CMS Price Transparency Data

Upper endoscopy with biopsy

Facility: UPMC Hamot

Billing Code: 43239 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$869
about 0.9× the $927 Medicare rate · typically $434–$1,068
modeled estimate · not a bill or quote
What this hospital charges insurers
$1,063
Above the fair price
about $194 over the fair price · 1.1× Medicare
Medicare pays $927 Fair price $869 This hospital $1,063 Cash price $3,124 Hospital's list price $5,207

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 $147 Priciest $1,063

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

A fair price for a Upper endoscopy with biopsy is about $869 (about 0.9× the $927 Medicare rate). UPMC Hamot charges insurers about $1,063, or about $3,124 in cash — above the fair price. Located in Erie, PA.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $869. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

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 $171 - $1,535 18%
Blue Cross Blue Shieldmajor $220 - $3,528 24%
Aetnamajor $178 - $3,645 19%
Cignamajor $1,114 - $2,083 120%
AmeriHealth $232 - $1,114 25%
Fidelis Care $1,032 111%
Geisinger $207 22%
HealthPartners $224 24%
Independent Health $1,300 - $1,413 140%
UPMC Health Plan $163 - $2,876 18%
WellCare $1,063 115%
+ 3 smaller / regional plans $253 - $4,166
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

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

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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