Unlisted procedure colon at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$2,799.00
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.
$4,665.00
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.
$699.75 with Univera vs $3,732.00 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 |
|---|---|---|---|
| Univera | Univera_Medicare_Hamot_2024 | $699.75 | ↓ -75% |
| Fidelis | Medicare | $1,003.17 | ↓ -64% |
| Aetna | Medicare | $1,023.23 | ↓ -63% |
| UPMC Health Plan | Partners/Select | $1,024.04 | ↓ -63% |
| Wellcare | Medicare Advantage | $1,033.27 | ↓ -63% |
| BCBS of Western NY | Medicare Advantage | $1,053.33 | ↓ -62% |
| United Healthcare | Medicare | $1,073.39 | ↓ -62% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,083.32 | ↓ -61% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,083.42 | ↓ -61% |
| Cigna | Medicare | $1,083.42 | ↓ -61% |
| AmeriHealth Caritas | Medicare | $1,083.42 | ↓ -61% |
| Aetna | Commercial | $1,166.25 | ↓ -58% |
| Independent Health | Medicare Advantage | $1,264.19 | ↓ -55% |
| Cigna | NBR ASO/FI | $1,399.50 | ↓ -50% |
| Cigna | New Business ASO | $1,399.50 | ↓ -50% |
| Independent Health | Commercial | $1,421.98 | ↓ -49% |
| United Healthcare | Commercial | $1,535.00 | ↓ -45% |
| Univera | Commercial | $1,539.45 | ↓ -45% |
| BCBS of Western NY | Commercial | $1,632.75 | ↓ -42% |
| UPMC Health Plan | Commercial | $1,716.72 | ↓ -39% |
| Cigna | EBR | $1,866.00 | ↓ -33% |
| Cigna | Commercial | $1,866.00 | ↓ -33% |
| Geisinger | Medicaid/CHIP | $2,565.75 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $2,565.75 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $3,032.25 | ↑ +8% |
| Aetna | AXA/MMO | $3,265.50 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $3,265.50 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $3,732.00 | ↑ +33% |
| InterGroup | Beech Street | $3,732.00 | ↑ +33% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted procedure colon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Mercy | Pittsburgh | $2,449.20 | $724.57 – $956.13 |
| UPMC Passavant-McCandless | Pittsburgh | $2,595.60 | $807.76 – $956.13 |
| UPMC Presbyterian | Pittsburgh | $3,264.60 | $608.32 – $956.13 |
| UPMC St. Margaret | Pittsburgh | $2,449.20 | $750.48 – $956.13 |
| UPMC Williamsport | Williamsport | $1,566.60 | $648.87 – $938.75 |
| Uniontown Hospital | Uniontown | $1,235.00 | $901.37 – $2,100.19 |