healthcosts.net
Shoulder MRI (with contrast) at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$1,948.80
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.
$3,248.00
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.
$201.09 with BCBS of Western NY vs $2,609.59 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 |
|---|---|---|---|
| BCBS of Western NY | Commercial | $201.09 | ↓ -90% |
| Univera | Univera_Medicare_Hamot_2024 | $487.20 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $539.76 | ↓ -72% |
| UPMC Health Plan | Commercial | $794.63 | ↓ -59% |
| Aetna | Commercial | $812.00 | ↓ -58% |
| Fidelis | Medicare | $869.32 | ↓ -55% |
| Aetna | Medicare | $886.71 | ↓ -54% |
| UPMC Health Plan | Partners/Select | $887.40 | ↓ -54% |
| Wellcare | Medicare Advantage | $895.40 | ↓ -54% |
| BCBS of Western NY | Medicare Advantage | $912.79 | ↓ -53% |
| United Healthcare | Medicare | $930.17 | ↓ -52% |
| Highmark Wholecare (prev Gateway) | Medicare | $938.78 | ↓ -52% |
| AmeriHealth Caritas | Medicare | $938.87 | ↓ -52% |
| Cigna | Medicare | $938.87 | ↓ -52% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $938.87 | ↓ -52% |
| Cigna | NBR ASO/FI | $974.40 | ↓ -50% |
| Cigna | New Business ASO | $974.40 | ↓ -50% |
| Independent Health | Medicare Advantage | $1,010.76 | ↓ -48% |
| Univera | Commercial | $1,071.84 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $1,109.81 | ↓ -43% |
| Cigna | EBR | $1,299.20 | ↓ -33% |
| Cigna | Commercial | $1,299.20 | ↓ -33% |
| Independent Health | Commercial | $1,346.13 | ↓ -31% |
| United Healthcare | Commercial | $1,478.00 | ↓ -24% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,631.01 | ↓ -16% |
| Geisinger | Medicaid/CHIP | $1,786.40 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,786.40 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $2,111.20 | ↑ +8% |
| Aetna | AXA/MMO | $2,273.60 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $2,273.60 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $2,598.40 | ↑ +33% |
| InterGroup | Beech Street | $2,598.40 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $2,609.59 | ↑ +34% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder MRI (with contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $4,621.20 | $441.61 – $6,546.70 |
| UPMC East | Monroeville | $5,074.20 | $437.75 – $6,765.60 |
| UPMC Horizon-Greenville | Greenville | $4,192.80 | $443.23 – $5,939.80 |
| UPMC Jameson | New Castle | $3,155.40 | $327.20 – $4,365.68 |
| UPMC Lititz | Lititz | $2,713.80 | $327.20 – $3,844.55 |
| UPMC McKeesport | Mckeesport | $4,936.20 | $449.34 – $6,992.95 |
| UPMC Altoona | Altoona | $2,119.20 | $425.00 – $2,825.60 |
| UPMC Carlisle | Carlisle | $2,713.80 | $403.15 – $3,844.55 |