Dilate biliary duct/ampulla at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$2,304.60
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.
$3,841.00
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.
$138.82 with Highmark Wholecare (prev Gateway) vs $9,539.00 with Cigna — 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 | $138.82 | ↓ -94% |
| UPMC Health Plan | Managed Medicaid | $142.10 | ↓ -94% |
| United Healthcare Community Plan for Families | PA Medicaid | $143.20 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $147.57 | ↓ -94% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $148.88 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $159.22 | ↓ -93% |
| PA Health & Wellness | PA Medicaid HMO | $186.29 | ↓ -92% |
| UPMC Work Partners | Workers Comp | $695.48 | ↓ -70% |
| Capital Blue Cross | Medicare Advantage | $729.79 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $729.79 | ↓ -68% |
| Prime Net | Managed Medicare | $929.52 | ↓ -60% |
| Aetna | Medicare | $1,359.71 | ↓ -41% |
| UPMC Health Plan | CHIP | $1,932.78 | ↓ -16% |
| Geisinger | Commercial | $2,515.09 | ↑ +9% |
| Capital Blue Cross | Commercial | $2,610.34 | ↑ +13% |
| Keystone Health Plan | Commercial | $2,610.34 | ↑ +13% |
| Capital Blue Cross | CHIP | $2,610.34 | ↑ +13% |
| UPMC Health Plan | Commercial | $2,688.70 | ↑ +17% |
| CareFirst | Commercial | $3,264.85 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,264.85 | ↑ +42% |
| Wellspan Population Health | Commercial | $3,341.67 | ↑ +45% |
| Cigna | Commercial | $9,539.00 | ↑ +314% |
| United Healthcare | Commercial | not published by hospital | — |
| Aetna | Commercial | not published by hospital | — |
| Aetna | ACO | not published by hospital | — |
Visitor-reported prices
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Dilate biliary duct/ampulla at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,304.60 | $138.82 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $2,304.60 | $143.20 – $3,264.85 |
| UPMC Lititz | Lititz | $2,304.60 | $124.67 – $695.48 |
| UPMC Memorial | York | $2,304.60 | $124.67 – $695.48 |
| UPMC Somerset | Somerset | $2,304.60 | $120.24 – $664.57 |
| WellSpan Good Samaritan Hospital | Lebanon | $3,115.20 | $136.64 – $371.65 |