Bx breast 1st lesion mr imag at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,858.80
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.
$3,098.00
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.
$178.31 with UPMC Health Plan vs $48,693.46 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 | Managed Medicaid | $178.31 | ↓ -90% |
| Aetna | CHIP/Medicaid | $178.31 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $186.41 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $225.30 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $240.39 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $253.05 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $276.25 | ↓ -85% |
| UPMC Health Plan | CHIP | $757.05 | ↓ -59% |
| UPMC Health Plan | Managed Medicare | $800.31 | ↓ -57% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $800.31 | ↓ -57% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $800.31 | ↓ -57% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $800.31 | ↓ -57% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $800.31 | ↓ -57% |
| Highmark Wholecare (prev Gateway) | Medicare | $823.02 | ↓ -56% |
| Aetna of PA | Medicare | $832.32 | ↓ -55% |
| United Healthcare | Unison Advantage Non Special Needs | $840.33 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $864.33 | ↓ -54% |
| United Healthcare | Unison Advantage Special Needs | $880.34 | ↓ -53% |
| UPMC Health Plan | Partners/Select | $944.37 | ↓ -49% |
| UPMC Work Partners | Workers Comp | $1,345.99 | ↓ -28% |
| United Healthcare | Commercial | $1,357.00 | ↓ -27% |
| UPMC Health Plan | Commercial | $1,457.85 | ↓ -22% |
| Focus Healthcare | Workers Compensation | $1,486.85 | ↓ -20% |
| Horizon Health Plan | Commercial | $1,514.10 | ↓ -19% |
| Cigna | Commercial | $1,514.10 | ↓ -19% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,622.25 | ↓ -13% |
| InterGroup | Commercial | $1,730.40 | ↓ -7% |
| Health Coalition Partners | PPO | $1,730.40 | ↓ -7% |
| Focus Healthcare | Disability/PPO/Auto | $2,054.85 | ↑ +11% |
| Highmark BCBS of PA | Managed Care - Social Mission | $3,215.29 | ↑ +73% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $3,215.29 | ↑ +73% |
| Highmark BCBS of PA | Managed Care | $3,938.36 | ↑ +112% |
| Highmark BCBS of PA | Commercial - Indemnity | $3,938.36 | ↑ +112% |
| Cigna | Medicare | $48,693.46 | ↑ +2520% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bx breast 1st lesion mr imag at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,606.40 | $162.10 – $3,475.20 |
| UPMC Carlisle | Carlisle | $2,087.40 | $205.87 – $6,413.00 |
| UPMC Community Osteopathic | Harrisburg | $2,087.40 | $218.84 – $2,957.15 |
| UPMC Hamot | Erie | $6,429.60 | $178.31 – $1,345.99 |
| UPMC Hanover | Hanover | $2,087.40 | $205.87 – $1,408.59 |
| UPMC Lititz | Lititz | $2,087.40 | $156.69 – $1,408.59 |
| UPMC Magee | Pittsburgh | $5,692.20 | $178.31 – $1,668.28 |
| UPMC Memorial | York | $2,087.40 | $156.69 – $1,408.59 |