Sigmoidoscopy/submucosal injection 45335 at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$1,558.80
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.
?
What you pay up front if you don't use insurance.
$2,598.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$86.52 with UPMC Health Plan vs $2,834.08 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $86.52 | ↓ -94% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $90.45 | ↓ -94% |
| Aetna | Medicaid | $94.38 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $109.32 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $116.64 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $118.60 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $122.78 | ↓ -92% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $134.04 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $264.33 | ↓ -83% |
| Univera | Univera_Medicare_Hamot_2024 | $389.70 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $586.19 | ↓ -62% |
| Aetna | Commercial | $649.50 | ↓ -58% |
| Cigna | New Business ASO | $779.40 | ↓ -50% |
| Cigna | NBR ASO/FI | $779.40 | ↓ -50% |
| Univera | Commercial | $857.34 | ↓ -45% |
| Fidelis | Medicare | $1,003.17 | ↓ -36% |
| Aetna | Medicare | $1,023.23 | ↓ -34% |
| UPMC Health Plan | Partners/Select | $1,024.04 | ↓ -34% |
| Wellcare | Medicare Advantage | $1,033.27 | ↓ -34% |
| Cigna | EBR | $1,039.20 | ↓ -33% |
| Cigna | Commercial | $1,039.20 | ↓ -33% |
| BCBS of Western NY | Medicare Advantage | $1,053.33 | ↓ -32% |
| United Healthcare | Medicare | $1,073.39 | ↓ -31% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,083.32 | ↓ -31% |
| AmeriHealth Caritas | Medicare | $1,083.42 | ↓ -30% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,083.42 | ↓ -30% |
| Cigna | Medicare | $1,083.42 | ↓ -30% |
| United Healthcare | Commercial | $1,147.00 | ↓ -26% |
| Independent Health | Medicare Advantage | $1,264.19 | ↓ -19% |
| Independent Health | Commercial | $1,421.98 | ↓ -9% |
| BCBS of Western NY | Commercial | $1,572.66 | ↑ +1% |
| InterGroup | Health Coalition Partners/PPO | $1,688.70 | ↑ +8% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,771.31 | ↑ +14% |
| Aetna | AXA/MMO | $1,818.60 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,818.60 | ↑ +17% |
| UPMC Health Plan | Commercial | $2,057.00 | ↑ +32% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $2,078.40 | ↑ +33% |
| InterGroup | Beech Street | $2,078.40 | ↑ +33% |
| Highmark BCBS of PA | UPMC Emergent | $2,834.08 | ↑ +82% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Sigmoidoscopy/submucosal injection 45335 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,459.20 | $78.65 – $1,945.60 |
| UPMC Bedford | Everett | $4,209.00 | $82.58 – $6,313.50 |
| UPMC Cole | Coudersport | $180.60 | $82.58 – $771.51 |
| UPMC East | Monroeville | $2,976.60 | $86.52 – $3,968.80 |
| UPMC Horizon-Greenville | Greenville | $2,907.00 | $86.52 – $1,140.40 |
| UPMC Jameson | New Castle | $2,907.00 | $86.52 – $1,173.43 |
| UPMC Magee | Pittsburgh | $2,232.00 | $86.52 – $938.75 |
| UPMC McKeesport | Mckeesport | $2,889.00 | $86.52 – $956.13 |