Mucopolysaccharides at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$318.00
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.
$530.00
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.
$18.00 with Health Partners Plans (Jefferson Health Plan) vs $424.00 with Multiplan — 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 |
|---|---|---|---|
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $18.00 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $19.80 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $20.70 | ↓ -93% |
| Aetna | Medicaid | $21.60 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $25.02 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicaid | $26.69 | ↓ -92% |
| United Healthcare | Commercial | $27.37 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $28.10 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $28.17 | ↓ -91% |
| Fidelis | Medicare | $28.50 | ↓ -91% |
| Aetna | Medicare | $29.07 | ↓ -91% |
| UPMC Health Plan | Partners/Select | $29.09 | ↓ -91% |
| Independent Health | Medicare Advantage | $29.36 | ↓ -91% |
| Wellcare | Medicare Advantage | $29.36 | ↓ -91% |
| Independent Health | Commercial | $29.36 | ↓ -91% |
| BCBS of Western NY | Medicare Advantage | $29.93 | ↓ -91% |
| United Healthcare | Medicare | $30.50 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $30.68 | ↓ -90% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $30.78 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $30.78 | ↓ -90% |
| AmeriHealth Caritas | Medicare | $30.78 | ↓ -90% |
| Cigna | Medicare | $30.78 | ↓ -90% |
| BCBS of Western NY | Commercial | $39.06 | ↓ -88% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $54.11 | ↓ -83% |
| Univera | Univera_Medicare_Hamot_2024 | $79.50 | ↓ -75% |
| UPMC Health Plan | Commercial | $81.93 | ↓ -74% |
| Aetna | Commercial | $132.50 | ↓ -58% |
| Cigna | New Business ASO | $159.00 | ↓ -50% |
| Cigna | NBR ASO/FI | $159.00 | ↓ -50% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $163.51 | ↓ -49% |
| Univera | Commercial | $174.90 | ↓ -45% |
| Cigna | EBR | $212.00 | ↓ -33% |
| Cigna | Commercial | $212.00 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $261.61 | ↓ -18% |
| InterGroup | Health Coalition Partners/PPO | $344.50 | ↑ +8% |
| Aetna | AXA/MMO | $371.00 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $371.00 | ↑ +17% |
| InterGroup | Beech Street | $424.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $424.00 | ↑ +33% |
Visitor-reported prices
Comments
Mucopolysaccharides at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $280.80 | $18.00 – $374.40 |
| UPMC East | Monroeville | $217.80 | $18.00 – $290.40 |
| UPMC Northwest | Seneca | $223.80 | $19.80 – $30.68 |
| UPMC Horizon-Greenville | Greenville | $223.20 | $18.00 – $53.48 |
| UPMC Jameson | New Castle | $226.20 | $19.80 – $55.06 |
| UPMC Kane | Kane | $279.00 | $19.80 – $123.01 |
| UPMC Magee | Pittsburgh | $162.00 | $19.80 – $54.62 |
| UPMC McKeesport | Mckeesport | $217.80 | $19.80 – $54.62 |