Clsd tx shoulder dislc/fx 23665 at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$2,055.00
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.
?
What you pay up front if you don't use insurance.
$3,425.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$199.39 with AmeriHealth Caritas vs $5,438.19 with Highmark BCBS of PA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 Caritas | Community HealthChoices (CHC)/Medicaid | $199.39 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicaid | $199.39 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $204.10 | ↓ -90% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $213.83 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $228.69 | ↓ -89% |
| PA Health & Wellness | PA Medicaid HMO | $267.56 | ↓ -87% |
| Capital Blue Cross | Medicare Advantage | $650.75 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $650.75 | ↓ -68% |
| UPMC Work Partners | Workers Comp | $785.49 | ↓ -62% |
| Prime Net | Managed Medicare | $828.85 | ↓ -60% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -51% |
| Highmark BCBS of PA | Medicare | $1,513.58 | ↓ -26% |
| Humana | Medicare | $1,528.87 | ↓ -26% |
| Aetna | Medicare | $1,594.61 | ↓ -22% |
| Geisinger | Medicare | $1,605.31 | ↓ -22% |
| Cigna | Medicare | $1,605.31 | ↓ -22% |
| United Healthcare | Medicare | $1,635.89 | ↓ -20% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $1,651.18 | ↓ -20% |
| Aetna | ACO | $1,945.40 | ↓ -5% |
| Geisinger | Commercial | $2,242.69 | ↑ +9% |
| UPMC Health Plan | CHIP | $2,298.74 | ↑ +12% |
| Capital Blue Cross | Commercial | $2,327.63 | ↑ +13% |
| Capital Blue Cross | CHIP | $2,327.63 | ↑ +13% |
| Keystone Health Plan | Commercial | $2,327.63 | ↑ +13% |
| UPMC Health Plan | Commercial | $2,397.50 | ↑ +17% |
| Keystone Autism Services | ACAP | $2,446.19 | ↑ +19% |
| Aetna | Commercial | $2,493.40 | ↑ +21% |
| Cigna | Commercial | $2,671.50 | ↑ +30% |
| CareFirst | Commercial | $2,911.25 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $2,911.25 | ↑ +42% |
| Wellspan Population Health | Commercial | $2,979.75 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $5,071.87 | ↑ +147% |
| Highmark BCBS of PA | Commercial | $5,438.19 | ↑ +165% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx shoulder dislc/fx 23665 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $157.00 – $4,246.40 |
| UPMC Bedford | Everett | $4,739.40 | $164.85 – $7,109.10 |
| UPMC Carlisle | Carlisle | $2,055.00 | $199.39 – $2,911.25 |
| UPMC Cole | Coudersport | $1,693.20 | $164.85 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $199.39 – $2,911.25 |
| UPMC East | Monroeville | $3,055.20 | $172.70 – $4,073.60 |
| UPMC Hamot | Erie | $3,099.00 | $172.70 – $2,219.16 |
| UPMC Northwest | Seneca | $2,186.40 | $172.70 – $1,602.09 |