CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: UPMC Hamot

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$76
about 0.8× the $95 Medicare rate · typically $56–$105
modeled estimate · not a bill or quote
What this hospital charges insurers
$57
Below the fair price — a good deal
about $19 under the fair price · 0.6× Medicare
Medicare pays $95 Fair price $76 This hospital $57 Cash price $157 Hospital's list price $261

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $57

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $76 (about 0.8× the $95 Medicare rate). UPMC Hamot charges insurers about $57, or about $157 in cash — below the fair price — a good deal. Located in Erie, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $40 42%
Blue Cross Blue Shieldmajor $52 - $198 55%
Aetnamajor $42 - $183 44%
Cignamajor $64 - $104 67%
AmeriHealth $55 58%
Geisinger $49 51%
HealthPartners $53 56%
Independent Health $151 - $161 159%
UPMC Health Plan $38 - $88 40%
+ 3 smaller / regional plans $39 - $209
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 201 State Street, Erie, PA 16550
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals