Penn Highlands Healthcare · Saint Marys, PA
34
In-network payers
250
Disclosed rate categories
35
Beds
4
Care quality
Penn Highlands Elk is a 35-bed voluntary non-profit - private hospital in Saint Marys, PA, affiliated with Penn Highlands Healthcare. Below you'll find publicly disclosed negotiated rates and facility details, including 34 in-network payers and 250 disclosed rate categories.
CCN (Medicare provider number)
391315
NPI
1326434242
Type
Critical Access Hospital
Ownership
Voluntary Non-Profit - Private
Beds
35
Care Quality
4
Insurance acceptance may vary by specific plan, network status, and services required. Contact your insurance provider or the hospital's billing department to confirm coverage details.
The 24 services Penn Highlands Elk most likely performs, ranked by likely volume and what it is paid. Each service names one insurer. * marks hidden insurer names; A, B and C rank the remaining rates from low to high and reset for each service.
Book a demo to see hidden insurer names, more payer rates, and hospital data.
Childbirth · Inpatient
MS-DRG 807
$3,720 - $7,271
from 4 insurers · median $4,424
CMS lists this service as CPT 59400, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Childbirth · Inpatient
MS-DRG 788
$5,127 - $14,497
from 4 insurers · median $6,741
CMS lists this service as CPT 59510, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 788, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
CT imaging
CPT 74177
$559 - $1,025
from 4 insurers · median $789
Typical for a hospital with this service line
Digestive procedures
CPT 43239
$1,521 - $3,801
from 4 insurers · median $2,959
Typical for a hospital with this service line
Digestive procedures
CPT 45385
$1,930 - $4,949
from 2 insurers · median $3,439
Typical for a hospital with this service line
Cardiology and vascular testing
CPT 93306
$555 - $2,063
from 4 insurers · median $1,506
Typical for a hospital with this service line
Digestive procedures
CPT 45378
$1,647 - $4,712
from 2 insurers · median $3,179
Typical for a hospital with this service line
Digestive procedures
CPT 45380
$1,567 - $1,683
from 2 insurers · median $1,625
Typical for a hospital with this service line
Childbirth · Inpatient
MS-DRG 807
$3,720 - $7,271
from 4 insurers · median $4,424
CMS lists this service as CPT 59610, the obstetrician's global fee. The hospital bills the delivery stay as MS-DRG 807, so these are facility case rates.
Hospital reports neonatal nursery services to CMS
Mammography
CPT 77067
$145 - $390
from 4 insurers · median $181
Typical for a hospital with this service line
CT imaging
CPT 70450
$175 - $314
from 4 insurers · median $243
Typical for a hospital with this service line
Nuclear imaging
CPT 78815
$2,251 - $6,091
from 3 insurers · median $2,535
Hospital reports pet scan services to CMS
CT imaging
CPT 74176
$287 - $708
from 4 insurers · median $445
Typical for a hospital with this service line
CT imaging
CPT 71275
$338 - $724
from 4 insurers · median $547
Typical for a hospital with this service line
Nuclear imaging
CPT 78452
$830 - $2,258
from 4 insurers · median $1,822
Hospital reports nuclear medicine services to CMS
MRI imaging
CPT 70553
$605 - $1,287
from 4 insurers · median $821
Typical for a hospital with this service line
Gynecology
CPT 58558
$5,362 - $6,036
from 2 insurers · median $5,699
Typical for a hospital with this service line
Medicine & Surgery
CPT 66984
$679 - $7,720
from 3 insurers · median $2,610
Typical for a hospital with this service line
X-ray and bone density
CPT 71046
$59 - $154
from 4 insurers · median $106
Typical for a hospital with this service line
Gynecology
CPT 58571
$3,856 - $5,594
from 2 insurers · median $4,725
Typical for a hospital with this service line
Medicine & Surgery
CPT 47562
$2,238 - $4,301
from 2 insurers · median $3,270
Typical for a hospital with this service line
Medicine & Surgery · Inpatient
MS-DRG 470
$10,754 - $29,165
from 3 insurers · median $11,984
Hospital reports orthopedic surgery services to CMS
Gynecology
CPT 58661
$1,566 - $8,834
from 2 insurers · median $5,200
Typical for a hospital with this service line
Urology
CPT 50590
$3,079 - $9,521
from 2 insurers · median $6,300
Typical for a hospital with this service line
Median rate as a percent of Medicare across the outpatient services above, and how many services sit above or below the same insurer's median at nearby hospitals. * marks hidden insurer names. These table labels track the same insurers across services; the labels on each service card reset.
| Insurer | Services | Median % of Medicare | Above nearby | Below nearby |
|---|---|---|---|---|
| Insurer A* | 16 | 289% | 1 | 2 |
| Insurer B* | 15 | 181% | 1 | 10 |
| Insurer C* | 23 | 164% | 15 | 0 |
| Insurer D* | 23 | 161% | 4 | 12 |
How we chose these services: 0 appear in this hospital's own Medicare claims, 0 are common here based on CMS Medicare volume, and 24 are typical for the service lines it reports to CMS. Rates come from insurer and hospital price transparency files as of October 2026. Rates under a quarter of Medicare or over 20 times Medicare are left out as likely physician-fee rows or file errors. Book a demo to see all 300 CMS shoppable services for Penn Highlands Elk.
763 Johnsonburg Road, Saint Marys, PA 15857
(814) 788-8000
The nearest hospitals of similar type and size. Their rates are compared with Penn Highlands Elk for the same insurers and services above.
Upmc Cole
▲ Rates typically 21% higher than Penn Highlands Elk (19 services)
Bucktail Medical Center
▼ Rates typically 38% lower than Penn Highlands Elk (7 services)
Cuba Memorial Hospital Inc
▼ Rates typically 58% lower than Penn Highlands Elk (16 services)
Titusville Area Hospital
▼ Rates typically 7% lower than Penn Highlands Elk (19 services)
Corry Memorial Hospital
▲ Rates typically 26% higher than Penn Highlands Elk (17 services)
Geisinger Jersey Shore Hospital
▼ Rates typically 33% lower than Penn Highlands Elk (19 services)
Brookville Hospital
Tyrone Hospital
Meyersdale Community Hospital
About Penn Highlands Elk's rates and hospital price transparency.
For MRI brain before and after contrast (CPT 70553), published negotiated rates at Penn Highlands Elk range from $605 to $1,287 across 4 insurers. UnitedHealthcare's rate is $653. The median at nearby comparable hospitals is $1,362. What a patient pays depends on their plan's deductible, coinsurance and network status.
For CT abdomen and pelvis with contrast (CPT 74177), published negotiated rates at Penn Highlands Elk range from $559 to $1,025 across 4 insurers. Aetna's rate is $559. The median at nearby comparable hospitals is $1,156. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Colonoscopy with polyp removal (CPT 45385), published negotiated rates at Penn Highlands Elk range from $1,930 to $4,949 across 2 insurers. Blue Cross Blue Shield's rate is $1,930. The median at nearby comparable hospitals is $1,260. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Vaginal delivery, hospital stay (MS-DRG 807), published negotiated rates at Penn Highlands Elk range from $3,720 to $7,271 across 4 insurers. Cigna's rate is $4,056. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Screening mammography, bilateral (CPT 77067), published negotiated rates at Penn Highlands Elk range from $145 to $390 across 4 insurers. Cigna's rate is $174. The median at nearby comparable hospitals is $167. What a patient pays depends on their plan's deductible, coinsurance and network status.
For Major lower-extremity joint replacement without MCC (MS-DRG 470), published negotiated rates at Penn Highlands Elk range from $10,754 to $29,165 across 3 insurers. Aetna's rate is $29,165. The median at nearby comparable hospitals is $13,652. What a patient pays depends on their plan's deductible, coinsurance and network status.
Penn Highlands Elk has 35 beds. Facility type: Critical Access Hospital.
Penn Highlands Elk is located at 763 Johnsonburg Road, Saint Marys, PA 15857. Its main phone number is (814) 788-8000.
Penn Highlands Elk's CMS Certification Number (CCN), also called its Medicare provider number, is 391315.
The National Provider Identifier (NPI) on file for Penn Highlands Elk is 1326434242.
Penn Highlands Elk is affiliated with Penn Highlands Healthcare.
Penn Highlands Elk lists 34 in-network payers, including Aetna, Ambetter, Ameri Health, Aspirus Health Plan, and is Medicare-certified. Insurance acceptance may vary by plan, so confirm coverage with your insurer or the hospital's billing department.
250 disclosed rate categories. Each shows the payer, category, code type and group with its code range, and contract type, along with how the rate compares with the state average.
Under 45 CFR Part 180, every US hospital must publish a machine-readable file of its standard charges, including gross charges, discounted cash prices and payer-specific negotiated rates, in the CMS template format. PayerPrice can help hospitals publish and maintain these files.
A chargemaster (charge description master, or CDM) is a hospital's master list of billable items, with codes, descriptions and gross charges. A chargemaster review looks at those lines for accuracy and pricing. PayerPrice can help hospitals review their chargemaster; contact us to discuss your needs.
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{
"description": "MRI of brain (no contrast)",
"code_information": [
{ "code": "611", "type": "RC" },
{ "code": "70551", "type": "CPT" }
],
"standard_charges": [{
"setting": "outpatient",
"minimum": 250,
"maximum": 400,
"gross_charge": 1200,
"discounted_cash": 1080,
"payers_information": [
{
"payer_name": "Platform Health Insurance",
"plan_name": "PPO",
"methodology": "fee schedule",
"standard_charge_dollar": 400
},
{
"payer_name": "Region Health Insurance",
"plan_name": "HMO",
"methodology": "fee schedule",
"standard_charge_dollar": 250
}
]
}]
}Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.
What a review covers