Prostate biopsy, any mthd at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$334.20
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.
$557.00
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.
$83.55 with Univera vs $3,744.89 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $83.55 | ↓ -75% |
| Aetna | Commercial | $139.25 | ↓ -58% |
| United Healthcare | Commercial | $157.05 | ↓ -53% |
| Cigna | New Business ASO | $167.10 | ↓ -50% |
| Cigna | NBR ASO/FI | $167.10 | ↓ -50% |
| Univera | Commercial | $183.81 | ↓ -45% |
| UPMC Health Plan | Commercial | $204.98 | ↓ -39% |
| Cigna | Commercial | $222.80 | ↓ -33% |
| Cigna | EBR | $222.80 | ↓ -33% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $306.35 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $306.35 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $362.05 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $389.90 | ↑ +17% |
| Aetna | AXA/MMO | $389.90 | ↑ +17% |
| Fidelis | Medicare | $395.81 | ↑ +18% |
| Aetna | Medicare | $403.73 | ↑ +21% |
| UPMC Health Plan | Partners/Select | $404.04 | ↑ +21% |
| Wellcare | Medicare Advantage | $407.68 | ↑ +22% |
| BCBS of Western NY | Medicare Advantage | $415.60 | ↑ +24% |
| United Healthcare | Medicare | $423.52 | ↑ +27% |
| Highmark Wholecare (prev Gateway) | Medicare | $427.44 | ↑ +28% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $427.47 | ↑ +28% |
| AmeriHealth Caritas | Medicare | $427.47 | ↑ +28% |
| Cigna | Medicare | $427.47 | ↑ +28% |
| InterGroup | Beech Street | $445.60 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $445.60 | ↑ +33% |
| Independent Health | Medicare Advantage | $719.78 | ↑ +115% |
| BCBS of Western NY | Commercial | $723.43 | ↑ +116% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $774.58 | ↑ +132% |
| Independent Health | Commercial | $958.59 | ↑ +187% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,340.58 | ↑ +600% |
| Highmark BCBS of PA | UPMC Emergent | $3,744.89 | ↑ +1021% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Prostate biopsy, any mthd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $287.40 | $239.50 – $774.58 |
| UPMC Bedford | Everett | $308.40 | $123.74 – $462.60 |
| UPMC Carlisle | Carlisle | $643.20 | $146.86 – $911.20 |
| UPMC Cole | Coudersport | $1,301.40 | $53.00 – $1,735.20 |
| UPMC Community Osteopathic | Harrisburg | $643.20 | $214.40 – $911.20 |
| UPMC East | Monroeville | $308.40 | $127.95 – $781.96 |
| UPMC Northwest | Seneca | $308.40 | $129.14 – $370.39 |
| UPMC Hanover | Hanover | $643.20 | $259.00 – $549.82 |