healthcosts.net
Established Patient Office Visit (level 4) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$134.40
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.
$224.00
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.
$52.50 with UPMC Health Plan vs $3,376.80 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 | $52.50 | ↓ -61% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $53.09 | ↓ -60% |
| Highmark BCBS of PA | Managed Care - Social Mission | $53.09 | ↓ -60% |
| UPMC Health Plan | Managed Medicare | $55.50 | ↓ -59% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $55.50 | ↓ -59% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $55.50 | ↓ -59% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $55.50 | ↓ -59% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $55.50 | ↓ -59% |
| Highmark Wholecare (prev Gateway) | Medicare | $57.08 | ↓ -58% |
| Aetna of PA | Medicare | $57.72 | ↓ -57% |
| United Healthcare | Unison Advantage Non Special Needs | $58.27 | ↓ -57% |
| Aetna | CHIP/Medicaid | $59.86 | ↓ -55% |
| UPMC Health Plan | Managed Medicaid | $59.86 | ↓ -55% |
| AmeriHealth Caritas | Medicare | $59.94 | ↓ -55% |
| United Healthcare | Unison Advantage Special Needs | $61.05 | ↓ -55% |
| United Healthcare Community Plan for Families | Unison Kids | $62.58 | ↓ -53% |
| Cigna | Commercial | $63.91 | ↓ -52% |
| Highmark BCBS of PA | Commercial - Indemnity | $65.03 | ↓ -52% |
| Highmark BCBS of PA | Managed Care | $65.03 | ↓ -52% |
| UPMC Health Plan | Partners/Select | $65.49 | ↓ -51% |
| Geisinger | Medicaid/CHIP | $75.64 | ↓ -44% |
| Highmark Wholecare (prev Gateway) | Medicaid | $80.70 | ↓ -40% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $84.96 | ↓ -37% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $92.74 | ↓ -31% |
| Horizon Health Plan | Commercial | $105.00 | ↓ -22% |
| United Healthcare | Commercial | $109.74 | ↓ -18% |
| Multiplan | Auto/PPO/Worker's Compensation | $112.50 | ↓ -16% |
| Health Coalition Partners | PPO | $120.00 | ↓ -11% |
| InterGroup | Commercial | $120.00 | ↓ -11% |
| UPMC Work Partners | Workers Comp | $122.27 | ↓ -9% |
| Focus Healthcare | Workers Compensation | $135.06 | ↑ +0% |
| UPMC Health Plan | Commercial | $136.29 | ↑ +1% |
| Focus Healthcare | Disability/PPO/Auto | $142.50 | ↑ +6% |
| Cigna | Medicare | $3,376.80 | ↑ +2413% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $250.80 | $59.86 – $355.30 |
| UPMC East | Monroeville | $216.00 | $36.08 – $288.00 |
| UPMC Altoona | Altoona | $274.20 | $20.00 – $365.60 |
| UPMC Bedford | Everett | $142.20 | $36.08 – $213.30 |
| UPMC Cole | Coudersport | $273.00 | $51.57 – $190.40 |
| UPMC Hamot | Erie | $178.20 | $44.55 – $247.66 |
| UPMC Community Osteopathic | Harrisburg | $271.80 | $31.00 – $337.75 |
| UPMC Hanover | Hanover | $93.00 | $29.45 – $134.85 |