Removal of hip foreign body 27087 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$4,596.00
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.
$7,660.00
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.
$71.50 with UPMC Health Plan vs $6,128.00 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $71.50 | ↓ -98% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $74.75 | ↓ -98% |
| Aetna | Medicaid | $78.00 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $90.34 | ↓ -98% |
| Highmark Wholecare (prev Gateway) | Medicaid | $96.39 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $98.02 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $101.47 | ↓ -98% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $110.77 | ↓ -98% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $836.96 | ↓ -82% |
| UPMC Work Partners | Workers Comp | $1,029.61 | ↓ -78% |
| Univera | Univera_Medicare_Hamot_2024 | $1,149.00 | ↓ -75% |
| United Healthcare | Commercial | $1,754.00 | ↓ -62% |
| Aetna | Commercial | $1,915.00 | ↓ -58% |
| Cigna | NBR ASO/FI | $2,298.00 | ↓ -50% |
| Cigna | New Business ASO | $2,298.00 | ↓ -50% |
| Univera | Commercial | $2,527.80 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,529.08 | ↓ -45% |
| BCBS of Western NY | Commercial | $2,794.87 | ↓ -39% |
| Cigna | Commercial | $3,064.00 | ↓ -33% |
| Cigna | EBR | $3,064.00 | ↓ -33% |
| UPMC Health Plan | Commercial | $3,273.70 | ↓ -29% |
| Fidelis | Medicare | $3,570.11 | ↓ -22% |
| Aetna | Medicare | $3,641.51 | ↓ -21% |
| UPMC Health Plan | Partners/Select | $3,644.37 | ↓ -21% |
| Wellcare | Medicare Advantage | $3,677.21 | ↓ -20% |
| BCBS of Western NY | Medicare Advantage | $3,748.62 | ↓ -18% |
| United Healthcare | Medicare | $3,820.02 | ↓ -17% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,855.36 | ↓ -16% |
| Cigna | Medicare | $3,855.72 | ↓ -16% |
| AmeriHealth Caritas | Medicare | $3,855.72 | ↓ -16% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,855.72 | ↓ -16% |
| Highmark BCBS of PA | UPMC Emergent | $4,046.49 | ↓ -12% |
| Independent Health | Medicare Advantage | $4,499.05 | ↓ -2% |
| InterGroup | Health Coalition Partners/PPO | $4,979.00 | ↑ +8% |
| Independent Health | Commercial | $5,093.35 | ↑ +11% |
| Multiplan | PPO (Includes PHCS as a Payer) | $5,362.00 | ↑ +17% |
| Aetna | AXA/MMO | $5,362.00 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $6,128.00 | ↑ +33% |
| InterGroup | Beech Street | $6,128.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Removal of hip foreign body 27087 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $5,152.80 | $65.00 – $6,870.40 |
| UPMC Bedford | Everett | $5,247.60 | $68.25 – $7,871.40 |
| UPMC East | Monroeville | $4,669.80 | $71.50 – $6,226.40 |
| UPMC Northwest | Seneca | $5,009.40 | $71.50 – $3,248.02 |
| UPMC Horizon-Greenville | Greenville | $3,645.60 | $71.50 – $3,340.82 |
| UPMC Jameson | New Castle | $3,645.60 | $71.50 – $4,176.02 |
| UPMC Magee | Pittsburgh | $3,961.20 | $71.50 – $3,340.82 |
| UPMC McKeesport | Mckeesport | $4,303.80 | $71.50 – $3,402.68 |