Clsd tx/prox/mid phalnx fx/no manp 26720 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$595.20
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.
?
What you pay up front if you don't use insurance.
$992.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$61.60 with UPMC Health Plan vs $22,331.90 with Cigna — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $61.60 | ↓ -90% |
| Aetna | CHIP/Medicaid | $61.60 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $64.40 | ↓ -89% |
| Geisinger | Medicaid/CHIP | $77.83 | ↓ -87% |
| Highmark Wholecare (prev Gateway) | Medicaid | $83.05 | ↓ -86% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $87.42 | ↓ -85% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $95.44 | ↓ -84% |
| UPMC Health Plan | Commercial | $221.32 | ↓ -63% |
| UPMC Work Partners | Workers Comp | $253.74 | ↓ -57% |
| Focus Healthcare | Workers Compensation | $280.30 | ↓ -53% |
| UPMC Health Plan | CHIP | $300.55 | ↓ -50% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $367.04 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $377.46 | ↓ -37% |
| Aetna of PA | Medicare | $381.72 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $385.39 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $396.40 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $403.74 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $433.11 | ↓ -27% |
| United Healthcare | Commercial | $485.98 | ↓ -18% |
| Cigna | Commercial | $694.40 | ↑ +17% |
| Horizon Health Plan | Commercial | $694.40 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $744.00 | ↑ +25% |
| InterGroup | Commercial | $793.60 | ↑ +33% |
| Health Coalition Partners | PPO | $793.60 | ↑ +33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $863.29 | ↑ +45% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $863.29 | ↑ +45% |
| Focus Healthcare | Disability/PPO/Auto | $942.40 | ↑ +58% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,057.43 | ↑ +78% |
| Highmark BCBS of PA | Managed Care | $1,057.43 | ↑ +78% |
| Cigna | Medicare | $22,331.90 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Clsd tx/prox/mid phalnx fx/no manp 26720 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $229.20 | $58.80 – $343.80 |
| UPMC Carlisle | Carlisle | $366.60 | $71.12 – $1,016.56 |
| UPMC Cole | Coudersport | $622.80 | $42.97 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $366.60 | $71.12 – $1,016.56 |
| UPMC Hamot | Erie | $543.60 | $61.60 – $332.62 |
| UPMC Hanover | Hanover | $366.60 | $71.12 – $1,016.56 |
| UPMC Lititz | Lititz | $366.60 | $71.12 – $1,016.56 |
| UPMC Magee | Pittsburgh | $384.00 | $61.60 – $272.41 |