Drainage mouth roof lesion at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$837.00
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.
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What you pay up front if you don't use insurance.
$1,395.00
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.
$25.40 with AmeriHealth Caritas vs $2,298.02 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $25.40 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $25.40 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $26.00 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $27.24 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $29.13 | ↓ -97% |
| PA Health & Wellness | PA Medicaid HMO | $34.08 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $193.33 | ↓ -77% |
| Highmark BCBS of PA | Medicare | $219.62 | ↓ -74% |
| Humana | Medicare | $221.84 | ↓ -73% |
| Aetna | Medicare | $231.38 | ↓ -72% |
| Geisinger | Medicare | $232.93 | ↓ -72% |
| Cigna | Medicare | $232.93 | ↓ -72% |
| United Healthcare | Medicare | $237.37 | ↓ -72% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $239.59 | ↓ -71% |
| Keystone Health Plan | Medicare Advantage | $265.05 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $265.05 | ↓ -68% |
| Prime Net | Managed Medicare | $337.59 | ↓ -60% |
| Keystone Autism Services | ACAP | $354.94 | ↓ -58% |
| Highmark BCBS of PA | Medicaid | $735.93 | ↓ -12% |
| Highmark BCBS of PA | Commercial | $789.08 | ↓ -6% |
| Aetna | ACO | $792.36 | ↓ -5% |
| Geisinger | Commercial | $913.45 | ↑ +9% |
| Keystone Health Plan | Commercial | $948.04 | ↑ +13% |
| Capital Blue Cross | Commercial | $948.04 | ↑ +13% |
| Capital Blue Cross | CHIP | $948.04 | ↑ +13% |
| UPMC Health Plan | Commercial | $976.50 | ↑ +17% |
| Aetna | Commercial | $1,015.56 | ↑ +21% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +21% |
| Cigna | Commercial | $1,088.10 | ↑ +30% |
| CareFirst | Commercial | $1,185.75 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,185.75 | ↑ +42% |
| Wellspan Population Health | Commercial | $1,213.65 | ↑ +45% |
| UPMC Health Plan | CHIP | $2,298.02 | ↑ +175% |
| 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
Drainage mouth roof lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $837.00 | $25.40 – $1,185.75 |
| UPMC Cole | Coudersport | $154.80 | $21.00 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $837.00 | $25.40 – $2,298.02 |
| UPMC East | Monroeville | $2,565.00 | $22.00 – $3,420.00 |
| UPMC Horizon-Greenville | Greenville | $3,349.80 | $22.00 – $415.44 |
| UPMC Jameson | New Castle | $808.20 | $22.00 – $892.40 |
| UPMC Lititz | Lititz | $837.00 | $25.40 – $1,016.56 |
| UPMC McKeesport | Mckeesport | $2,912.40 | $22.00 – $736.75 |