M/phmtrc alys ishquant/semiq at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$426.00
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.
$710.00
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.
$93.18 with Highmark BCBS of PA vs $858.76 with BCBS of Western NY — 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 | $93.18 | ↓ -78% |
| Univera | Univera_Medicare_Hamot_2024 | $106.50 | ↓ -75% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $161.78 | ↓ -62% |
| Aetna | Commercial | $177.50 | ↓ -58% |
| UPMC Health Plan | Managed Medicaid | $177.96 | ↓ -58% |
| United Healthcare | Commercial | $183.62 | ↓ -57% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $186.05 | ↓ -56% |
| Fidelis | Medicare | $188.55 | ↓ -56% |
| Aetna | Medicare | $192.32 | ↓ -55% |
| UPMC Health Plan | Partners/Select | $192.47 | ↓ -55% |
| Aetna | Medicaid | $194.14 | ↓ -54% |
| Wellcare | Medicare Advantage | $194.21 | ↓ -54% |
| BCBS of Western NY | Medicare Advantage | $197.98 | ↓ -54% |
| United Healthcare | Medicare | $201.75 | ↓ -53% |
| Highmark Wholecare (prev Gateway) | Medicare | $203.62 | ↓ -52% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $203.63 | ↓ -52% |
| AmeriHealth Caritas | Medicare | $203.63 | ↓ -52% |
| Cigna | Medicare | $203.63 | ↓ -52% |
| Cigna | NBR ASO/FI | $213.00 | ↓ -50% |
| Cigna | New Business ASO | $213.00 | ↓ -50% |
| Independent Health | Medicare Advantage | $213.04 | ↓ -50% |
| Geisinger | Medicaid/CHIP | $224.86 | ↓ -47% |
| Univera | Commercial | $234.30 | ↓ -45% |
| Highmark Wholecare (prev Gateway) | Medicaid | $239.92 | ↓ -44% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $252.55 | ↓ -41% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $275.71 | ↓ -35% |
| UPMC Work Partners | Workers Comp | $279.34 | ↓ -34% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $281.57 | ↓ -34% |
| Independent Health | Commercial | $283.73 | ↓ -33% |
| Cigna | EBR | $284.00 | ↓ -33% |
| Cigna | Commercial | $284.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $327.82 | ↓ -23% |
| Highmark BCBS of PA | UPMC Emergent | $450.51 | ↑ +6% |
| InterGroup | Health Coalition Partners/PPO | $461.50 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $497.00 | ↑ +17% |
| Aetna | AXA/MMO | $497.00 | ↑ +17% |
| InterGroup | Beech Street | $568.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $568.00 | ↑ +33% |
| BCBS of Western NY | Commercial | $858.76 | ↑ +102% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
M/phmtrc alys ishquant/semiq at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $463.20 | $93.18 – $617.60 |
| UPMC Carlisle | Carlisle | $337.20 | $76.99 – $477.70 |
| UPMC Cole | Coudersport | $1,052.40 | $53.00 – $1,403.20 |
| UPMC Community Osteopathic | Harrisburg | $337.20 | $112.40 – $656.49 |
| UPMC East | Monroeville | $370.20 | $94.07 – $493.60 |
| UPMC Northwest | Seneca | $646.80 | $148.16 – $279.34 |
| UPMC Horizon-Greenville | Greenville | $400.20 | $146.27 – $279.34 |
| UPMC Jameson | New Castle | $528.00 | $94.83 – $279.34 |