X-ray sinus tract/fistula/abscess at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$313.20
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.
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What you pay up front if you don't use insurance.
$522.00
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.
$30.25 with UPMC Health Plan vs $952.19 with Independent Health — 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 |
|---|---|---|---|
| UPMC Health Plan | Managed Medicaid | $30.25 | ↓ -90% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $31.62 | ↓ -90% |
| Aetna | Medicaid | $33.00 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $38.22 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $40.78 | ↓ -87% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $41.47 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $42.93 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $46.87 | ↓ -85% |
| Univera | Univera_Medicare_Hamot_2024 | $78.30 | ↓ -75% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $79.24 | ↓ -75% |
| BCBS of Western NY | Commercial | $127.23 | ↓ -59% |
| UPMC Health Plan | Commercial | $129.19 | ↓ -59% |
| Aetna | Commercial | $130.50 | ↓ -58% |
| Cigna | New Business ASO | $156.60 | ↓ -50% |
| Cigna | NBR ASO/FI | $156.60 | ↓ -50% |
| Univera | Commercial | $172.26 | ↓ -45% |
| UPMC Work Partners | Workers Comp | $176.04 | ↓ -44% |
| Cigna | EBR | $208.80 | ↓ -33% |
| Cigna | Commercial | $208.80 | ↓ -33% |
| United Healthcare | Commercial | $237.25 | ↓ -24% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $239.44 | ↓ -24% |
| InterGroup | Health Coalition Partners/PPO | $339.30 | ↑ +8% |
| Multiplan | PPO (Includes PHCS as a Payer) | $365.40 | ↑ +17% |
| Aetna | AXA/MMO | $365.40 | ↑ +17% |
| Highmark BCBS of PA | UPMC Emergent | $383.11 | ↑ +22% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $417.60 | ↑ +33% |
| InterGroup | Beech Street | $417.60 | ↑ +33% |
| Fidelis | Medicare | $603.31 | ↑ +93% |
| Aetna | Medicare | $615.38 | ↑ +96% |
| UPMC Health Plan | Partners/Select | $615.86 | ↑ +97% |
| Wellcare | Medicare Advantage | $621.41 | ↑ +98% |
| BCBS of Western NY | Medicare Advantage | $633.48 | ↑ +102% |
| United Healthcare | Medicare | $645.54 | ↑ +106% |
| Highmark Wholecare (prev Gateway) | Medicare | $651.51 | ↑ +108% |
| Cigna | Medicare | $651.57 | ↑ +108% |
| AmeriHealth Caritas | Medicare | $651.57 | ↑ +108% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $651.57 | ↑ +108% |
| Independent Health | Medicare Advantage | $714.96 | ↑ +128% |
| Independent Health | Commercial | $952.19 | ↑ +204% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
X-ray sinus tract/fistula/abscess at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $292.20 | $16.50 – $389.60 |
| UPMC Carlisle | Carlisle | $1,129.80 | $21.61 – $1,600.55 |
| UPMC Cole | Coudersport | $188.40 | $28.88 – $251.20 |
| UPMC Community Osteopathic | Harrisburg | $1,129.80 | $21.61 – $1,600.55 |
| UPMC East | Monroeville | $2,294.40 | $30.25 – $3,059.20 |
| UPMC Northwest | Seneca | $502.20 | $30.25 – $548.88 |
| UPMC Hanover | Hanover | $1,129.80 | $21.61 – $838.06 |
| UPMC Horizon-Greenville | Greenville | $339.60 | $30.25 – $564.56 |