Clsd tx fx radius/ulna w/manip 25565 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
not published by hospital
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.
not published by hospital
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.
$220.55 with Aetna vs $2,733.81 with Highmark BCBS of PA — 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 | $220.55 | — |
| UPMC Health Plan | Managed Medicaid | $220.55 | — |
| United Healthcare Community Plan for Families | Unison Kids | $230.57 | — |
| Geisinger | Medicaid/CHIP | $278.67 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $297.34 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $313.00 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $341.69 | — |
| UPMC Work Partners | Workers Comp | $1,062.25 | — |
| Focus Healthcare | Workers Compensation | $1,173.41 | — |
| UPMC Health Plan | Commercial | $1,693.31 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,231.89 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,231.89 | — |
| UPMC Health Plan | CHIP | $2,299.53 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $2,733.81 | — |
| Highmark BCBS of PA | Managed Care | $2,733.81 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx fx radius/ulna w/manip 25565 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $3,184.80 | $200.50 – $4,246.40 |
| UPMC Bedford | Everett | $1,626.60 | $210.53 – $2,439.90 |
| UPMC Carlisle | Carlisle | $2,055.00 | $254.63 – $2,911.25 |
| UPMC Cole | Coudersport | $1,693.20 | $210.53 – $1,178.40 |
| UPMC Community Osteopathic | Harrisburg | $2,055.00 | $254.63 – $2,911.25 |
| UPMC East | Monroeville | $3,706.20 | $220.55 – $4,941.60 |
| UPMC Hamot | Erie | $3,100.80 | $220.55 – $2,219.16 |
| UPMC Northwest | Seneca | $2,186.40 | $220.55 – $1,602.09 |