Unlisted px leg/ankle at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$393.00
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.
$655.00
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.
$18.59 with Highmark BCBS of PA vs $524.00 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 |
|---|---|---|---|
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $18.59 | ↓ -95% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $56.17 | ↓ -86% |
| UPMC Health Plan | Commercial | $82.60 | ↓ -79% |
| Highmark BCBS of PA | UPMC Emergent | $89.87 | ↓ -77% |
| Univera | Univera_Medicare_Hamot_2024 | $98.25 | ↓ -75% |
| Aetna | Commercial | $163.75 | ↓ -58% |
| Cigna | NBR ASO/FI | $196.50 | ↓ -50% |
| Cigna | New Business ASO | $196.50 | ↓ -50% |
| Univera | Commercial | $216.15 | ↓ -45% |
| BCBS of Western NY | Commercial | $229.25 | ↓ -42% |
| Cigna | EBR | $262.00 | ↓ -33% |
| Cigna | Commercial | $262.00 | ↓ -33% |
| Fidelis | Medicare | $263.94 | ↓ -33% |
| Aetna | Medicare | $269.22 | ↓ -31% |
| UPMC Health Plan | Partners/Select | $269.43 | ↓ -31% |
| Wellcare | Medicare Advantage | $271.86 | ↓ -31% |
| BCBS of Western NY | Medicare Advantage | $277.14 | ↓ -29% |
| United Healthcare | Medicare | $282.42 | ↓ -28% |
| Highmark Wholecare (prev Gateway) | Medicare | $285.03 | ↓ -27% |
| Cigna | Medicare | $285.06 | ↓ -27% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $285.06 | ↓ -27% |
| AmeriHealth Caritas | Medicare | $285.06 | ↓ -27% |
| Independent Health | Medicare Advantage | $332.62 | ↓ -15% |
| United Healthcare | Commercial | $340.00 | ↓ -13% |
| Independent Health | Commercial | $354.21 | ↓ -10% |
| Geisinger | Medicaid/CHIP | $360.25 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $360.25 | ↓ -8% |
| InterGroup | Health Coalition Partners/PPO | $425.75 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $458.50 | ↑ +17% |
| Aetna | AXA/MMO | $458.50 | ↑ +17% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $524.00 | ↑ +33% |
| InterGroup | Beech Street | $524.00 | ↑ +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 px leg/ankle at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $115.80 | $18.59 – $247.00 |
| UPMC East | Monroeville | $97.20 | $18.77 – $247.00 |
| UPMC Northwest | Seneca | $118.20 | $47.94 – $247.00 |
| UPMC Mercy | Pittsburgh | $348.60 | $18.59 – $251.57 |
| UPMC Williamsport | Williamsport | $114.60 | $161.64 – $247.00 |
| Uniontown Hospital | Uniontown | $324.00 | $239.08 – $557.06 |
| UPMC Carlisle | Carlisle | not published | $66.53 – $367.15 |
| UPMC Community Osteopathic | Harrisburg | not published | $66.53 – $1,471.05 |