Diagnostic radio unlisted proc at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$264.00
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.
$440.00
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.
$47.67 with UPMC Health Plan vs $9,905.28 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 | Commercial | $47.67 | ↓ -82% |
| UPMC Health Plan | CHIP | $154.00 | ↓ -42% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $162.80 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $162.80 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $162.80 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $162.80 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $162.80 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $167.42 | ↓ -37% |
| Aetna of PA | Medicare | $169.31 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $170.94 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $175.82 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $179.08 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $192.10 | ↓ -27% |
| United Healthcare | Commercial | $215.56 | ↓ -18% |
| Geisinger | Medicaid/CHIP | $242.00 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $242.00 | ↓ -8% |
| Cigna | Commercial | $308.00 | ↑ +17% |
| Horizon Health Plan | Commercial | $308.00 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $330.00 | ↑ +25% |
| InterGroup | Commercial | $352.00 | ↑ +33% |
| Health Coalition Partners | PPO | $352.00 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $418.00 | ↑ +58% |
| Cigna | Medicare | $9,905.28 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
| Focus Healthcare | Workers Compensation | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic radio unlisted proc at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $255.00 | $64.74 – $340.00 |
| UPMC Carlisle | Carlisle | $170.40 | $38.91 – $241.40 |
| UPMC Community Osteopathic | Harrisburg | $170.40 | $56.80 – $241.40 |
| UPMC Hanover | Hanover | $170.40 | $64.74 – $134.58 |
| UPMC Lititz | Lititz | $170.40 | $64.74 – $135.31 |
| UPMC Magee | Pittsburgh | $2,070.60 | $18.84 – $92.34 |
| UPMC Memorial | York | $170.40 | $64.74 – $279.67 |
| UPMC Presbyterian | Pittsburgh | $686.40 | $63.60 – $92.34 |