Penn Highlands Mon Valley
Penn Highlands Mon Valley in Monongahela, PA charges 4.1x the Medicare reimbursement rate across 16 analyzed procedures at this nonprofit hospital.
Monongahela, PA 15063 · Acute Care Hospitals · CMS Rating: 2/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Pricing grade
C
Average
Avg markup vs Medicare
4.09x
Charge / Medicare rate
Max markup
7.72x
Worst procedure
Procedures analyzed
16
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $65,805 | $32,902 | — | 7.7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $96,634 | $48,317 | — | 6.1x |
| PSYCHOSES | 885 | $31,997 | $15,998 | — | 4.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $31,781 | $15,890 | — | 4.4x |
| RENAL FAILURE WITH CC | 683 | $19,782 | $9,891 | — | 4.2x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $50,835 | $25,418 | — | 4.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $23,568 | $11,784 | — | 4.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $15,755 | $7,878 | — | 3.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $40,245 | $20,123 | — | 3.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $34,310 | $17,155 | — | 3.4x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $14,437 | $7,219 | — | 3.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $17,170 | $8,585 | — | 3.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $28,865 | $14,433 | — | 3.3x |
| RENAL FAILURE WITH MCC | 682 | $26,663 | $13,331 | — | 3.1x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $22,482 | $11,241 | — | 3.1x |
| CELLULITIS WITHOUT MCC | 603 | $13,212 | $6,606 | — | 2.9x |
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use