healthcosts.net
New Patient Office Visit (level 4) at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$126.00
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.
$210.00
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.
$39.90 with Capital Blue Cross vs $371.06 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 | $39.90 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $39.90 | ↓ -68% |
| Prime Net | Managed Medicare | $50.82 | ↓ -60% |
| Aetna | Medicare | $74.34 | ↓ -41% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $114.77 | ↓ -9% |
| Highmark Wholecare (prev Gateway) | Medicaid | $114.77 | ↓ -9% |
| UPMC Health Plan | Managed Medicaid | $117.48 | ↓ -7% |
| United Healthcare Community Plan for Families | PA Medicaid | $118.38 | ↓ -6% |
| Aetna | ACO | $119.28 | ↓ -5% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $123.08 | ↓ -2% |
| Geisinger | Medicaid/CHIP | $131.63 | ↑ +4% |
| Geisinger | Commercial | $137.51 | ↑ +9% |
| Capital Blue Cross | CHIP | $142.72 | ↑ +13% |
| Capital Blue Cross | Commercial | $142.72 | ↑ +13% |
| Keystone Health Plan | Commercial | $142.72 | ↑ +13% |
| UPMC Health Plan | Commercial | $147.00 | ↑ +17% |
| Aetna | Commercial | $152.88 | ↑ +21% |
| PA Health & Wellness | PA Medicaid HMO | $154.01 | ↑ +22% |
| CareFirst | Commercial | $178.50 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $178.50 | ↑ +42% |
| Wellspan Population Health | Commercial | $182.70 | ↑ +45% |
| UPMC Work Partners | Workers Comp | $205.92 | ↑ +63% |
| UPMC Health Plan | CHIP | $371.06 | ↑ +194% |
Visitor-reported prices
Comments
New Patient Office Visit (level 4) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $303.00 | $99.41 – $429.25 |
| UPMC East | Monroeville | $425.40 | $36.08 – $567.20 |
| UPMC Hamot | Erie | $297.00 | $74.25 – $419.02 |
| UPMC Altoona | Altoona | $274.20 | $20.00 – $365.60 |
| UPMC Bedford | Everett | $287.40 | $36.08 – $431.10 |
| UPMC Cole | Coudersport | $420.00 | $61.30 – $300.00 |
| UPMC Community Osteopathic | Harrisburg | $610.80 | $42.00 – $658.70 |
| UPMC Horizon-Greenville | Greenville | $433.80 | $94.89 – $614.55 |