Surgical pathology level 6 gross & microscopic examination at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$320.40
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.
$534.00
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.
$66.79 with Highmark BCBS of PA vs $1,242.08 with Independent Health — 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $66.79 | ↓ -79% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $67.60 | ↓ -79% |
| UPMC Health Plan | Managed Medicaid | $74.36 | ↓ -77% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $77.74 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $80.10 | ↓ -75% |
| Aetna | Medicaid | $81.12 | ↓ -75% |
| Geisinger | Medicaid/CHIP | $93.96 | ↓ -71% |
| UPMC Health Plan | Commercial | $98.38 | ↓ -69% |
| Highmark Wholecare (prev Gateway) | Medicaid | $100.25 | ↓ -69% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $105.53 | ↓ -67% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $115.20 | ↓ -64% |
| Aetna | Commercial | $133.50 | ↓ -58% |
| United Healthcare | Commercial | $157.05 | ↓ -51% |
| Cigna | New Business ASO | $160.20 | ↓ -50% |
| Cigna | NBR ASO/FI | $160.20 | ↓ -50% |
| Univera | Commercial | $176.22 | ↓ -45% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $201.81 | ↓ -37% |
| Cigna | EBR | $213.60 | ↓ -33% |
| Cigna | Commercial | $213.60 | ↓ -33% |
| Highmark BCBS of PA | UPMC Emergent | $322.90 | ↑ +1% |
| InterGroup | Health Coalition Partners/PPO | $347.10 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $373.80 | ↑ +17% |
| Aetna | AXA/MMO | $373.80 | ↑ +17% |
| UPMC Work Partners | Workers Comp | $389.27 | ↑ +21% |
| InterGroup | Beech Street | $427.20 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $427.20 | ↑ +33% |
| BCBS of Western NY | Commercial | $897.07 | ↑ +180% |
| Fidelis | Medicare | $898.85 | ↑ +181% |
| Aetna | Medicare | $916.83 | ↑ +186% |
| UPMC Health Plan | Partners/Select | $917.55 | ↑ +186% |
| Wellcare | Medicare Advantage | $925.82 | ↑ +189% |
| Independent Health | Medicare Advantage | $932.64 | ↑ +191% |
| BCBS of Western NY | Medicare Advantage | $943.79 | ↑ +195% |
| United Healthcare | Medicare | $961.77 | ↑ +200% |
| Highmark Wholecare (prev Gateway) | Medicare | $970.67 | ↑ +203% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $970.76 | ↑ +203% |
| Cigna | Medicare | $970.76 | ↑ +203% |
| AmeriHealth Caritas | Medicare | $970.76 | ↑ +203% |
| Independent Health | Commercial | $1,242.08 | ↑ +288% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Surgical pathology level 6 gross & microscopic examination at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $336.00 | $17.50 – $448.00 |
| UPMC Bedford | Everett | $273.00 | $54.94 – $409.50 |
| UPMC Carlisle | Carlisle | $1,472.40 | $22.93 – $2,085.90 |
| UPMC Cole | Coudersport | $811.20 | $53.00 – $1,081.60 |
| UPMC Community Osteopathic | Harrisburg | $1,472.40 | $22.93 – $2,085.90 |
| UPMC East | Monroeville | $516.00 | $54.19 – $817.76 |
| UPMC Northwest | Seneca | $691.20 | $54.70 – $817.76 |
| UPMC Hanover | Hanover | $1,472.40 | $22.93 – $1,248.61 |