Unlisted px arthroscopy at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
not published by hospital
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.
not published by hospital
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.
$263.94 with Fidelis vs $2,957.22 with UPMC Health Plan — 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 |
|---|---|---|---|
| Fidelis | Medicare | $263.94 | — |
| Aetna | Medicare | $269.22 | — |
| UPMC Health Plan | Partners/Select | $269.43 | — |
| Wellcare | Medicare Advantage | $271.86 | — |
| BCBS of Western NY | Medicare Advantage | $277.14 | — |
| United Healthcare | Medicare | $282.42 | — |
| Highmark Wholecare (prev Gateway) | Medicare | $285.03 | — |
| Cigna | Medicare | $285.06 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $285.06 | — |
| AmeriHealth Caritas | Medicare | $285.06 | — |
| Independent Health | Medicare Advantage | $332.62 | — |
| United Healthcare | Commercial | $340.00 | — |
| Independent Health | Commercial | $354.21 | — |
| UPMC Health Plan | Commercial | $2,957.22 | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted px arthroscopy at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Uniontown Hospital | Uniontown | $1,354.00 | $239.08 – $557.06 |
| UPMC Altoona | Altoona | not published | $233.23 – $247.00 |
| UPMC Carlisle | Carlisle | not published | $126.21 – $2,381.90 |
| UPMC Community Osteopathic | Harrisburg | not published | $165.43 – $7,348.95 |
| UPMC East | Monroeville | not published | $229.32 – $251.57 |
| UPMC Northwest | Seneca | not published | $207.41 – $247.00 |
| UPMC Lititz | Lititz | not published | $165.43 – $2,381.90 |
| UPMC Magee | Pittsburgh | not published | $214.04 – $251.57 |