Repair of achilles tendon at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$9,067.20
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.
$15,112.00
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.
$605.79 with AmeriHealth Caritas vs $24,274.43 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 | $605.79 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $605.79 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $620.10 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $649.67 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $694.80 | ↓ -92% |
| PA Health & Wellness | PA Medicaid HMO | $812.90 | ↓ -91% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,016.56 | ↓ -89% |
| UPMC Work Partners | Workers Comp | $2,375.78 | ↓ -74% |
| UPMC Health Plan | CHIP | $2,654.51 | ↓ -71% |
| Capital Blue Cross | Medicare Advantage | $2,871.28 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $2,871.28 | ↓ -68% |
| Prime Net | Managed Medicare | $3,657.10 | ↓ -60% |
| Cigna | Commercial | $6,413.00 | ↓ -29% |
| Highmark BCBS of PA | Medicare | $6,756.17 | ↓ -25% |
| Humana | Medicare | $6,824.41 | ↓ -25% |
| Aetna | Medicare | $7,117.86 | ↓ -21% |
| Geisinger | Medicare | $7,165.63 | ↓ -21% |
| Cigna | Medicare | $7,165.63 | ↓ -21% |
| United Healthcare | Medicare | $7,302.12 | ↓ -19% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $7,370.36 | ↓ -19% |
| Aetna | ACO | $8,583.62 | ↓ -5% |
| Geisinger | Commercial | $9,895.34 | ↑ +9% |
| Capital Blue Cross | CHIP | $10,270.12 | ↑ +13% |
| Capital Blue Cross | Commercial | $10,270.12 | ↑ +13% |
| Keystone Health Plan | Commercial | $10,270.12 | ↑ +13% |
| UPMC Health Plan | Commercial | $10,578.40 | ↑ +17% |
| Keystone Autism Services | ACAP | $10,919.06 | ↑ +20% |
| Aetna | Commercial | $11,001.54 | ↑ +21% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $12,845.20 | ↑ +42% |
| CareFirst | Commercial | $12,845.20 | ↑ +42% |
| Wellspan Population Health | Commercial | $13,147.44 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $22,639.30 | ↑ +150% |
| Highmark BCBS of PA | Commercial | $24,274.43 | ↑ +168% |
| 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
Repair of achilles tendon at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $9,067.20 | $605.79 – $12,845.20 |
| UPMC Cole | Coudersport | $1,296.00 | $500.85 – $1,970.19 |
| UPMC Community Osteopathic | Harrisburg | $9,067.20 | $605.79 – $12,845.20 |
| UPMC Lititz | Lititz | $9,067.20 | $605.79 – $10,978.03 |
| UPMC Memorial | York | $9,067.20 | $605.79 – $10,960.19 |
| UPMC Somerset | Somerset | $9,067.20 | $524.70 – $6,810.69 |
| Uniontown Hospital | Uniontown | $5,326.50 | $7,033.14 – $16,387.22 |
| UPMC Altoona | Altoona | not published | $477.00 – $7,355.55 |