Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 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.
$46.75 with UPMC Health Plan vs $36,604.51 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 | $46.75 | ↓ -96% |
| Aetna | CHIP/Medicaid | $46.75 | ↓ -96% |
| United Healthcare Community Plan for Families | Unison Kids | $48.88 | ↓ -95% |
| Geisinger | Medicaid/CHIP | $59.07 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicaid | $63.03 | ↓ -94% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $66.35 | ↓ -94% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $72.43 | ↓ -93% |
| UPMC Work Partners | Workers Comp | $205.30 | ↓ -80% |
| Focus Healthcare | Workers Compensation | $226.78 | ↓ -78% |
| UPMC Health Plan | CHIP | $569.10 | ↓ -46% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $601.62 | ↓ -42% |
| UPMC Health Plan | Managed Medicare | $601.62 | ↓ -42% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $601.62 | ↓ -42% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $601.62 | ↓ -42% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $601.62 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicare | $618.69 | ↓ -41% |
| Aetna of PA | Medicare | $625.68 | ↓ -40% |
| United Healthcare | Unison Advantage Non Special Needs | $631.70 | ↓ -40% |
| AmeriHealth Caritas | Medicare | $649.75 | ↓ -38% |
| United Healthcare | Unison Advantage Special Needs | $661.78 | ↓ -37% |
| Highmark BCBS of PA | Managed Care - Social Mission | $670.06 | ↓ -36% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $670.06 | ↓ -36% |
| UPMC Health Plan | Partners/Select | $709.91 | ↓ -32% |
| Highmark BCBS of PA | Managed Care | $820.74 | ↓ -21% |
| Highmark BCBS of PA | Commercial - Indemnity | $820.74 | ↓ -21% |
| United Healthcare | Commercial | $853.41 | ↓ -18% |
| Cigna | Commercial | $1,138.20 | ↑ +9% |
| Horizon Health Plan | Commercial | $1,138.20 | ↑ +9% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,219.50 | ↑ +17% |
| UPMC Health Plan | Commercial | $1,274.97 | ↑ +22% |
| Health Coalition Partners | PPO | $1,300.80 | ↑ +24% |
| InterGroup | Commercial | $1,300.80 | ↑ +24% |
| Focus Healthcare | Disability/PPO/Auto | $1,544.70 | ↑ +48% |
| Cigna | Medicare | $36,604.51 | ↑ +3402% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc ben+marg excep skin tag snhfg 0.6-1cm 11421 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $286.80 | $42.50 – $545.04 |
| UPMC Carlisle | Carlisle | $2,287.20 | $53.98 – $3,240.20 |
| UPMC Cole | Coudersport | $1,266.00 | $31.32 – $2,094.25 |
| UPMC Magee | Pittsburgh | $1,431.00 | $46.75 – $724.45 |
| UPMC Mercy | Pittsburgh | $2,377.20 | $46.75 – $737.87 |
| UPMC Passavant-McCandless | Pittsburgh | $2,815.20 | $46.75 – $737.87 |
| UPMC Presbyterian | Pittsburgh | $2,286.00 | $46.75 – $813.60 |
| UPMC St. Margaret | Pittsburgh | $2,712.00 | $46.75 – $737.87 |