Treat big toe fracture at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$6,649.80
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.
$11,083.00
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.
$211.46 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 | $211.46 | ↓ -97% |
| Highmark Wholecare (prev Gateway) | Medicaid | $211.46 | ↓ -97% |
| UPMC Health Plan | Managed Medicaid | $216.45 | ↓ -97% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $226.77 | ↓ -97% |
| Geisinger | Medicaid/CHIP | $242.52 | ↓ -96% |
| PA Health & Wellness | PA Medicaid HMO | $283.75 | ↓ -96% |
| UPMC Work Partners | Workers Comp | $775.33 | ↓ -88% |
| United Healthcare Community Plan for Families | PA Medicaid | $1,685.97 | ↓ -75% |
| Capital Blue Cross | Medicare Advantage | $2,105.77 | ↓ -68% |
| Keystone Health Plan | Medicare Advantage | $2,105.77 | ↓ -68% |
| UPMC Health Plan | CHIP | $2,655.30 | ↓ -60% |
| Prime Net | Managed Medicare | $2,682.09 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $3,068.58 | ↓ -54% |
| Humana | Medicare | $3,099.58 | ↓ -53% |
| Aetna | Medicare | $3,232.86 | ↓ -51% |
| Cigna | Medicare | $3,254.56 | ↓ -51% |
| Geisinger | Medicare | $3,254.56 | ↓ -51% |
| United Healthcare | Medicare | $3,316.55 | ↓ -50% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $3,347.55 | ↓ -50% |
| Keystone Autism Services | ACAP | $4,959.33 | ↓ -25% |
| Aetna | ACO | $6,295.14 | ↓ -5% |
| Geisinger | Commercial | $7,257.15 | ↑ +9% |
| Keystone Health Plan | Commercial | $7,532.01 | ↑ +13% |
| Capital Blue Cross | Commercial | $7,532.01 | ↑ +13% |
| Capital Blue Cross | CHIP | $7,532.01 | ↑ +13% |
| UPMC Health Plan | Commercial | $7,758.10 | ↑ +17% |
| Aetna | Commercial | $8,068.42 | ↑ +21% |
| Cigna | Commercial | $8,644.74 | ↑ +30% |
| CareFirst | Commercial | $9,420.55 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $9,420.55 | ↑ +42% |
| Wellspan Population Health | Commercial | $9,642.21 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $10,282.55 | ↑ +55% |
| Highmark BCBS of PA | Commercial | $11,025.21 | ↑ +66% |
| 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
Treat big toe fracture at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $6,649.80 | $211.46 – $9,420.55 |
| UPMC Cole | Coudersport | $858.00 | $174.82 – $1,192.92 |
| UPMC Community Osteopathic | Harrisburg | $6,649.80 | $211.46 – $9,420.55 |
| UPMC Hamot | Erie | $4,856.40 | $183.15 – $4,499.05 |
| UPMC Lititz | Lititz | $6,649.80 | $211.46 – $4,986.11 |
| UPMC Memorial | York | $6,649.80 | $211.46 – $4,978.02 |
| UPMC Somerset | Somerset | $6,649.80 | $183.15 – $3,093.35 |
| UPMC Altoona | Altoona | not published | $166.50 – $3,340.82 |