Avulsion nail plate partial/complete simple single nail plate at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$157.20
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.
$262.00
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.
$28.32 with Aetna vs $5,898.14 with Cigna — 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $28.32 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $28.32 | ↓ -82% |
| United Healthcare Community Plan for Families | Unison Kids | $29.61 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $35.79 | ↓ -77% |
| Highmark Wholecare (prev Gateway) | Medicaid | $38.19 | ↓ -76% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $40.20 | ↓ -74% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $43.88 | ↓ -72% |
| UPMC Health Plan | CHIP | $91.70 | ↓ -42% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $96.94 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $96.94 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $96.94 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $96.94 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $96.94 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $99.69 | ↓ -37% |
| Aetna of PA | Medicare | $100.82 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $101.79 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $104.70 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $106.63 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $114.39 | ↓ -27% |
| UPMC Work Partners | Workers Comp | $127.74 | ↓ -19% |
| Focus Healthcare | Workers Compensation | $141.10 | ↓ -10% |
| Horizon Health Plan | Commercial | $183.40 | ↑ +17% |
| Cigna | Commercial | $183.40 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $196.50 | ↑ +25% |
| InterGroup | Commercial | $209.60 | ↑ +33% |
| Health Coalition Partners | PPO | $209.60 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $248.90 | ↑ +58% |
| UPMC Health Plan | Commercial | $309.48 | ↑ +97% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $480.67 | ↑ +206% |
| Highmark BCBS of PA | Managed Care - Social Mission | $480.67 | ↑ +206% |
| Highmark BCBS of PA | Managed Care | $588.77 | ↑ +275% |
| Highmark BCBS of PA | Commercial - Indemnity | $588.77 | ↑ +275% |
| Cigna | Medicare | $5,898.14 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Avulsion nail plate partial/complete simple single nail plate at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $584.40 | $25.75 – $779.20 |
| UPMC Bedford | Everett | $289.20 | $27.04 – $433.80 |
| UPMC Carlisle | Carlisle | $520.80 | $32.70 – $1,016.56 |
| UPMC Cole | Coudersport | $330.60 | $19.13 – $2,094.25 |
| UPMC Community Osteopathic | Harrisburg | $520.80 | $32.70 – $1,016.56 |
| UPMC East | Monroeville | $543.60 | $28.32 – $724.80 |
| UPMC Hamot | Erie | $566.40 | $28.32 – $275.52 |
| UPMC Northwest | Seneca | $417.00 | $28.32 – $198.91 |