Tomosynthesis breast screen bilateral at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$45.00
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.
$75.00
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.
$11.25 with Univera vs $136.00 with United Healthcare — 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $11.25 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $16.19 | ↓ -64% |
| Aetna | Commercial | $18.75 | ↓ -58% |
| Cigna | New Business ASO | $22.50 | ↓ -50% |
| Cigna | NBR ASO/FI | $22.50 | ↓ -50% |
| Univera | Commercial | $24.75 | ↓ -45% |
| Independent Health | Medicare Advantage | $26.50 | ↓ -41% |
| UPMC Health Plan | Commercial | $27.60 | ↓ -39% |
| Independent Health | Commercial | $28.02 | ↓ -38% |
| Aetna | Medicare | $30.00 | ↓ -33% |
| Cigna | EBR | $30.00 | ↓ -33% |
| Cigna | Commercial | $30.00 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $37.50 | ↓ -17% |
| UPMC Health Plan | Managed Medicaid | $48.43 | ↑ +8% |
| InterGroup | Health Coalition Partners/PPO | $48.75 | ↑ +8% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $48.92 | ↑ +9% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $50.63 | ↑ +13% |
| Aetna | AXA/MMO | $52.50 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $52.50 | ↑ +17% |
| Aetna | Medicaid | $52.84 | ↑ +17% |
| InterGroup | Beech Street | $60.00 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $60.00 | ↑ +33% |
| Geisinger | Medicaid/CHIP | $61.20 | ↑ +36% |
| Highmark Wholecare (prev Gateway) | Medicaid | $65.30 | ↑ +45% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $66.40 | ↑ +48% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $68.74 | ↑ +53% |
| BCBS of Western NY | Commercial | $73.82 | ↑ +64% |
| UPMC Work Partners | Workers Comp | $74.61 | ↑ +66% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $75.04 | ↑ +67% |
| Highmark BCBS of PA | UPMC Emergent | $78.28 | ↑ +74% |
| United Healthcare | Commercial | $136.00 | ↑ +202% |
Visitor-reported prices
Comments
Tomosynthesis breast screen bilateral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $45.00 | $16.19 – $60.00 |
| UPMC Bedford | Everett | $45.00 | $18.75 – $75.04 |
| UPMC Carlisle | Carlisle | $65.40 | $14.93 – $128.05 |
| UPMC Cole | Coudersport | $129.00 | $46.23 – $212.00 |
| UPMC Community Osteopathic | Harrisburg | $65.40 | $21.80 – $92.65 |
| UPMC Northwest | Seneca | $45.00 | $42.02 – $75.04 |
| UPMC Hanover | Hanover | $65.40 | $26.27 – $128.05 |
| UPMC Horizon-Greenville | Greenville | $45.00 | $31.50 – $75.04 |