Consultation/report referred slides prepared elsewhere at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$210.00
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.
?
What you pay up front if you don't use insurance.
$350.00
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.
$12.71 with United Healthcare vs $7,879.20 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 |
|---|---|---|---|
| United Healthcare | Commercial | $12.71 | ↓ -94% |
| UPMC Health Plan | Commercial | $119.83 | ↓ -43% |
| UPMC Health Plan | CHIP | $122.50 | ↓ -42% |
| UPMC Health Plan | Managed Medicare | $129.50 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $129.50 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $129.50 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $129.50 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $129.50 | ↓ -38% |
| UPMC Work Partners | Workers Comp | $132.96 | ↓ -37% |
| Aetna of PA | Medicare | $134.68 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $135.97 | ↓ -35% |
| Highmark Wholecare (prev Gateway) | Medicare | $139.86 | ↓ -33% |
| AmeriHealth Caritas | Medicare | $139.86 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $142.45 | ↓ -32% |
| Focus Healthcare | Workers Compensation | $146.88 | ↓ -30% |
| UPMC Health Plan | Partners/Select | $152.81 | ↓ -27% |
| Geisinger | Medicaid/CHIP | $192.50 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $192.50 | ↓ -8% |
| Horizon Health Plan | Commercial | $245.00 | ↑ +17% |
| Cigna | Commercial | $245.00 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $262.50 | ↑ +25% |
| InterGroup | Commercial | $280.00 | ↑ +33% |
| Health Coalition Partners | PPO | $280.00 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $332.50 | ↑ +58% |
| Highmark BCBS of PA | Managed Care - Social Mission | $407.30 | ↑ +94% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $407.30 | ↑ +94% |
| Highmark BCBS of PA | Managed Care | $498.90 | ↑ +138% |
| Highmark BCBS of PA | Commercial - Indemnity | $498.90 | ↑ +138% |
| Cigna | Medicare | $7,879.20 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Consultation/report referred slides prepared elsewhere at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $298.20 | $38.16 – $397.60 |
| UPMC Carlisle | Carlisle | $78.60 | $17.95 – $139.15 |
| UPMC Cole | Coudersport | $336.60 | $53.00 – $448.80 |
| UPMC Community Osteopathic | Harrisburg | $163.20 | $26.20 – $162.74 |
| UPMC Hamot | Erie | $342.00 | $12.71 – $137.12 |
| UPMC Hanover | Hanover | $78.60 | $37.12 – $162.74 |
| UPMC Horizon-Greenville | Greenville | $204.00 | $33.50 – $131.19 |
| UPMC Lititz | Lititz | $78.60 | $37.32 – $162.74 |