M/phmtrc alysishquant/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.
$30.54 with Highmark BCBS of PA vs $568.00 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $30.54 | ↓ -93% |
| United Healthcare | Commercial | $48.69 | ↓ -89% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $55.85 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $61.44 | ↓ -86% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $64.23 | ↓ -85% |
| Aetna | Medicaid | $67.02 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $77.63 | ↓ -82% |
| Highmark Wholecare (prev Gateway) | Medicaid | $82.83 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $87.19 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $92.28 | ↓ -78% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $95.18 | ↓ -78% |
| UPMC Work Partners | Workers Comp | $96.27 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $106.50 | ↓ -75% |
| Highmark BCBS of PA | UPMC Emergent | $147.65 | ↓ -65% |
| Aetna | Commercial | $177.50 | ↓ -58% |
| Cigna | New Business ASO | $213.00 | ↓ -50% |
| Cigna | NBR ASO/FI | $213.00 | ↓ -50% |
| Univera | Commercial | $234.30 | ↓ -45% |
| BCBS of Western NY | Commercial | $240.11 | ↓ -44% |
| Cigna | Commercial | $284.00 | ↓ -33% |
| Aetna | Medicare | $284.00 | ↓ -33% |
| Cigna | EBR | $284.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $339.73 | ↓ -20% |
| Highmark Wholecare (prev Gateway) | Medicare | $355.00 | ↓ -17% |
| InterGroup | Health Coalition Partners/PPO | $461.50 | ↑ +8% |
| Aetna | AXA/MMO | $497.00 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $497.00 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $568.00 | ↑ +33% |
| InterGroup | Beech Street | $568.00 | ↑ +33% |
Visitor-reported prices
Comments
M/phmtrc alysishquant/semiq at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $152.40 | $30.54 – $203.20 |
| UPMC Carlisle | Carlisle | $166.20 | $37.95 – $235.45 |
| UPMC Cole | Coudersport | $514.80 | $53.00 – $686.40 |
| UPMC Community Osteopathic | Harrisburg | $166.20 | $47.36 – $680.34 |
| UPMC East | Monroeville | $1,038.00 | $30.83 – $1,384.00 |
| UPMC Northwest | Seneca | $646.80 | $61.44 – $96.27 |
| UPMC Horizon-Greenville | Greenville | $400.20 | $49.38 – $96.27 |
| UPMC Jameson | New Castle | $112.80 | $31.08 – $244.91 |