X-ray surgical specimen at UPMC Hamot
201 State Street, Erie, PA · UPMC · · NPI 1487647590
$562.20
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.
$937.00
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.
$20.58 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 | $20.58 | ↓ -96% |
| United Healthcare Community Plan for Families | PA CHIP/PA Medicaid | $21.52 | ↓ -96% |
| Aetna | Medicaid | $22.45 | ↓ -96% |
| Geisinger | Medicaid/CHIP | $26.01 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $27.75 | ↓ -95% |
| Highmark BCBS of PA | Complete Blue Medicare Advantage/Freedom Blue Medicare Advantage/Security Blue Medicare Advantage | $27.96 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $28.21 | ↓ -95% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $29.21 | ↓ -95% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $31.89 | ↓ -94% |
| UPMC Health Plan | Commercial | $47.71 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $60.21 | ↓ -89% |
| BCBS of Western NY | Commercial | $80.01 | ↓ -86% |
| Highmark BCBS of PA | Commercial - Indemnity/Commercial - Social Mission Indemnity/Managed Care/Managed Care - Social Mission | $84.48 | ↓ -85% |
| Highmark BCBS of PA | UPMC Emergent | $135.16 | ↓ -76% |
| Univera | Univera_Medicare_Hamot_2024 | $140.55 | ↓ -75% |
| Aetna | Commercial | $234.25 | ↓ -58% |
| Cigna | NBR ASO/FI | $281.10 | ↓ -50% |
| Cigna | New Business ASO | $281.10 | ↓ -50% |
| Univera | Commercial | $309.21 | ↓ -45% |
| Cigna | Commercial | $374.80 | ↓ -33% |
| Cigna | EBR | $374.80 | ↓ -33% |
| United Healthcare | Commercial | $425.87 | ↓ -24% |
| Fidelis | Medicare | $603.31 | ↑ +7% |
| InterGroup | Health Coalition Partners/PPO | $609.05 | ↑ +8% |
| Aetna | Medicare | $615.38 | ↑ +9% |
| UPMC Health Plan | Partners/Select | $615.86 | ↑ +10% |
| Wellcare | Medicare Advantage | $621.41 | ↑ +11% |
| BCBS of Western NY | Medicare Advantage | $633.48 | ↑ +13% |
| United Healthcare | Medicare | $645.54 | ↑ +15% |
| Highmark Wholecare (prev Gateway) | Medicare | $651.51 | ↑ +16% |
| AmeriHealth Caritas | Medicare | $651.57 | ↑ +16% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $651.57 | ↑ +16% |
| Cigna | Medicare | $651.57 | ↑ +16% |
| Aetna | AXA/MMO | $655.90 | ↑ +17% |
| Multiplan | PPO (Includes PHCS as a Payer) | $655.90 | ↑ +17% |
| Independent Health | Medicare Advantage | $714.96 | ↑ +27% |
| InterGroup | Beech Street | $749.60 | ↑ +33% |
| Multiplan | Complimentary Network Rate (Includes Multiplan as Payer) | $749.60 | ↑ +33% |
| Independent Health | Commercial | $952.19 | ↑ +69% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
X-ray surgical specimen at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $190.20 | $10.62 – $253.60 |
| UPMC Bedford | Everett | $540.60 | $19.65 – $810.90 |
| UPMC Carlisle | Carlisle | $1,129.80 | $13.91 – $1,600.55 |
| UPMC Cole | Coudersport | $80.40 | $19.65 – $107.20 |
| UPMC Community Osteopathic | Harrisburg | $1,129.80 | $13.91 – $1,600.55 |
| UPMC East | Monroeville | $4,123.80 | $20.58 – $5,498.40 |
| UPMC Northwest | Seneca | $536.40 | $20.58 – $548.88 |
| UPMC Hanover | Hanover | $1,129.80 | $13.91 – $838.06 |