Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$1,505.40
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.
$2,509.00
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.
$80.72 with UPMC Health Plan vs $2,360.34 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 Health Plan | Managed Medicaid | $80.72 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $84.39 | ↓ -94% |
| Aetna | Medicaid | $88.06 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $101.99 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $108.82 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $110.66 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $114.55 | ↓ -92% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $125.05 | ↓ -92% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $142.40 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $307.62 | ↓ -80% |
| Univera | Univera_Medicare_Hamot_2024 | $376.35 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $430.30 | ↓ -71% |
| Aetna | Commercial | $627.25 | ↓ -58% |
| Highmark BCBS of PA | UPMC Emergent | $688.48 | ↓ -54% |
| Cigna | NBR ASO/FI | $752.70 | ↓ -50% |
| Cigna | New Business ASO | $752.70 | ↓ -50% |
| Fidelis | Medicare | $761.99 | ↓ -49% |
| Aetna | Medicare | $777.23 | ↓ -48% |
| UPMC Health Plan | Partners/Select | $777.84 | ↓ -48% |
| Wellcare | Medicare Advantage | $784.85 | ↓ -48% |
| BCBS of Western NY | Medicare Advantage | $800.09 | ↓ -47% |
| United Healthcare | Medicare | $815.33 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $822.87 | ↓ -45% |
| Cigna | Medicare | $822.95 | ↓ -45% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $822.95 | ↓ -45% |
| AmeriHealth Caritas | Medicare | $822.95 | ↓ -45% |
| Univera | Commercial | $827.97 | ↓ -45% |
| Independent Health | Medicare Advantage | $960.26 | ↓ -36% |
| Cigna | Commercial | $1,003.60 | ↓ -33% |
| Cigna | EBR | $1,003.60 | ↓ -33% |
| Independent Health | Commercial | $1,102.52 | ↓ -27% |
| United Healthcare | Commercial | $1,147.00 | ↓ -24% |
| BCBS of Western NY | Commercial | $1,572.66 | ↑ +4% |
| InterGroup | Health Coalition Partners/PPO | $1,630.85 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,756.30 | ↑ +17% |
| Aetna | AXA/MMO | $1,756.30 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $2,007.20 | ↑ +33% |
| InterGroup | Beech Street | $2,007.20 | ↑ +33% |
| UPMC Health Plan | Commercial | $2,360.34 | ↑ +57% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,360.20 | $73.38 – $1,813.60 |
| UPMC Carlisle | Carlisle | $2,461.20 | $93.19 – $3,486.70 |
| UPMC Cole | Coudersport | $126.00 | $58.21 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $2,461.20 | $93.19 – $3,486.70 |
| UPMC East | Monroeville | $1,439.40 | $80.72 – $1,919.20 |
| UPMC Northwest | Seneca | $1,439.40 | $80.72 – $693.24 |
| UPMC Hanover | Hanover | $2,461.20 | $93.19 – $1,058.50 |
| UPMC Horizon-Greenville | Greenville | $1,439.40 | $80.72 – $713.05 |