healthcosts.net
Brain MRI (with and without contrast) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$2,954.40
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.
$4,924.00
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.
$148.75 with UPMC Health Plan vs $9,567.60 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 |
|---|---|---|---|
| UPMC Health Plan | CHIP | $148.75 | ↓ -95% |
| UPMC Health Plan | Managed Medicare | $157.25 | ↓ -95% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $157.25 | ↓ -95% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $157.25 | ↓ -95% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $157.25 | ↓ -95% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $157.25 | ↓ -95% |
| Highmark Wholecare (prev Gateway) | Medicare | $161.71 | ↓ -95% |
| Aetna of PA | Medicare | $163.54 | ↓ -94% |
| United Healthcare | Unison Advantage Non Special Needs | $165.11 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $169.83 | ↓ -94% |
| United Healthcare | Unison Advantage Special Needs | $172.97 | ↓ -94% |
| UPMC Health Plan | Partners/Select | $185.56 | ↓ -94% |
| Horizon Health Plan | Commercial | $297.50 | ↓ -90% |
| Cigna | Commercial | $297.50 | ↓ -90% |
| Multiplan | Auto/PPO/Worker's Compensation | $318.75 | ↓ -89% |
| Health Coalition Partners | PPO | $340.00 | ↓ -88% |
| InterGroup | Commercial | $340.00 | ↓ -88% |
| Aetna | CHIP/Medicaid | $372.90 | ↓ -87% |
| UPMC Health Plan | Managed Medicaid | $372.90 | ↓ -87% |
| United Healthcare Community Plan for Families | Unison Kids | $389.85 | ↓ -87% |
| Focus Healthcare | Disability/PPO/Auto | $403.75 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $471.18 | ↓ -84% |
| Highmark Wholecare (prev Gateway) | Medicaid | $502.74 | ↓ -83% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $529.21 | ↓ -82% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $577.72 | ↓ -80% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $916.85 | ↓ -69% |
| Highmark BCBS of PA | Managed Care - Social Mission | $916.85 | ↓ -69% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,123.03 | ↓ -62% |
| Highmark BCBS of PA | Managed Care | $1,123.03 | ↓ -62% |
| United Healthcare | Commercial | $1,357.00 | ↓ -54% |
| UPMC Work Partners | Workers Comp | $2,380.18 | ↓ -19% |
| Focus Healthcare | Workers Compensation | $2,629.27 | ↓ -11% |
| UPMC Health Plan | Commercial | $2,807.25 | ↓ -5% |
| Cigna | Medicare | $9,567.60 | ↑ +224% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Brain MRI (with and without contrast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $5,999.40 | $316.41 – $8,499.15 |
| UPMC East | Monroeville | $6,218.40 | $341.40 – $8,291.20 |
| UPMC Hamot | Erie | $7,916.40 | $281.64 – $9,235.80 |
| UPMC Horizon-Greenville | Greenville | $3,601.80 | $304.83 – $5,102.55 |
| UPMC Jameson | New Castle | $2,584.20 | $309.35 – $3,790.16 |
| UPMC McKeesport | Mckeesport | $6,049.20 | $315.59 – $8,569.70 |
| UPMC Altoona | Altoona | $2,604.00 | $269.00 – $3,472.00 |
| UPMC Carlisle | Carlisle | $2,854.80 | $338.22 – $4,044.30 |