Complx repair enel 1.1-2.5 cm 13151 at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$1,332.60
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.
$2,221.00
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.
$224.79 with Highmark Wholecare (prev Gateway) vs $2,636.26 with UPMC Health Plan — 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 | $224.79 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $224.79 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $230.10 | ↓ -83% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $241.07 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $257.82 | ↓ -81% |
| PA Health & Wellness | PA Medicaid HMO | $301.64 | ↓ -77% |
| Keystone Health Plan | Medicare Advantage | $421.99 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $421.99 | ↓ -68% |
| Prime Net | Managed Medicare | $537.48 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $578.92 | ↓ -57% |
| Humana | Medicare | $584.77 | ↓ -56% |
| Aetna | Medicare | $609.92 | ↓ -54% |
| Geisinger | Medicare | $614.01 | ↓ -54% |
| Cigna | Medicare | $614.01 | ↓ -54% |
| United Healthcare | Medicare | $625.70 | ↓ -53% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $631.55 | ↓ -53% |
| UPMC Work Partners | Workers Comp | $693.07 | ↓ -48% |
| Keystone Autism Services | ACAP | $935.63 | ↓ -30% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -24% |
| Aetna | ACO | $1,261.53 | ↓ -5% |
| Geisinger | Commercial | $1,454.31 | ↑ +9% |
| Capital Blue Cross | Commercial | $1,509.39 | ↑ +13% |
| Capital Blue Cross | CHIP | $1,509.39 | ↑ +13% |
| Keystone Health Plan | Commercial | $1,509.39 | ↑ +13% |
| UPMC Health Plan | Commercial | $1,554.70 | ↑ +17% |
| Aetna | Commercial | $1,616.89 | ↑ +21% |
| Cigna | Commercial | $1,732.38 | ↑ +30% |
| CareFirst | Commercial | $1,887.85 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,887.85 | ↑ +42% |
| Wellspan Population Health | Commercial | $1,932.27 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $1,939.92 | ↑ +46% |
| Highmark BCBS of PA | Commercial | $2,080.03 | ↑ +56% |
| UPMC Health Plan | CHIP | $2,636.26 | ↑ +98% |
| 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
Complx repair enel 1.1-2.5 cm 13151 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,637.80 | $177.00 – $4,850.40 |
| UPMC Bedford | Everett | $5,765.40 | $185.85 – $8,648.10 |
| UPMC Carlisle | Carlisle | $1,332.60 | $224.79 – $1,887.85 |
| UPMC Cole | Coudersport | $1,941.60 | $185.85 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $1,332.60 | $224.79 – $2,636.26 |
| UPMC East | Monroeville | $4,030.80 | $194.70 – $5,374.40 |
| UPMC Hamot | Erie | $3,556.80 | $194.70 – $848.80 |
| UPMC Northwest | Seneca | $4,909.80 | $194.70 – $662.27 |