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Diagnostic Mammogram (both breasts) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$238.80
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.
$398.00
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.
$116.00 with United Healthcare vs $8,959.78 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 |
|---|---|---|---|
| United Healthcare | Commercial | $116.00 | ↓ -51% |
| UPMC Health Plan | CHIP | $139.30 | ↓ -42% |
| Aetna | CHIP/Medicaid | $142.84 | ↓ -40% |
| UPMC Health Plan | Managed Medicaid | $142.84 | ↓ -40% |
| UPMC Health Plan | Managed Medicare | $147.26 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $147.26 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $147.26 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $147.26 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $147.26 | ↓ -38% |
| United Healthcare Community Plan for Families | Unison Kids | $149.33 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $151.44 | ↓ -37% |
| Aetna of PA | Medicare | $153.15 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $154.62 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $159.04 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $161.99 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $173.77 | ↓ -27% |
| Geisinger | Medicaid/CHIP | $180.48 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicaid | $192.57 | ↓ -19% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $202.71 | ↓ -15% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $221.29 | ↓ -7% |
| Horizon Health Plan | Commercial | $278.60 | ↑ +17% |
| Cigna | Commercial | $278.60 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $298.50 | ↑ +25% |
| Health Coalition Partners | PPO | $318.40 | ↑ +33% |
| InterGroup | Commercial | $318.40 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $378.10 | ↑ +58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $455.73 | ↑ +91% |
| Highmark BCBS of PA | Managed Care - Social Mission | $455.73 | ↑ +91% |
| UPMC Health Plan | Commercial | $497.07 | ↑ +108% |
| Highmark BCBS of PA | Commercial - Indemnity | $558.21 | ↑ +134% |
| Highmark BCBS of PA | Managed Care | $558.21 | ↑ +134% |
| Cigna | Medicare | $8,959.78 | ↑ +3652% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Focus Healthcare | Workers Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic Mammogram (both breasts) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Hamot | Erie | $612.00 | $73.61 – $714.00 |
| UPMC Carlisle | Carlisle | $310.20 | $70.83 – $611.06 |
| UPMC Altoona | Altoona | $583.20 | $73.61 – $777.60 |
| UPMC Bedford | Everett | $609.00 | $136.34 – $913.50 |
| UPMC Cole | Coudersport | $458.40 | $136.34 – $611.20 |
| UPMC Community Osteopathic | Harrisburg | $310.20 | $103.40 – $675.02 |
| UPMC Hanover | Hanover | $310.20 | $98.23 – $611.06 |
| UPMC Jameson | New Castle | $306.00 | $74.91 – $448.80 |