Diagnostic digital breast tomosynthesis bil at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$126.00
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.
$210.00
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.
$53.01 with Aetna vs $4,727.52 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 | $53.01 | ↓ -58% |
| UPMC Health Plan | Managed Medicaid | $53.01 | ↓ -58% |
| United Healthcare Community Plan for Families | Unison Kids | $55.42 | ↓ -56% |
| Geisinger | Medicaid/CHIP | $66.98 | ↓ -47% |
| Highmark Wholecare (prev Gateway) | Medicaid | $71.47 | ↓ -43% |
| UPMC Health Plan | CHIP | $73.50 | ↓ -42% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $75.23 | ↓ -40% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $77.70 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $77.70 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $77.70 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $77.70 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $77.70 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $79.91 | ↓ -37% |
| Aetna of PA | Medicare | $80.81 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $81.58 | ↓ -35% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $82.13 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $83.92 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $85.47 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $91.69 | ↓ -27% |
| United Healthcare | Commercial | $116.00 | ↓ -8% |
| Cigna | Commercial | $147.00 | ↑ +17% |
| Horizon Health Plan | Commercial | $147.00 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $157.50 | ↑ +25% |
| InterGroup | Commercial | $168.00 | ↑ +33% |
| Health Coalition Partners | PPO | $168.00 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $199.50 | ↑ +58% |
| UPMC Health Plan | Commercial | $223.78 | ↑ +78% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $519.47 | ↑ +312% |
| Highmark BCBS of PA | Managed Care - Social Mission | $519.47 | ↑ +312% |
| Highmark BCBS of PA | Commercial - Indemnity | $636.30 | ↑ +405% |
| Highmark BCBS of PA | Managed Care | $636.30 | ↑ +405% |
| Cigna | Medicare | $4,727.52 | ↑ +3652% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Focus Healthcare | Workers Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic digital breast tomosynthesis bil at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $847.20 | $50.60 – $1,129.60 |
| WellSpan Chambersburg Hospital | Chambersburg | $157.60 | $14.09 – $109.19 |
| WellSpan Ephrata Community Hospital | Ephrata | $93.60 | $14.23 – $163.85 |
| Uniontown Hospital | Uniontown | $394.50 | $24.76 – $28.14 |
| WellSpan Waynesboro Hospital | Waynesboro | $157.60 | $14.09 – $109.19 |
| WellSpan Evangelical Community Hospital | Lewisburg | $103.20 | $13.95 – $109.19 |
| WellSpan Good Samaritan Hospital | Lebanon | $93.60 | $14.09 – $163.85 |
| WellSpan Gettysburg Hospital | Gettysburg | $88.80 | $14.09 – $163.85 |