healthcosts.net
New Patient Office Visit (level 3) at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$117.60
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.
$196.00
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.
$37.24 with Capital Blue Cross vs $289.24 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 |
|---|---|---|---|
| Capital Blue Cross | Medicare Advantage | $37.24 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $37.24 | ↓ -68% |
| Prime Net | Managed Medicare | $47.43 | ↓ -60% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $68.90 | ↓ -41% |
| Highmark Wholecare (prev Gateway) | Medicaid | $68.90 | ↓ -41% |
| Aetna | Medicare | $69.38 | ↓ -41% |
| UPMC Health Plan | Managed Medicaid | $70.53 | ↓ -40% |
| United Healthcare Community Plan for Families | PA Medicaid | $71.07 | ↓ -40% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $73.89 | ↓ -37% |
| Geisinger | Medicaid/CHIP | $79.02 | ↓ -33% |
| PA Health & Wellness | PA Medicaid HMO | $92.45 | ↓ -21% |
| Aetna | ACO | $111.33 | ↓ -5% |
| Geisinger | Commercial | $128.34 | ↑ +9% |
| Capital Blue Cross | CHIP | $133.20 | ↑ +13% |
| Capital Blue Cross | Commercial | $133.20 | ↑ +13% |
| Keystone Health Plan | Commercial | $133.20 | ↑ +13% |
| UPMC Work Partners | Workers Comp | $136.50 | ↑ +16% |
| UPMC Health Plan | Commercial | $137.20 | ↑ +17% |
| Aetna | Commercial | $142.69 | ↑ +21% |
| CareFirst | Commercial | $166.60 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $166.60 | ↑ +42% |
| Wellspan Population Health | Commercial | $170.52 | ↑ +45% |
| UPMC Health Plan | CHIP | $289.24 | ↑ +146% |
Visitor-reported prices
Comments
New Patient Office Visit (level 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $330.00 | $36.08 – $440.00 |
| UPMC Passavant-McCandless | Pittsburgh | $238.80 | $59.67 – $338.30 |
| UPMC Hamot | Erie | $231.60 | $57.90 – $274.62 |
| UPMC Altoona | Altoona | $230.40 | $20.00 – $307.20 |
| UPMC Bedford | Everett | $229.20 | $36.08 – $343.80 |
| UPMC Cole | Coudersport | $271.80 | $56.06 – $190.40 |
| UPMC Community Osteopathic | Harrisburg | $441.00 | $39.20 – $513.69 |
| UPMC Horizon-Greenville | Greenville | $338.40 | $56.96 – $479.40 |