Endoluminal bx biliary tree at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$2,354.40
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.
$3,924.00
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.
$174.38 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 | $174.38 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $178.50 | ↓ -92% |
| United Healthcare Community Plan for Families | PA Medicaid | $179.88 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $185.37 | ↓ -92% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $187.02 | ↓ -92% |
| Geisinger | Medicaid/CHIP | $200.01 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $234.00 | ↓ -90% |
| Capital Blue Cross | Medicare Advantage | $745.56 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $745.56 | ↓ -68% |
| Prime Net | Managed Medicare | $949.61 | ↓ -60% |
| Aetna | Medicare | $1,389.10 | ↓ -41% |
| UPMC Work Partners | Workers Comp | $1,769.44 | ↓ -25% |
| UPMC Health Plan | CHIP | $1,995.28 | ↓ -15% |
| Geisinger | Commercial | $2,569.44 | ↑ +9% |
| Capital Blue Cross | CHIP | $2,666.75 | ↑ +13% |
| Keystone Health Plan | Commercial | $2,666.75 | ↑ +13% |
| Capital Blue Cross | Commercial | $2,666.75 | ↑ +13% |
| UPMC Health Plan | Commercial | $2,746.80 | ↑ +17% |
| CareFirst | Commercial | $3,335.40 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $3,335.40 | ↑ +42% |
| Wellspan Population Health | Commercial | $3,413.88 | ↑ +45% |
| Cigna | Commercial | $9,539.00 | ↑ +305% |
| 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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Endoluminal bx biliary tree at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,354.40 | $174.38 – $9,539.00 |
| UPMC Community Osteopathic | Harrisburg | $2,354.40 | $179.88 – $3,643.97 |
| UPMC Hamot | Erie | $8,707.20 | $151.04 – $1,690.79 |
| UPMC Lititz | Lititz | $2,354.40 | $131.69 – $1,769.44 |
| UPMC Memorial | York | $2,354.40 | $131.69 – $1,769.44 |
| UPMC Mercy | Pittsburgh | $7,821.60 | $151.04 – $1,960.27 |
| UPMC Passavant-McCandless | Pittsburgh | $20,091.00 | $151.04 – $1,966.04 |
| UPMC Somerset | Somerset | $2,354.40 | $151.04 – $1,690.79 |