Exc ben+marg excep skin tag feenlm <0.5cm 11440 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,045.20
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.
$1,742.00
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.
$59.95 with UPMC Health Plan vs $18,617.42 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 | Managed Medicaid | $59.95 | ↓ -94% |
| Aetna | CHIP/Medicaid | $59.95 | ↓ -94% |
| United Healthcare Community Plan for Families | Unison Kids | $62.67 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $75.75 | ↓ -93% |
| Highmark Wholecare (prev Gateway) | Medicaid | $80.82 | ↓ -92% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $85.08 | ↓ -92% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $92.88 | ↓ -91% |
| UPMC Work Partners | Workers Comp | $182.50 | ↓ -83% |
| Focus Healthcare | Workers Compensation | $201.60 | ↓ -81% |
| UPMC Health Plan | CHIP | $289.45 | ↓ -72% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $305.99 | ↓ -71% |
| UPMC Health Plan | Managed Medicare | $305.99 | ↓ -71% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $305.99 | ↓ -71% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $305.99 | ↓ -71% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $305.99 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicare | $314.67 | ↓ -70% |
| Aetna of PA | Medicare | $318.23 | ↓ -70% |
| United Healthcare | Unison Advantage Non Special Needs | $321.29 | ↓ -69% |
| AmeriHealth Caritas | Medicare | $330.47 | ↓ -68% |
| United Healthcare | Unison Advantage Special Needs | $336.59 | ↓ -68% |
| UPMC Health Plan | Partners/Select | $361.07 | ↓ -65% |
| Cigna | Commercial | $578.90 | ↓ -45% |
| Horizon Health Plan | Commercial | $578.90 | ↓ -45% |
| Highmark BCBS of PA | Managed Care - Social Mission | $597.98 | ↓ -43% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $597.98 | ↓ -43% |
| Multiplan | Auto/PPO/Worker's Compensation | $620.25 | ↓ -41% |
| InterGroup | Commercial | $661.60 | ↓ -37% |
| Health Coalition Partners | PPO | $661.60 | ↓ -37% |
| Highmark BCBS of PA | Managed Care | $732.46 | ↓ -30% |
| Highmark BCBS of PA | Commercial - Indemnity | $732.46 | ↓ -30% |
| Focus Healthcare | Disability/PPO/Auto | $785.65 | ↓ -25% |
| United Healthcare | Commercial | $853.41 | ↓ -18% |
| UPMC Health Plan | Commercial | $1,274.10 | ↑ +22% |
| Cigna | Medicare | $18,617.42 | ↑ +1681% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc ben+marg excep skin tag feenlm <0.5cm 11440 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $286.80 | $54.50 – $545.04 |
| UPMC Carlisle | Carlisle | $2,184.60 | $69.22 – $3,094.85 |
| UPMC Cole | Coudersport | $123.00 | $25.78 – $2,325.85 |
| UPMC Community Osteopathic | Harrisburg | $2,184.60 | $69.22 – $3,094.85 |
| UPMC Hanover | Hanover | $2,184.60 | $69.22 – $1,075.42 |
| UPMC Horizon-Greenville | Greenville | $2,304.60 | $59.95 – $1,060.34 |
| UPMC Lititz | Lititz | $2,184.60 | $69.22 – $1,081.23 |
| UPMC Memorial | York | $2,184.60 | $69.22 – $1,079.47 |