healthcosts.net
Diagnostic Mammogram (one breast) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$186.60
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.
$311.00
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.
$108.85 with UPMC Health Plan vs $7,001.23 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 |
|---|---|---|---|
| UPMC Health Plan | CHIP | $108.85 | ↓ -42% |
| Aetna | CHIP/Medicaid | $112.65 | ↓ -40% |
| UPMC Health Plan | Managed Medicaid | $112.65 | ↓ -40% |
| UPMC Health Plan | Managed Medicare | $115.07 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $115.07 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $115.07 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $115.07 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $115.07 | ↓ -38% |
| United Healthcare | Commercial | $116.00 | ↓ -38% |
| United Healthcare Community Plan for Families | Unison Kids | $117.77 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicare | $118.34 | ↓ -37% |
| Aetna of PA | Medicare | $119.67 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $120.82 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $124.28 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $126.58 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $135.78 | ↓ -27% |
| Geisinger | Medicaid/CHIP | $142.34 | ↓ -24% |
| Highmark Wholecare (prev Gateway) | Medicaid | $151.87 | ↓ -19% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $159.87 | ↓ -14% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $174.53 | ↓ -6% |
| Horizon Health Plan | Commercial | $217.70 | ↑ +17% |
| Cigna | Commercial | $217.70 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $233.25 | ↑ +25% |
| Health Coalition Partners | PPO | $248.80 | ↑ +33% |
| InterGroup | Commercial | $248.80 | ↑ +33% |
| UPMC Health Plan | Commercial | $268.33 | ↑ +44% |
| Focus Healthcare | Disability/PPO/Auto | $295.45 | ↑ +58% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $357.49 | ↑ +92% |
| Highmark BCBS of PA | Managed Care - Social Mission | $357.49 | ↑ +92% |
| Highmark BCBS of PA | Commercial - Indemnity | $437.89 | ↑ +135% |
| Highmark BCBS of PA | Managed Care | $437.89 | ↑ +135% |
| Cigna | Medicare | $7,001.23 | ↑ +3652% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Focus Healthcare | Workers Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic Mammogram (one breast) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $336.60 | $58.27 – $448.80 |
| UPMC Passavant-McCandless | Pittsburgh | $427.20 | $58.27 – $605.20 |
| UPMC Hamot | Erie | $478.80 | $57.72 – $558.60 |
| UPMC Carlisle | Carlisle | $243.60 | $19.45 – $479.38 |
| UPMC Altoona | Altoona | $475.80 | $57.72 – $634.40 |
| UPMC Bedford | Everett | $502.20 | $107.53 – $753.30 |
| UPMC Cole | Coudersport | $360.00 | $107.53 – $480.00 |
| UPMC Community Osteopathic | Harrisburg | $349.80 | $28.40 – $364.39 |