Biliary endoscopy thru skin at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$18,827.40
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.
$31,379.00
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.
$285.75 with Highmark Wholecare (prev Gateway) vs $35,377.35 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $285.75 | ↓ -98% |
| UPMC Health Plan | Managed Medicaid | $292.50 | ↓ -98% |
| United Healthcare Community Plan for Families | PA Medicaid | $294.75 | ↓ -98% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $303.75 | ↓ -98% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $306.45 | ↓ -98% |
| Geisinger | Medicaid/CHIP | $327.74 | ↓ -98% |
| PA Health & Wellness | PA Medicaid HMO | $383.44 | ↓ -98% |
| UPMC Work Partners | Workers Comp | $1,044.86 | ↓ -94% |
| UPMC Health Plan | CHIP | $1,757.00 | ↓ -91% |
| Keystone Health Plan | Medicare Advantage | $5,962.01 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $5,962.01 | ↓ -68% |
| Prime Net | Managed Medicare | $7,593.72 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $9,846.38 | ↓ -48% |
| Humana | Medicare | $9,945.84 | ↓ -47% |
| Aetna | Medicare | $10,373.51 | ↓ -45% |
| Cigna | Medicare | $10,443.13 | ↓ -45% |
| Geisinger | Medicare | $10,443.13 | ↓ -45% |
| United Healthcare | Medicare | $10,642.05 | ↓ -43% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $10,741.51 | ↓ -43% |
| Keystone Autism Services | ACAP | $15,913.34 | ↓ -15% |
| Cigna | Commercial | $16,693.00 | ↓ -11% |
| Geisinger | Commercial | $20,546.97 | ↑ +9% |
| Capital Blue Cross | CHIP | $21,325.17 | ↑ +13% |
| Keystone Health Plan | Commercial | $21,325.17 | ↑ +13% |
| Capital Blue Cross | Commercial | $21,325.17 | ↑ +13% |
| UPMC Health Plan | Commercial | $21,965.30 | ↑ +17% |
| CareFirst | Commercial | $26,672.15 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $26,672.15 | ↑ +42% |
| Wellspan Population Health | Commercial | $27,299.73 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $32,994.33 | ↑ +75% |
| Highmark BCBS of PA | Commercial | $35,377.35 | ↑ +88% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| Aetna | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Aetna | ACO | not published by hospital | — |
Visitor-reported prices
Comments
Biliary endoscopy thru skin at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $18,827.40 | $285.75 – $26,672.15 |
| UPMC Community Osteopathic | Harrisburg | $18,827.40 | $294.75 – $26,672.15 |
| UPMC Hamot | Erie | $5,424.00 | $247.50 – $12,372.12 |
| UPMC Lititz | Lititz | $18,827.40 | $285.75 – $15,999.30 |
| UPMC Magee | Pittsburgh | $12,186.60 | $247.50 – $10,719.92 |
| UPMC Memorial | York | $18,827.40 | $285.75 – $15,973.31 |
| UPMC Somerset | Somerset | $18,827.40 | $247.50 – $9,925.85 |
| UPMC Williamsport | Williamsport | $1,036.20 | $247.50 – $10,620.66 |