Exc breast duct fistula 19112 at GROVE CITY HOSPITAL
631 NORTH BROAD STREET EXT, GROVE CITY, PA · Ahn · · NPI 1023000296
$210.45
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.
$915.00
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.
$17.00 with Amerihealth vs $10,489.52 with Medical Mutual — 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 |
|---|---|---|---|
| Amerihealth | Amerihealth Medicaid CHC | $17.00 | ↓ -92% |
| Amerihealth | Amerihealth Medicaid HC | $17.00 | ↓ -92% |
| Univera | Univera Healthy New York | $26.32 | ↓ -87% |
| Univera | Univera Essential Plan | $26.32 | ↓ -87% |
| Univera | Univera Medicare | $31.95 | ↓ -85% |
| Univera | Univera Commercial | $34.72 | ↓ -84% |
| Aetna | Aetna Better Health CHIP | $198.00 | ↓ -6% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $207.90 | ↓ -1% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $207.90 | ↓ -1% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $227.70 | ↑ +8% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $227.70 | ↑ +8% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $227.70 | ↑ +8% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $261.36 | ↑ +24% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $273.24 | ↑ +30% |
| Highmark | Highmark Community Blue Medicare | $283.57 | ↑ +35% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $287.10 | ↑ +36% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $287.10 | ↑ +36% |
| Geisinger | Geisinger CHIP | $287.10 | ↑ +36% |
| Geisinger | Geisinger Medicaid HC | $287.10 | ↑ +36% |
| United Healthcare | United Healthcare Medicaid | $287.10 | ↑ +36% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $297.00 | ↑ +41% |
| Life Pittsburgh | Life Pittsburgh Medicare | $304.91 | ↑ +45% |
| Allwell | Allwell by Wellcare | $304.91 | ↑ +45% |
| Highmark | Highmark Security Blue | $314.06 | ↑ +49% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $323.20 | ↑ +54% |
| Devoted Medicare | Devoted Health Medicare Advantage | $323.20 | ↑ +54% |
| American Health Plans | American Health Plans Medicare | $335.40 | ↑ +59% |
| Highmark | Highmark Together Blue | $374.06 | ↑ +78% |
| Highmark | Highmark My Direct Blue | $395.68 | ↑ +88% |
| Highmark | Highmark Performance Blue | $395.68 | ↑ +88% |
| Highmark | Highmark Community Blue | $395.68 | ↑ +88% |
| Highmark | Highmark Social Mission Indemnity | $395.68 | ↑ +88% |
| Highmark | Highmark Social Mission Managed Care | $395.68 | ↑ +88% |
| Highmark | Highmark Indemnity | $395.68 | ↑ +88% |
| Highmark | Highmark My Blue Access | $395.68 | ↑ +88% |
| Highmark | Highmark Managed Care | $395.68 | ↑ +88% |
| Highmark | Highmark Blue High Performance | $395.68 | ↑ +88% |
| Highmark | Highmark Connect Blue | $395.68 | ↑ +88% |
| Cigna | Cigna Commercial | $514.90 | ↑ +145% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $573.67 | ↑ +173% |
| United Healthcare | United Healthcare Of OH Medicaid | $604.81 | ↑ +187% |
| United Healthcare | United Healthcare Commercial | $604.81 | ↑ +187% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $725.59 | ↑ +245% |
| United Healthcare | United Healthcare CHIP | $1,241.60 | ↑ +490% |
| Highmark | Highmark Complete Blue Medicare | $3,389.14 | ↑ +1510% |
| Highmark | Highmark Community Blue Medicare PPO | $3,389.14 | ↑ +1510% |
| Highmark | Highmark Freedom Blue | $3,425.97 | ↑ +1528% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Life Medicare PPO | $3,683.84 | ↑ +1650% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Life Medicare HMO | $3,683.84 | ↑ +1650% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Life Medicare Specialty Plan D-SNP | $3,683.84 | ↑ +1650% |
| Highmark | Highmark Community Blue Medicare HMO | $3,831.20 | ↑ +1720% |
| Highmark | Highmark Together Blue Medicare | $3,831.20 | ↑ +1720% |
| United Healthcare | United Healthcare Medicare | $3,831.20 | ↑ +1720% |
| Aetna | Aetna Medicare | $3,831.20 | ↑ +1720% |
| Humana | Humana Commercial | $3,904.87 | ↑ +1755% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $3,904.87 | ↑ +1755% |
| United Healthcare | United Healthcare Medicare I-SNP | $3,941.71 | ↑ +1773% |
| Cigna | Cigna Medicare | $3,941.71 | ↑ +1773% |
| United Healthcare | United Healthcare Medicare D-SNP | $3,978.55 | ↑ +1790% |
| Molina | Molina Ohio | $4,015.39 | ↑ +1808% |
| Highmark | Highmark Performance Blue Enhanced | $7,265.65 | ↑ +3352% |
| Aetna | Aetna Commercial | $7,835.54 | ↑ +3623% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $10,489.52 | ↑ +4884% |
Visitor-reported prices
Comments
Exc breast duct fistula 19112 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| AHN WEXFORD HOSPITAL | WEXFORD | $237.90 | $17.00 – $12,223.18 |
| UPMC Cole | Coudersport | $465.00 | $207.90 – $1,192.92 |