Clsd tx/prox/mid phalnx fx/no manp 26720 at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$366.60
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.
$611.00
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.
$71.12 with Highmark Wholecare (prev Gateway) vs $1,016.56 with United Healthcare Community Plan for Families — 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 | $71.12 | ↓ -81% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $71.12 | ↓ -81% |
| UPMC Health Plan | Managed Medicaid | $72.80 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $76.27 | ↓ -79% |
| Geisinger | Medicaid/CHIP | $81.57 | ↓ -78% |
| PA Health & Wellness | PA Medicaid HMO | $95.44 | ↓ -74% |
| Keystone Health Plan | Medicare Advantage | $116.09 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $116.09 | ↓ -68% |
| Prime Net | Managed Medicare | $147.86 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $226.87 | ↓ -38% |
| Humana | Medicare | $229.16 | ↓ -37% |
| Aetna | Medicare | $239.01 | ↓ -35% |
| Geisinger | Medicare | $240.62 | ↓ -34% |
| Cigna | Medicare | $240.62 | ↓ -34% |
| United Healthcare | Medicare | $245.20 | ↓ -33% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $247.49 | ↓ -32% |
| UPMC Work Partners | Workers Comp | $268.66 | ↓ -27% |
| UPMC Health Plan | CHIP | $300.55 | ↓ -18% |
| Aetna | ACO | $347.05 | ↓ -5% |
| Keystone Autism Services | ACAP | $366.66 | ↑ +0% |
| Geisinger | Commercial | $400.08 | ↑ +9% |
| Capital Blue Cross | Commercial | $415.24 | ↑ +13% |
| Capital Blue Cross | CHIP | $415.24 | ↑ +13% |
| Keystone Health Plan | Commercial | $415.24 | ↑ +13% |
| UPMC Health Plan | Commercial | $427.70 | ↑ +17% |
| Aetna | Commercial | $444.81 | ↑ +21% |
| Cigna | Commercial | $476.58 | ↑ +30% |
| CareFirst | Commercial | $519.35 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $519.35 | ↑ +42% |
| Wellspan Population Health | Commercial | $531.57 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $760.22 | ↑ +107% |
| Highmark BCBS of PA | Commercial | $815.12 | ↑ +122% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +177% |
| Tricare | East Region | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx/prox/mid phalnx fx/no manp 26720 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $229.20 | $58.80 – $343.80 |
| UPMC Carlisle | Carlisle | $366.60 | $71.12 – $1,016.56 |
| UPMC Cole | Coudersport | $622.80 | $42.97 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $366.60 | $71.12 – $1,016.56 |
| UPMC Hamot | Erie | $543.60 | $61.60 – $332.62 |
| UPMC Kane | Kane | $595.20 | $61.60 – $863.29 |
| UPMC Lititz | Lititz | $366.60 | $71.12 – $1,016.56 |
| UPMC Magee | Pittsburgh | $384.00 | $61.60 – $272.41 |