healthcosts.net
Established Patient Office Visit (level 3) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$79.20
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.
$132.00
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.
$26.25 with UPMC Health Plan vs $1,688.40 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 | $26.25 | ↓ -67% |
| UPMC Health Plan | Managed Medicare | $27.75 | ↓ -65% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $27.75 | ↓ -65% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $27.75 | ↓ -65% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $27.75 | ↓ -65% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $27.75 | ↓ -65% |
| Highmark Wholecare (prev Gateway) | Medicare | $28.54 | ↓ -64% |
| Aetna of PA | Medicare | $28.86 | ↓ -64% |
| United Healthcare | Unison Advantage Non Special Needs | $29.14 | ↓ -63% |
| AmeriHealth Caritas | Medicare | $29.97 | ↓ -62% |
| United Healthcare | Unison Advantage Special Needs | $30.52 | ↓ -61% |
| UPMC Health Plan | Partners/Select | $32.74 | ↓ -59% |
| Aetna | CHIP/Medicaid | $38.50 | ↓ -51% |
| UPMC Health Plan | Managed Medicaid | $38.50 | ↓ -51% |
| United Healthcare Community Plan for Families | Unison Kids | $40.25 | ↓ -49% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $40.70 | ↓ -49% |
| Highmark BCBS of PA | Managed Care - Social Mission | $40.70 | ↓ -49% |
| Geisinger | Medicaid/CHIP | $48.65 | ↓ -39% |
| Highmark BCBS of PA | Commercial - Indemnity | $49.85 | ↓ -37% |
| Highmark BCBS of PA | Managed Care | $49.85 | ↓ -37% |
| Highmark Wholecare (prev Gateway) | Medicaid | $51.91 | ↓ -34% |
| Horizon Health Plan | Commercial | $52.50 | ↓ -34% |
| Cigna | Commercial | $52.50 | ↓ -34% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $54.64 | ↓ -31% |
| Multiplan | Auto/PPO/Worker's Compensation | $56.25 | ↓ -29% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $59.65 | ↓ -25% |
| Health Coalition Partners | PPO | $60.00 | ↓ -24% |
| InterGroup | Commercial | $60.00 | ↓ -24% |
| Focus Healthcare | Disability/PPO/Auto | $71.25 | ↓ -10% |
| UPMC Work Partners | Workers Comp | $82.05 | ↑ +4% |
| Focus Healthcare | Workers Compensation | $90.64 | ↑ +14% |
| UPMC Health Plan | Commercial | $114.76 | ↑ +45% |
| Cigna | Medicare | $1,688.40 | ↑ +2032% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $179.40 | $38.50 – $254.15 |
| UPMC East | Monroeville | $186.60 | $36.08 – $248.80 |
| UPMC Altoona | Altoona | $230.40 | $20.00 – $307.20 |
| UPMC Bedford | Everett | $121.20 | $36.08 – $181.80 |
| UPMC Cole | Coudersport | $183.00 | $36.75 – $128.00 |
| UPMC Hamot | Erie | $156.60 | $38.50 – $182.70 |
| UPMC Community Osteopathic | Harrisburg | $240.60 | $20.60 – $288.22 |
| UPMC Hanover | Hanover | $61.80 | $19.57 – $89.61 |