Prgrmg eval implantable dfb at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$585.60
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.
$976.00
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.
$41.03 with Fidelis vs $780.80 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 |
|---|---|---|---|
| Fidelis | Medicare | $41.03 | ↓ -93% |
| Aetna | Medicare | $41.85 | ↓ -93% |
| UPMC Health Plan | Partners/Select | $41.88 | ↓ -93% |
| Wellcare | Medicare Advantage | $42.26 | ↓ -93% |
| BCBS of Western NY | Medicare Advantage | $43.08 | ↓ -93% |
| United Healthcare | Medicare | $43.90 | ↓ -93% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $44.31 | ↓ -92% |
| Highmark Wholecare (prev Gateway) | Medicare | $44.31 | ↓ -92% |
| AmeriHealth Caritas | Medicare | $44.31 | ↓ -92% |
| Cigna | Medicare | $44.31 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $53.76 | ↓ -91% |
| Independent Health | Medicare Advantage | $53.82 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $64.44 | ↓ -89% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $67.37 | ↓ -88% |
| Aetna | Medicaid | $70.30 | ↓ -88% |
| Independent Health | Commercial | $71.67 | ↓ -88% |
| Geisinger | Medicaid/CHIP | $81.42 | ↓ -86% |
| Highmark Wholecare (prev Gateway) | Medicaid | $86.87 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $88.34 | ↓ -85% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $91.45 | ↓ -84% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $99.83 | ↓ -83% |
| UPMC Health Plan | Commercial | $139.90 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $146.40 | ↓ -75% |
| UPMC Work Partners | Workers Comp | $153.32 | ↓ -74% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $162.44 | ↓ -72% |
| Aetna | Commercial | $244.00 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $259.90 | ↓ -56% |
| BCBS of Western NY | Commercial | $277.46 | ↓ -53% |
| Cigna | New Business ASO | $292.80 | ↓ -50% |
| Cigna | NBR ASO/FI | $292.80 | ↓ -50% |
| Univera | Commercial | $322.08 | ↓ -45% |
| Cigna | EBR | $390.40 | ↓ -33% |
| Cigna | Commercial | $390.40 | ↓ -33% |
| United Healthcare | Commercial | $443.59 | ↓ -24% |
| InterGroup | Health Coalition Partners/PPO | $634.40 | ↑ +8% |
| Aetna | AXA/MMO | $683.20 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $683.20 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $780.80 | ↑ +33% |
| InterGroup | Beech Street | $780.80 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Prgrmg eval implantable dfb at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $379.80 | $16.63 – $506.40 |
| UPMC Cole | Coudersport | $183.00 | $61.51 – $244.00 |
| UPMC Jameson | New Castle | $332.40 | $19.12 – $153.32 |
| UPMC Magee | Pittsburgh | $318.00 | $33.27 – $153.32 |
| UPMC Mercy | Pittsburgh | $183.60 | $29.63 – $171.31 |
| UPMC Passavant-McCandless | Pittsburgh | $298.80 | $33.04 – $178.28 |
| UPMC Presbyterian | Pittsburgh | $649.80 | $19.96 – $199.20 |
| UPMC St. Margaret | Pittsburgh | $316.80 | $30.69 – $153.32 |