healthcosts.net
Established Patient Office Visit (level 1) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$72.60
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.
$121.00
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.
$22.00 with Aetna vs $2,723.95 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 | $22.00 | ↓ -70% |
| UPMC Health Plan | Managed Medicaid | $22.00 | ↓ -70% |
| United Healthcare Community Plan for Families | Unison Kids | $23.00 | ↓ -68% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $23.22 | ↓ -68% |
| Highmark BCBS of PA | Managed Care - Social Mission | $23.22 | ↓ -68% |
| Geisinger | Medicaid/CHIP | $27.80 | ↓ -62% |
| Highmark BCBS of PA | Commercial - Indemnity | $28.44 | ↓ -61% |
| Highmark BCBS of PA | Managed Care | $28.44 | ↓ -61% |
| Highmark Wholecare (prev Gateway) | Medicaid | $29.66 | ↓ -59% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $31.22 | ↓ -57% |
| UPMC Work Partners | Workers Comp | $32.39 | ↓ -55% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $34.08 | ↓ -53% |
| Focus Healthcare | Workers Compensation | $35.78 | ↓ -51% |
| UPMC Health Plan | CHIP | $42.35 | ↓ -42% |
| UPMC Health Plan | Managed Medicare | $44.77 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $44.77 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $44.77 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $44.77 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $44.77 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $46.04 | ↓ -37% |
| Aetna of PA | Medicare | $46.56 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $47.01 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $48.35 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $49.25 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $52.83 | ↓ -27% |
| Cigna | Commercial | $63.91 | ↓ -12% |
| UPMC Health Plan | Commercial | $68.95 | ↓ -5% |
| Horizon Health Plan | Commercial | $84.70 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $90.75 | ↑ +25% |
| Health Coalition Partners | PPO | $96.80 | ↑ +33% |
| InterGroup | Commercial | $96.80 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $114.95 | ↑ +58% |
| Cigna | Medicare | $2,723.95 | ↑ +3652% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $108.60 | $22.00 – $153.85 |
| UPMC Altoona | Altoona | $174.60 | $6.00 – $232.80 |
| UPMC Bedford | Everett | $83.40 | $21.00 – $125.10 |
| UPMC Cole | Coudersport | $84.00 | $19.64 – $70.40 |
| UPMC Hamot | Erie | $118.20 | $20.20 – $151.40 |
| UPMC Community Osteopathic | Harrisburg | $97.80 | $8.20 – $180.41 |
| UPMC Hanover | Hanover | $24.60 | $7.79 – $38.11 |
| UPMC Horizon-Greenville | Greenville | $141.00 | $21.00 – $199.75 |