Valvuloplasty mitral at UPMC Hanover
300 Highland Avenue, Hanover, PA · UPMC · · NPI 1730158981
$23,686.20
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.
$39,477.00
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.
$1,310.00 with United Healthcare Community Plan for Families vs $38,535.29 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 |
|---|---|---|---|
| United Healthcare Community Plan for Families | PA Medicaid | $1,310.00 | ↓ -94% |
| UPMC Health Plan | CHIP | $2,468.82 | ↓ -90% |
| UPMC Work Partners | Workers Comp | $2,898.89 | ↓ -88% |
| Keystone Health Plan | Medicare Advantage | $7,500.63 | ↓ -68% |
| Capital Blue Cross | Medicare Advantage | $7,500.63 | ↓ -68% |
| Prime Net | Managed Medicare | $9,553.43 | ↓ -60% |
| Highmark BCBS of PA | Medicare | $10,725.31 | ↓ -55% |
| Humana | Medicare | $10,833.65 | ↓ -54% |
| Aetna | Medicare | $11,299.50 | ↓ -52% |
| Cigna | Medicare | $11,375.33 | ↓ -52% |
| Geisinger | Medicare | $11,375.33 | ↓ -52% |
| United Healthcare | Medicare | $11,592.01 | ↓ -51% |
| PA Health & Wellness | Allwell Medicare Advantage DSNP/Medicare Advantage (Allwell by Wellcare) | $11,700.34 | ↓ -51% |
| Keystone Autism Services | ACAP | $17,333.84 | ↓ -27% |
| United Healthcare | Commercial | $20,488.56 | ↓ -14% |
| PA Health & Wellness | PA Medicaid HMO | $21,712.35 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $21,712.35 | ↓ -8% |
| Aetna | ACO | $22,422.94 | ↓ -5% |
| Geisinger | Commercial | $25,849.54 | ↑ +9% |
| Capital Blue Cross | Commercial | $26,828.57 | ↑ +13% |
| Capital Blue Cross | CHIP | $26,828.57 | ↑ +13% |
| Keystone Health Plan | Commercial | $26,828.57 | ↑ +13% |
| UPMC Health Plan | Commercial | $27,633.90 | ↑ +17% |
| Aetna | Commercial | $28,739.26 | ↑ +21% |
| Cigna | Commercial | $30,792.06 | ↑ +30% |
| CareFirst | Commercial | $33,555.45 | ↑ +42% |
| Multiplan | PPO (Includes PHCS and Humana as Payers) | $33,555.45 | ↑ +42% |
| Wellspan Population Health | Commercial | $34,344.99 | ↑ +45% |
| Highmark BCBS of PA | Medicaid | $35,939.55 | ↑ +52% |
| Highmark BCBS of PA | Commercial | $38,535.29 | ↑ +63% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Valvuloplasty mitral at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $23,686.20 | $1,310.00 – $33,555.45 |
| UPMC Community Osteopathic | Harrisburg | $23,686.20 | $1,310.00 – $33,555.45 |
| UPMC Lititz | Lititz | $23,686.20 | $1,310.00 – $17,427.46 |
| UPMC Memorial | York | $23,686.20 | $650.97 – $17,399.15 |
| UPMC Presbyterian | Pittsburgh | $17,108.40 | $806.29 – $11,893.06 |
| UPMC Somerset | Somerset | $23,686.20 | $790.61 – $11,675.74 |