Hanover Hospital is providing this estimated price list for charges of our most common procedures. The hospital’s charges are the same for all patients, but a patient’s responsibility may vary, depending on payment plans negotiated with individual health insurers. To obtain pricing information for services not listed below, please contact our Chargemaster Coordinator at
(717) 633-7102.
These prices are correct as of September 1, 2012.
The following list does not include charges for anesthesia, drugs, or supplies required for a particular procedure. Fees for physician services or anesthesia administration are also not reflected, and will be billed separately by your physician.
Room and Board - Per Day Charges
| Private |
735.00 |
| Semi-Private |
695.00 |
| Critical Care |
1,900.00 |
| Inpatient Rehab - Semi-Private |
1,134.00 |
| Inpatient Rehab - Isolation |
1,332.00 |
Cardiac Services
| 93307 |
Echocardiogram |
1,118.00 |
| C8928 |
Stress Echo with Contrast |
2,094.75 |
| 93798 |
Cardiac Rehabilitation – Initial Visit |
144.00 |
| 93017 |
Treadmill Stress Test |
521.00 |
Emergency Department Exam Charges
Emergency Department charges are based on the level of emergency care provided to patients. The levels, with level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.
| 99281 |
Emergency Department Exam/Brief |
205.00 |
| 99282 |
Emergency Department Exam/Limited |
319.00 |
| 99283 |
Emergency Department Exam/Intermediate |
552.00 |
| 99284 |
Emergency Department Exam/Extended |
801.00 |
| 99285 |
Emergency Department Exam/Complicated |
1,107.00 |
| 99291 |
Emergency Department Exam/Critical Care |
2,559.00 |
Labor & Delivery Charges
| |
Average Vaginal Delivery* |
7,238.51 |
| |
Average Cesarean Section Delivery* |
12,542.72 |
| 59025 |
Fetal Non-Stress Test |
400.00 |
Laboratory Charges
| 85025 |
CBC w/ Diff |
66.25 |
| 82378 |
CEA-Screening |
117.00 |
| 80061 |
Coronary Risk Profile |
100.25 |
| 80051 |
Electrolytes |
77.25 |
| 82947 |
Glucose |
23.00 |
| 88175 |
PapSmear - Diagnostic |
118.00 |
| 84702 |
Pregnancy Blood Test |
85.50 |
| 85610 |
Prothrombin time |
40.50 |
| G0103 |
PSA Screening |
114.50 |
| 81003 |
Routine Urinalysis |
31.25 |
| 82270 |
Stool Occult Blood Screening |
37.25 |
| 84443 |
Thyroid |
127.00 |
Physical Therapy Charges
| 97113 |
Aquatic Therapy (15 Min Intervals) |
67.50 |
| 97014 |
Electrical Stimulation |
60.50 |
| 97116 |
Gait Training (15 Min Intervals) |
80.00 |
| 97001 |
Physical Therapy Evaluation |
192.00 |
| 97035 |
Ultrasound (15 Min Intervals) |
77.00 |
Surgical Procedures
Surgery prices are based upon one primary procedure. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular surgery.
| 45378 |
Colonoscopy - Diagnostic |
1,088.50 |
| G0121 |
Colonoscopy - Screening |
1,088.50 |
| 45330 |
Sigmoidoscopy |
935.00 |
| 43235 |
Upper Gastrointestinal Endoscopy (EGD) |
930.50 |
Ultrasounds
| 76700 |
Abdomen Complete |
901.00 |
| 76645 |
Breast |
374.00 |
| 76817 |
Transvaginal Complete Pregnancy |
455.00 |
X-Rays and Radiological Charges
| 74020 |
Abdomen Complete |
243.00 |
| 71020 |
Chest X-Ray (2 Views) |
196.00 |
| 72110 |
Lumbar Complete w/ Obliques |
469.00 |
| 74241 |
Upper GI Series |
555.00 |
| 74160 |
CT Abdomen with Contrast |
1,907.00 |
| 74150 |
CT Abdomen without Contrast |
1,524.00 |
| 72193 |
CT Pelvis with Contrast |
1,616.00 |
| 72192 |
CT Pelvis without Contrast |
1,429.00 |
| 74177 |
CT Abdomen & Pelvis with Contrast |
3,224.25 |
| 74176 |
CT Abdomen & Pelvis without Contrast |
2,648.00 |
| 70487 |
CT Sinuses with Contrast |
1,716.00 |
| 70486 |
CT Sinuses without Contrast |
1,476.00 |
| 77058 |
MRI Breast Unilateral |
2,214.00 |
| 72149 |
MRI Lumbar Spine with Contrast |
2,361.00 |
| 72148 |
MRI Lumbar Spine without Contrast |
1,786.25 |
Other
| G0204 |
Mammogram-Bilateral - Diagnostic |
250.00 |
| G0202 |
Mammogram-Bilateral - Screening |
190.00 |
| 95810 |
Sleep Study with EEG |
2,364.00 |
| 95807 |
Sleep Study without EEG |
1,563.00 |
Hospital Billing Policies
Hanover Hospital has a trained staff of professionals to help you with your billing needs. As a courtesy to our patients, Hanover Hospital submits claims to all applicable insurances provided at the time of registration.
Once all applicable insurances have paid their obligated portion, Hanover Hospital will send a statement to the listed responsible party. If you are unable to pay the amount due, please call one of our customer service representatives immediately to make other arrangements. You can contact a customer service representative by calling (717) 633-8877 or 800-673-2426, ext. 8877.
Alternate payment options and financial aid are available to qualified patients. If you have questions concerning the Financial Assistance program, please contact a Patient Financial Advocate at (717) 646-6972, (717) 646-6973, or 800-673-2426 Monday - Friday, 8 a.m.-4:30 p.m. & 5 - 11 p.m. and Saturday and Sunday, 8 a.m. - 3 p.m. & 4 -9 p.m. for free, confidential assistance.
*Fees are average for these services and generally vary from patient to patient.