healthcosts.net
Colonoscopy (with biopsy) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,398.60
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.
$2,331.00
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.
$247.96 with Aetna vs $52,475.47 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $247.96 | ↓ -82% |
| UPMC Health Plan | Managed Medicaid | $247.96 | ↓ -82% |
| United Healthcare Community Plan for Families | Unison Kids | $259.23 | ↓ -81% |
| Geisinger | Medicaid/CHIP | $313.31 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $334.30 | ↓ -76% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $351.90 | ↓ -75% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $384.16 | ↓ -73% |
| UPMC Work Partners | Workers Comp | $841.35 | ↓ -40% |
| UPMC Health Plan | Managed Medicare | $862.47 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $862.47 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $862.47 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $862.47 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $862.47 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $886.95 | ↓ -37% |
| Aetna of PA | Medicare | $896.97 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $905.59 | ↓ -35% |
| Focus Healthcare | Workers Compensation | $929.39 | ↓ -34% |
| AmeriHealth Caritas | Medicare | $931.47 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $948.72 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $1,017.71 | ↓ -27% |
| United Healthcare | Commercial | $1,141.96 | ↓ -18% |
| Horizon Health Plan | Commercial | $1,631.70 | ↑ +17% |
| Cigna | Commercial | $1,631.70 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,692.90 | ↑ +21% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,748.25 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,812.55 | ↑ +30% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,812.55 | ↑ +30% |
| Health Coalition Partners | PPO | $1,864.80 | ↑ +33% |
| InterGroup | Commercial | $1,864.80 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $2,214.45 | ↑ +58% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,220.16 | ↑ +59% |
| Highmark BCBS of PA | Managed Care | $2,220.16 | ↑ +59% |
| UPMC Health Plan | CHIP | $2,298.97 | ↑ +64% |
| Cigna | Medicare | $52,475.47 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Colonoscopy (with biopsy) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,214.00 | $247.96 – $3,136.50 |
| UPMC East | Monroeville | $3,055.20 | $247.96 – $4,073.60 |
| UPMC Hamot | Erie | $3,099.00 | $247.96 – $3,615.50 |
| UPMC Altoona | Altoona | $1,764.60 | $225.42 – $2,352.80 |
| UPMC Bedford | Everett | $1,656.60 | $236.69 – $2,484.90 |
| UPMC Cole | Coudersport | $727.20 | $236.69 – $1,041.88 |
| UPMC Horizon-Greenville | Greenville | $2,476.20 | $247.96 – $3,507.95 |
| UPMC Jameson | New Castle | $2,476.20 | $247.96 – $3,631.76 |