Lysis of labial adhesions at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
not published by hospital
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.
not published by hospital
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.
$80.01 with Highmark Wholecare (prev Gateway) vs $10,804.07 with Highmark BCBS of PA — 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 | $80.01 | — |
| UPMC Health Plan | Managed Medicaid | $81.90 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $85.05 | — |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $85.81 | — |
| Geisinger | Medicaid/CHIP | $91.77 | — |
| PA Health & Wellness | PA Medicaid HMO | $107.36 | — |
| UPMC Work Partners | Workers Comp | $369.39 | — |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | — |
| UPMC Health Plan | CHIP | $1,715.22 | — |
| Highmark BCBS of PA | Medicare | $3,007.04 | — |
| Humana | Medicare | $3,037.41 | — |
| Aetna | Medicare | $3,168.02 | — |
| Geisinger | Medicare | $3,189.28 | — |
| Cigna | Medicare | $3,189.28 | — |
| United Healthcare | Medicare | $3,250.03 | — |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,280.40 | — |
| Cigna | Commercial | $3,397.00 | — |
| Keystone Autism Services | ACAP | $4,859.86 | — |
| Highmark BCBS of PA | Medicaid | $10,076.30 | — |
| Highmark BCBS of PA | Commercial | $10,804.07 | — |
| Aetna | ACO | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
| Aetna | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Lysis of labial adhesions at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $223.20 | $66.15 – $771.51 |
| UPMC Magee | Pittsburgh | $2,389.20 | $69.30 – $3,273.80 |
| Uniontown Hospital | Uniontown | $3,720.50 | $69.30 – $6,516.82 |
| UPMC Community Osteopathic | Harrisburg | not published | $85.05 – $5,805.45 |
| UPMC East | Monroeville | not published | $69.30 – $3,334.43 |
| UPMC Hamot | Erie | not published | $69.30 – $4,408.81 |
| UPMC Memorial | York | not published | $80.01 – $4,878.16 |