Ther/proph/diag inj ia at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$250.20
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.
$417.00
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.
$11.88 with UPMC Health Plan vs $333.60 with Multiplan — 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 | $11.88 | ↓ -95% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $12.42 | ↓ -95% |
| Aetna | Medicaid | $12.96 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $15.01 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $16.02 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $16.29 | ↓ -93% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $16.86 | ↓ -93% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $17.65 | ↓ -93% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $18.41 | ↓ -93% |
| UPMC Health Plan | Commercial | $26.26 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $27.00 | ↓ -89% |
| Highmark BCBS of PA | UPMC Emergent | $28.24 | ↓ -89% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $32.81 | ↓ -87% |
| BCBS of Western NY | Commercial | $46.31 | ↓ -81% |
| Univera | Univera_Medicare_Hamot_2024 | $62.55 | ↓ -75% |
| Aetna | Commercial | $104.25 | ↓ -58% |
| Cigna | NBR ASO/FI | $125.10 | ↓ -50% |
| Cigna | New Business ASO | $125.10 | ↓ -50% |
| Univera | Commercial | $137.61 | ↓ -45% |
| Cigna | EBR | $166.80 | ↓ -33% |
| Cigna | Commercial | $166.80 | ↓ -33% |
| Aetna | Medicare | $166.80 | ↓ -33% |
| United Healthcare | Commercial | $189.53 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicare | $208.50 | ↓ -17% |
| InterGroup | Health Coalition Partners/PPO | $271.05 | ↑ +8% |
| Aetna | AXA/MMO | $291.90 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $291.90 | ↑ +17% |
| InterGroup | Beech Street | $333.60 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $333.60 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Ther/proph/diag inj ia at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $205.20 | $11.34 – $307.80 |
| UPMC Cole | Coudersport | $108.00 | $11.34 – $50.40 |
| UPMC Community Osteopathic | Harrisburg | $369.00 | $13.72 – $522.75 |
| UPMC Hanover | Hanover | $369.00 | $13.72 – $322.03 |
| UPMC Magee | Pittsburgh | $198.60 | $11.88 – $216.94 |
| UPMC Memorial | York | $369.00 | $13.72 – $323.25 |
| UPMC Muncy | Muncy | $378.00 | $11.88 – $28.89 |
| UPMC Passavant-McCandless | Pittsburgh | $198.60 | $11.88 – $220.96 |