Bx vulva or perineum/1 lesion 56605 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$414.00
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.
$690.00
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.
$61.06 with UPMC Health Plan vs $15,533.28 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 | $61.06 | ↓ -85% |
| Aetna | CHIP/Medicaid | $61.06 | ↓ -85% |
| United Healthcare Community Plan for Families | Unison Kids | $63.84 | ↓ -85% |
| Geisinger | Medicaid/CHIP | $77.15 | ↓ -81% |
| Highmark Wholecare (prev Gateway) | Medicaid | $82.32 | ↓ -80% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $86.66 | ↓ -79% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $94.60 | ↓ -77% |
| UPMC Work Partners | Workers Comp | $216.20 | ↓ -48% |
| Focus Healthcare | Workers Compensation | $238.83 | ↓ -42% |
| UPMC Health Plan | CHIP | $241.50 | ↓ -42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $255.30 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $255.30 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $255.30 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $255.30 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $255.30 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $262.55 | ↓ -37% |
| Aetna of PA | Medicare | $265.51 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $268.06 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $275.72 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $280.83 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $301.25 | ↓ -27% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $407.17 | ↓ -2% |
| Highmark BCBS of PA | Managed Care - Social Mission | $407.17 | ↓ -2% |
| Cigna | Commercial | $483.00 | ↑ +17% |
| Horizon Health Plan | Commercial | $483.00 | ↑ +17% |
| Highmark BCBS of PA | Commercial - Indemnity | $498.74 | ↑ +20% |
| Highmark BCBS of PA | Managed Care | $498.74 | ↑ +20% |
| Multiplan | Auto/PPO/Worker's Compensation | $517.50 | ↑ +25% |
| Health Coalition Partners | PPO | $552.00 | ↑ +33% |
| InterGroup | Commercial | $552.00 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $655.50 | ↑ +58% |
| UPMC Health Plan | Commercial | $1,275.17 | ↑ +208% |
| Cigna | Medicare | $15,533.28 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Bx vulva or perineum/1 lesion 56605 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Community Osteopathic | Harrisburg | $1,452.00 | $70.50 – $2,057.00 |
| UPMC Hamot | Erie | $3,131.40 | $61.06 – $1,203.71 |
| UPMC Hanover | Hanover | $1,452.00 | $70.50 – $1,330.91 |
| UPMC Magee | Pittsburgh | $1,717.20 | $61.06 – $896.56 |
| UPMC Memorial | York | $1,452.00 | $70.50 – $1,335.92 |
| UPMC Passavant-McCandless | Pittsburgh | $3,544.20 | $61.06 – $913.16 |
| UPMC Presbyterian | Pittsburgh | $3,063.60 | $61.06 – $931.20 |
| UPMC Somerset | Somerset | $1,452.00 | $61.06 – $892.40 |