Unlisted procedure microbiology at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$193.20
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.
?
What you pay up front if you don't use insurance.
$322.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$29.65 with BCBS of Western NY vs $445.57 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| BCBS of Western NY | Commercial | $29.65 | ↓ -85% |
| Univera | Univera_Medicare_Hamot_2024 | $48.30 | ↓ -75% |
| Aetna | Commercial | $80.50 | ↓ -58% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $92.16 | ↓ -52% |
| Cigna | NBR ASO/FI | $96.60 | ↓ -50% |
| Cigna | New Business ASO | $96.60 | ↓ -50% |
| Univera | Commercial | $106.26 | ↓ -45% |
| UPMC Health Plan | Commercial | $126.65 | ↓ -34% |
| Aetna | Medicare | $128.80 | ↓ -33% |
| Cigna | EBR | $128.80 | ↓ -33% |
| Cigna | Commercial | $128.80 | ↓ -33% |
| Highmark Wholecare (prev Gateway) | Medicare | $161.00 | ↓ -17% |
| Geisinger | Medicaid/CHIP | $177.10 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $177.10 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $209.30 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $225.40 | ↑ +17% |
| Aetna | AXA/MMO | $225.40 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $257.60 | ↑ +33% |
| InterGroup | Beech Street | $257.60 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $278.48 | ↑ +44% |
| Highmark BCBS of PA | UPMC Emergent | $445.57 | ↑ +131% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted procedure microbiology at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $124.80 | $92.16 – $253.62 |
| UPMC Bedford | Everett | $578.40 | $70.73 – $867.60 |
| UPMC Carlisle | Carlisle | $112.20 | $25.62 – $308.94 |
| UPMC Community Osteopathic | Harrisburg | $112.20 | $37.40 – $368.42 |
| UPMC East | Monroeville | $711.60 | $69.77 – $948.80 |
| UPMC Northwest | Seneca | $312.00 | $70.42 – $239.19 |
| UPMC Hanover | Hanover | $112.20 | $91.96 – $308.94 |
| UPMC Horizon-Greenville | Greenville | $288.60 | $70.64 – $149.02 |