Oth resp proc, group at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$80.40
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.
$134.00
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.
$9.42 with Highmark BCBS of PA vs $198.79 with Molina Healthcare of 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 | $9.42 | ↓ -88% |
| Univera | Univera_Medicare_Hamot_2024 | $20.10 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $28.48 | ↓ -65% |
| BCBS of Western NY | Commercial | $30.77 | ↓ -62% |
| Aetna | Commercial | $33.50 | ↓ -58% |
| Cigna | New Business ASO | $40.20 | ↓ -50% |
| Cigna | NBR ASO/FI | $40.20 | ↓ -50% |
| Univera | Commercial | $44.22 | ↓ -45% |
| Highmark BCBS of PA | UPMC Emergent | $45.56 | ↓ -43% |
| UPMC Health Plan | Commercial | $49.31 | ↓ -39% |
| Cigna | Commercial | $53.60 | ↓ -33% |
| Cigna | EBR | $53.60 | ↓ -33% |
| Aetna | Medicare | $53.60 | ↓ -33% |
| United Healthcare | Commercial | $60.90 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $67.00 | ↓ -17% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $73.70 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $73.70 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $87.10 | ↑ +8% |
| Fidelis | Child Health Plus/Family Health Plus/Medicaid | $88.35 | ↑ +10% |
| Aetna | AXA/MMO | $93.80 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $93.80 | ↑ +17% |
| InterGroup | Beech Street | $107.20 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $107.20 | ↑ +33% |
| Fidelis | Essential Plan | $198.79 | ↑ +147% |
| Molina Healthcare of NY | CHIP (For Kids)/Essential Plan/Medicaid | $198.79 | ↑ +147% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, group at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $304.80 | $27.14 – $431.80 |
| UPMC Hanover | Hanover | $304.80 | $27.14 – $60.54 |
| UPMC Jameson | New Castle | $58.80 | $9.59 – $46.77 |
| UPMC Lititz | Lititz | $304.80 | $27.14 – $60.54 |
| UPMC McKeesport | Mckeesport | $58.80 | $9.51 – $41.16 |
| UPMC Memorial | York | $304.80 | $7.68 – $60.54 |
| UPMC Mercy | Pittsburgh | $38.40 | $9.42 – $47.80 |
| UPMC Passavant-McCandless | Pittsburgh | $72.00 | $9.51 – $41.16 |