CMS Price Transparency Data

Spinal fusion, single level (inpatient stay)

Facility: UPMC Hamot

Billing Code: 451 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$30,001

about 1.3× the $23,504 Medicare rate · typically $21,911–$36,726

modeled estimate · not a bill or quote

What this hospital charges insurers

$30,941

About the fair price

about $940 over the fair price · 1.3× Medicare

Medicare pays $23,504 Fair price $30,001 This hospital $30,941

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 $11,459 Priciest $30,941

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

A fair price for a Spinal fusion, single level (inpatient stay) is about $30,001 (about 1.3× the $23,504 Medicare rate). UPMC Hamot charges insurers about $30,941 — about the fair price. 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	$29,526 - $30,798	126%
Blue Cross Blue Shieldmajor	$28,784 - $64,513	122%
Aetnamajor	$29,359	125%
Cignamajor	$31,086	132%
AmeriHealth	$31,086	132%
Fidelis Care	$28,784	122%
Independent Health	$29,143	124%
UPMC Health Plan	$9,495 - $33,965	40%
WellCare	$29,647	126%
+ 2 smaller / regional plans	$31,086 - $31,662

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 451.

Insurance Before you use insurance

Call your insurance company to confirm UPMC Hamot is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 451.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at UPMC Hamot

Compare: Spinal fusion, single level (inpatient stay) at other PA hospitals

Independence Health System Butler Memorial Hospita · Butler $11,459
Geisinger-Bloomsburg Hospital · Bloomsburg $20,421
Uniontown Hospital · Uniontown $21,447
Meadville Medical Center · Meadville $22,466
Advanced Surgical Hospital · Washington $22,477
Allegheny Valley Hospital · Natrona $22,528
Canonsburg General Hospital · Canonsburg $22,545
Penn State Health Lancaster Medical Center · Lancaster $22,668

Insurance negotiated median for the same procedure, sorted lowest first.