Ghs simple repair 12.6 - 20.0 cm - 12005 at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$819.60
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.
?
What you pay up front if you don't use insurance.
$1,366.00
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.
$116.84 with Highmark Wholecare (prev Gateway) vs $2,297.06 with UPMC Health Plan — 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 |
|---|---|---|---|
| Highmark Wholecare (prev Gateway) | Medicaid | $116.84 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $116.84 | ↓ -86% |
| UPMC Health Plan | Managed Medicaid | $119.60 | ↓ -85% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $125.30 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $134.01 | ↓ -84% |
| PA Health & Wellness | PA Medicaid HMO | $156.79 | ↓ -81% |
| Keystone Health Plan | Medicare Advantage | $259.54 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $259.54 | ↓ -68% |
| Prime Net | Managed Medicare | $330.57 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $377.85 | ↓ -54% |
| Humana | Medicare | $381.67 | ↓ -53% |
| Aetna | Medicare | $398.08 | ↓ -51% |
| Geisinger | Medicare | $400.75 | ↓ -51% |
| Cigna | Medicare | $400.75 | ↓ -51% |
| United Healthcare | Medicare | $408.39 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $412.20 | ↓ -50% |
| UPMC Work Partners | Workers Comp | $439.46 | ↓ -46% |
| Keystone Autism Services | ACAP | $610.67 | ↓ -25% |
| Aetna | ACO | $775.89 | ↓ -5% |
| Geisinger | Commercial | $894.46 | ↑ +9% |
| Keystone Health Plan | Commercial | $928.33 | ↑ +13% |
| Capital Blue Cross | CHIP | $928.33 | ↑ +13% |
| Capital Blue Cross | Commercial | $928.33 | ↑ +13% |
| UPMC Health Plan | Commercial | $956.20 | ↑ +17% |
| Aetna | Commercial | $994.45 | ↑ +21% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↑ +24% |
| Cigna | Commercial | $1,065.48 | ↑ +30% |
| CareFirst | Commercial | $1,161.10 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $1,161.10 | ↑ +42% |
| Wellspan Population Health | Commercial | $1,188.42 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $1,266.15 | ↑ +54% |
| Highmark BCBS of PA | Commercial | $1,357.60 | ↑ +66% |
| UPMC Health Plan | CHIP | $2,297.06 | ↑ +180% |
| 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
Ghs simple repair 12.6 - 20.0 cm - 12005 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,305.00 | $92.00 – $1,740.00 |
| UPMC Bedford | Everett | $1,626.60 | $96.60 – $2,439.90 |
| UPMC Carlisle | Carlisle | $819.60 | $116.84 – $1,161.10 |
| UPMC Cole | Coudersport | $1,693.20 | $96.60 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $819.60 | $116.84 – $2,297.06 |
| UPMC East | Monroeville | $3,055.20 | $101.20 – $4,073.60 |
| UPMC Hamot | Erie | $3,097.80 | $101.20 – $729.80 |
| UPMC Northwest | Seneca | $2,183.40 | $101.20 – $419.93 |