Treatment of thigh fracture at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$2,334.00
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.
$3,890.00
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.
$340.00 with United Healthcare vs $3,112.00 with InterGroup — 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 |
|---|---|---|---|
| United Healthcare | Commercial | $340.00 | ↓ -85% |
| UPMC Health Plan | Managed Medicaid | $348.70 | ↓ -85% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $364.55 | ↓ -84% |
| Aetna | Medicaid | $380.40 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $440.60 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $470.11 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $478.04 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $494.87 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $540.23 | ↓ -77% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $545.04 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $583.50 | ↓ -75% |
| Aetna | Commercial | $972.50 | ↓ -58% |
| Cigna | NBR ASO/FI | $1,167.00 | ↓ -50% |
| Cigna | New Business ASO | $1,167.00 | ↓ -50% |
| Univera | Commercial | $1,283.70 | ↓ -45% |
| Cigna | Commercial | $1,556.00 | ↓ -33% |
| Cigna | EBR | $1,556.00 | ↓ -33% |
| UPMC Work Partners | Workers Comp | $1,570.96 | ↓ -33% |
| BCBS of Western NY | Commercial | $1,572.66 | ↓ -33% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $1,646.96 | ↓ -29% |
| Fidelis | Medicare | $1,760.96 | ↓ -25% |
| Aetna | Medicare | $1,796.18 | ↓ -23% |
| UPMC Health Plan | Partners/Select | $1,797.59 | ↓ -23% |
| Wellcare | Medicare Advantage | $1,813.79 | ↓ -22% |
| BCBS of Western NY | Medicare Advantage | $1,849.01 | ↓ -21% |
| United Healthcare | Medicare | $1,884.23 | ↓ -19% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,901.66 | ↓ -19% |
| Cigna | Medicare | $1,901.84 | ↓ -19% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,901.84 | ↓ -19% |
| AmeriHealth Caritas | Medicare | $1,901.84 | ↓ -19% |
| UPMC Health Plan | Commercial | $2,147.94 | ↓ -8% |
| Independent Health | Medicare Advantage | $2,219.16 | ↓ -5% |
| Independent Health | Commercial | $2,454.61 | ↑ +5% |
| InterGroup | Health Coalition Partners/PPO | $2,528.50 | ↑ +8% |
| Highmark BCBS of PA | UPMC Emergent | $2,635.11 | ↑ +13% |
| Multiplan | PPO (Includes PHCS as a Payer) | $2,723.00 | ↑ +17% |
| Aetna | AXA/MMO | $2,723.00 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $3,112.00 | ↑ +33% |
| InterGroup | Beech Street | $3,112.00 | ↑ +33% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of thigh fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,275.20 | $317.00 – $3,033.60 |
| UPMC Carlisle | Carlisle | $2,055.00 | $402.59 – $2,911.25 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $402.59 – $2,911.25 |
| UPMC East | Monroeville | $2,790.00 | $348.70 – $3,720.00 |
| UPMC Northwest | Seneca | $3,352.80 | $348.70 – $1,602.09 |
| UPMC Hanover | Hanover | $2,055.00 | $402.59 – $2,446.19 |
| UPMC Horizon-Greenville | Greenville | $4,482.60 | $348.70 – $1,647.86 |
| UPMC Jameson | New Castle | $379.80 | $348.70 – $2,059.83 |