Exc leg/ankle tum subfasc<5cm 27619 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,453.80
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.
$2,423.00
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.
$132.00 with Aetna vs $54,546.58 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 | $132.00 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $132.00 | ↓ -91% |
| United Healthcare Community Plan for Families | Unison Kids | $138.00 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $166.79 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $177.96 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $187.33 | ↓ -87% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $204.50 | ↓ -86% |
| UPMC Health Plan | CHIP | $848.05 | ↓ -42% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $896.51 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $896.51 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $896.51 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $896.51 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $896.51 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $921.95 | ↓ -37% |
| Aetna of PA | Medicare | $932.37 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $941.34 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $968.23 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $986.16 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $1,057.88 | ↓ -27% |
| UPMC Work Partners | Workers Comp | $1,158.97 | ↓ -20% |
| Focus Healthcare | Workers Compensation | $1,280.26 | ↓ -12% |
| Cigna | Commercial | $1,696.10 | ↑ +17% |
| Horizon Health Plan | Commercial | $1,696.10 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,817.25 | ↑ +25% |
| InterGroup | Commercial | $1,938.40 | ↑ +33% |
| Health Coalition Partners | PPO | $1,938.40 | ↑ +33% |
| UPMC Health Plan | Commercial | $1,942.84 | ↑ +34% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,981.78 | ↑ +36% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,981.78 | ↑ +36% |
| Focus Healthcare | Disability/PPO/Auto | $2,301.85 | ↑ +58% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,427.45 | ↑ +67% |
| Highmark BCBS of PA | Managed Care | $2,427.45 | ↑ +67% |
| Cigna | Medicare | $54,546.58 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc leg/ankle tum subfasc<5cm 27619 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,153.80 | $126.00 – $1,538.40 |
| Uniontown Hospital | Uniontown | $1,595.67 | $2,815.42 – $6,559.93 |
| UPMC Hamot | Erie | not published | $132.00 – $3,968.58 |
| UPMC Lititz | Lititz | not published | $152.40 – $4,398.21 |
| UPMC Wellsboro | Wellsboro | not published | $132.00 – $1,158.97 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $10,638.00 – $10,638.00 |