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$99.00
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.
$165.00
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.
$9.90 with UPMC Health Plan vs $132.00 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $9.90 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $10.35 | ↓ -90% |
| Aetna | Medicaid | $10.80 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $12.51 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $13.35 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $13.57 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $14.05 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $15.34 | ↓ -85% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.33 | ↓ -81% |
| Univera | Univera_Medicare_Hamot_2024 | $24.75 | ↓ -75% |
| UPMC Health Plan | Commercial | $32.69 | ↓ -67% |
| Aetna | Commercial | $41.25 | ↓ -58% |
| BCBS of Western NY | Commercial | $48.01 | ↓ -52% |
| Cigna | New Business ASO | $49.50 | ↓ -50% |
| Cigna | NBR ASO/FI | $49.50 | ↓ -50% |
| Univera | Commercial | $54.45 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $55.38 | ↓ -44% |
| Fidelis | Medicare | $65.36 | ↓ -34% |
| Cigna | Commercial | $66.00 | ↓ -33% |
| Cigna | EBR | $66.00 | ↓ -33% |
| Aetna | Medicare | $66.67 | ↓ -33% |
| UPMC Health Plan | Partners/Select | $66.72 | ↓ -33% |
| Wellcare | Medicare Advantage | $67.32 | ↓ -32% |
| UPMC Work Partners | Workers Comp | $67.73 | ↓ -32% |
| BCBS of Western NY | Medicare Advantage | $68.63 | ↓ -31% |
| United Healthcare | Medicare | $69.94 | ↓ -29% |
| Highmark Wholecare (prev Gateway) | Medicare | $70.58 | ↓ -29% |
| Cigna | Medicare | $70.59 | ↓ -29% |
| AmeriHealth Caritas | Medicare | $70.59 | ↓ -29% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $70.59 | ↓ -29% |
| United Healthcare | Commercial | $74.99 | ↓ -24% |
| Independent Health | Medicare Advantage | $81.67 | ↓ -18% |
| Highmark BCBS of PA | UPMC Emergent | $88.61 | ↓ -10% |
| InterGroup | Health Coalition Partners/PPO | $107.25 | ↑ +8% |
| Independent Health | Commercial | $108.76 | ↑ +10% |
| Aetna | AXA/MMO | $115.50 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $115.50 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $132.00 | ↑ +33% |
| InterGroup | Beech Street | $132.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Lung function test (mbc/mvv) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $163.80 | $5.40 – $218.40 |
| UPMC Community Osteopathic | Harrisburg | $155.40 | $6.20 – $70.60 |
| UPMC East | Monroeville | $109.20 | $9.90 – $145.60 |
| UPMC Northwest | Seneca | $115.80 | $9.90 – $67.46 |
| UPMC Hanover | Hanover | $145.20 | $7.07 – $90.78 |
| UPMC Horizon-Greenville | Greenville | $102.60 | $9.90 – $67.46 |
| UPMC Jameson | New Castle | $100.20 | $6.21 – $70.79 |
| UPMC Magee | Pittsburgh | $86.40 | $9.90 – $67.73 |