Repos lv lead pm/icd at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$4,972.20
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.
$8,287.00
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.
$884.67 with UPMC Work Partners vs $12,002.06 with UPMC Health Plan — 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 Work Partners | Workers Comp | $884.67 | ↓ -82% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $892.58 | ↓ -82% |
| Univera | Univera_Medicare_Hamot_2024 | $1,243.05 | ↓ -75% |
| Aetna | Commercial | $2,071.75 | ↓ -58% |
| BCBS of Western NY | Commercial | $2,177.52 | ↓ -56% |
| Cigna | New Business ASO | $2,486.10 | ↓ -50% |
| Cigna | NBR ASO/FI | $2,486.10 | ↓ -50% |
| United Healthcare | Commercial | $2,608.00 | ↓ -48% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $2,697.13 | ↓ -46% |
| Univera | Commercial | $2,734.71 | ↓ -45% |
| Cigna | EBR | $3,314.80 | ↓ -33% |
| Cigna | Commercial | $3,314.80 | ↓ -33% |
| Fidelis | Medicare | $3,463.26 | ↓ -30% |
| Aetna | Medicare | $3,532.53 | ↓ -29% |
| UPMC Health Plan | Partners/Select | $3,535.30 | ↓ -29% |
| Wellcare | Medicare Advantage | $3,567.16 | ↓ -28% |
| BCBS of Western NY | Medicare Advantage | $3,636.42 | ↓ -27% |
| United Healthcare | Medicare | $3,705.69 | ↓ -25% |
| Highmark Wholecare (prev Gateway) | Medicare | $3,739.97 | ↓ -25% |
| Cigna | Medicare | $3,740.32 | ↓ -25% |
| AmeriHealth Caritas | Medicare | $3,740.32 | ↓ -25% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,740.32 | ↓ -25% |
| Highmark BCBS of PA | UPMC Emergent | $4,315.37 | ↓ -13% |
| Independent Health | Medicare Advantage | $4,364.40 | ↓ -12% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $4,557.85 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $4,557.85 | ↓ -8% |
| Independent Health | Commercial | $5,097.31 | ↑ +3% |
| InterGroup | Health Coalition Partners/PPO | $5,386.55 | ↑ +8% |
| Aetna | AXA/MMO | $5,800.90 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $5,800.90 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $6,629.60 | ↑ +33% |
| InterGroup | Beech Street | $6,629.60 | ↑ +33% |
| UPMC Health Plan | Commercial | $12,002.06 | ↑ +141% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Repos lv lead pm/icd at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $4,201.80 | $925.82 – $5,952.55 |
| UPMC Community Osteopathic | Harrisburg | $4,201.80 | $925.82 – $9,667.11 |
| UPMC Hanover | Hanover | $4,201.80 | $925.82 – $9,667.11 |
| UPMC Lititz | Lititz | $4,201.80 | $925.82 – $9,667.11 |
| UPMC Memorial | York | $4,201.80 | $727.49 – $9,667.11 |
| UPMC Passavant-McCandless | Pittsburgh | $3,023.40 | $884.67 – $3,300.84 |
| UPMC Presbyterian | Pittsburgh | $5,535.00 | $901.08 – $3,677.82 |
| UPMC Somerset | Somerset | $4,201.80 | $883.55 – $3,240.52 |