Pr correction hammertoe at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$5,713.20
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.
$9,522.00
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.
$294.00 with AmeriHealth Caritas vs $11,025.21 with Highmark BCBS of PA — 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 |
|---|---|---|---|
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $294.00 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicaid | $294.00 | ↓ -95% |
| UPMC Health Plan | Managed Medicaid | $300.95 | ↓ -95% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $315.30 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $337.20 | ↓ -94% |
| PA Health & Wellness | PA Medicaid HMO | $394.52 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $851.60 | ↓ -85% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,240.57 | ↓ -78% |
| Capital Blue Cross | Medicare Advantage | $1,809.18 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $1,809.18 | ↓ -68% |
| Prime Net | Managed Medicare | $2,304.32 | ↓ -60% |
| UPMC Health Plan | CHIP | $2,636.54 | ↓ -54% |
| Highmark BCBS of PA | Medicare | $3,068.58 | ↓ -46% |
| Humana | Medicare | $3,099.58 | ↓ -46% |
| Aetna | Medicare | $3,232.86 | ↓ -43% |
| Cigna | Medicare | $3,254.56 | ↓ -43% |
| Geisinger | Medicare | $3,254.56 | ↓ -43% |
| United Healthcare | Medicare | $3,316.55 | ↓ -42% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,347.55 | ↓ -41% |
| Keystone Autism Services | ACAP | $4,959.33 | ↓ -13% |
| Aetna | ACO | $5,408.50 | ↓ -5% |
| Geisinger | Commercial | $6,235.01 | ↑ +9% |
| Cigna | Commercial | $6,413.00 | ↑ +12% |
| Capital Blue Cross | Commercial | $6,471.15 | ↑ +13% |
| Keystone Health Plan | Commercial | $6,471.15 | ↑ +13% |
| Capital Blue Cross | CHIP | $6,471.15 | ↑ +13% |
| UPMC Health Plan | Commercial | $6,665.40 | ↑ +17% |
| Aetna | Commercial | $6,932.02 | ↑ +21% |
| CareFirst | Commercial | $8,093.70 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $8,093.70 | ↑ +42% |
| Wellspan Population Health | Commercial | $8,284.14 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $10,282.55 | ↑ +80% |
| Highmark BCBS of PA | Commercial | $11,025.21 | ↑ +93% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| United Healthcare | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Pr correction hammertoe at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $5,713.20 | $294.00 – $8,093.70 |
| UPMC Cole | Coudersport | $638.40 | $243.07 – $1,192.92 |
| UPMC Lititz | Lititz | $5,713.20 | $294.00 – $4,986.11 |
| UPMC Wellsboro | Wellsboro | $669.00 | $254.65 – $1,212.16 |
| Uniontown Hospital | Uniontown | $2,399.75 | $3,171.41 – $7,389.39 |
| UPMC Altoona | Altoona | not published | $231.50 – $3,340.82 |
| UPMC Community Osteopathic | Harrisburg | not published | $312.52 – $5,805.45 |
| UPMC East | Monroeville | not published | $254.65 – $3,402.68 |