Biopsy abdominal mass at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,273.80
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.
$2,123.00
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.
$89.07 with Aetna vs $30,256.13 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 | $89.07 | ↓ -93% |
| UPMC Health Plan | Managed Medicaid | $89.07 | ↓ -93% |
| United Healthcare Community Plan for Families | Unison Kids | $93.12 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $112.54 | ↓ -91% |
| Highmark Wholecare (prev Gateway) | Medicaid | $120.08 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $126.40 | ↓ -90% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $137.99 | ↓ -89% |
| UPMC Health Plan | CHIP | $470.40 | ↓ -63% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $497.28 | ↓ -61% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $497.28 | ↓ -61% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $497.28 | ↓ -61% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $497.28 | ↓ -61% |
| UPMC Health Plan | Managed Medicare | $497.28 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicare | $511.39 | ↓ -60% |
| Aetna of PA | Medicare | $517.17 | ↓ -59% |
| United Healthcare | Unison Advantage Non Special Needs | $522.14 | ↓ -59% |
| AmeriHealth Caritas | Medicare | $537.06 | ↓ -58% |
| United Healthcare | Unison Advantage Special Needs | $547.01 | ↓ -57% |
| UPMC Health Plan | Partners/Select | $586.79 | ↓ -54% |
| UPMC Work Partners | Workers Comp | $650.93 | ↓ -49% |
| United Healthcare | Commercial | $701.00 | ↓ -45% |
| Focus Healthcare | Workers Compensation | $719.05 | ↓ -44% |
| Highmark BCBS of PA | Managed Care - Social Mission | $732.64 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $732.64 | ↓ -42% |
| Highmark BCBS of PA | Commercial - Indemnity | $897.40 | ↓ -30% |
| Highmark BCBS of PA | Managed Care | $897.40 | ↓ -30% |
| Horizon Health Plan | Commercial | $940.80 | ↓ -26% |
| Cigna | Commercial | $940.80 | ↓ -26% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,008.00 | ↓ -21% |
| InterGroup | Commercial | $1,075.20 | ↓ -16% |
| Health Coalition Partners | PPO | $1,075.20 | ↓ -16% |
| UPMC Health Plan | Commercial | $1,262.51 | ↓ -1% |
| Focus Healthcare | Disability/PPO/Auto | $1,276.80 | ↑ +0% |
| Cigna | Medicare | $30,256.13 | ↑ +2275% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Biopsy abdominal mass at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $1,224.60 | $80.97 – $1,632.80 |
| UPMC Carlisle | Carlisle | $2,461.20 | $102.83 – $3,486.70 |
| UPMC Community Osteopathic | Harrisburg | $2,461.20 | $102.83 – $3,486.70 |
| UPMC East | Monroeville | $1,689.60 | $89.07 – $2,252.80 |
| UPMC Hamot | Erie | $2,312.40 | $89.07 – $2,246.66 |
| UPMC Northwest | Seneca | $2,419.20 | $89.07 – $1,621.93 |
| UPMC Hanover | Hanover | $2,461.20 | $102.83 – $2,476.51 |
| UPMC Horizon-Greenville | Greenville | $2,304.60 | $89.07 – $1,668.28 |