Exc mal+marg tal 2.1-3 cm 11603 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$972.00
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.
$1,620.00
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.
$94.05 with Aetna vs $36,469.44 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 | $94.05 | ↓ -90% |
| UPMC Health Plan | Managed Medicaid | $94.05 | ↓ -90% |
| United Healthcare Community Plan for Families | Unison Kids | $98.33 | ↓ -90% |
| Geisinger | Medicaid/CHIP | $118.84 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicaid | $126.80 | ↓ -87% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $133.47 | ↓ -86% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $145.71 | ↓ -85% |
| UPMC Work Partners | Workers Comp | $444.47 | ↓ -54% |
| Focus Healthcare | Workers Compensation | $490.98 | ↓ -49% |
| UPMC Health Plan | CHIP | $567.00 | ↓ -42% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $599.40 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $599.40 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $599.40 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $599.40 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $599.40 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $616.41 | ↓ -37% |
| Aetna of PA | Medicare | $623.38 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $629.37 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $647.35 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $659.34 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $707.29 | ↓ -27% |
| Cigna | Commercial | $1,134.00 | ↑ +17% |
| Horizon Health Plan | Commercial | $1,134.00 | ↑ +17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,168.38 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,168.38 | ↑ +20% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,215.00 | ↑ +25% |
| UPMC Health Plan | Commercial | $1,262.51 | ↑ +30% |
| Health Coalition Partners | PPO | $1,296.00 | ↑ +33% |
| InterGroup | Commercial | $1,296.00 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,431.14 | ↑ +47% |
| Highmark BCBS of PA | Managed Care | $1,431.14 | ↑ +47% |
| Focus Healthcare | Disability/PPO/Auto | $1,539.00 | ↑ +58% |
| Cigna | Medicare | $36,469.44 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Exc mal+marg tal 2.1-3 cm 11603 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $2,034.60 | $108.58 – $2,882.35 |
| UPMC Cole | Coudersport | $969.60 | $45.18 – $2,094.25 |
| UPMC Community Osteopathic | Harrisburg | $508.20 | $719.95 – $719.95 |
| UPMC Hanover | Hanover | $2,034.60 | $108.58 – $1,075.42 |
| UPMC Lititz | Lititz | $2,034.60 | $108.58 – $1,081.23 |
| UPMC Magee | Pittsburgh | $2,584.20 | $94.05 – $724.45 |
| UPMC Passavant-McCandless | Pittsburgh | $2,584.20 | $94.05 – $737.87 |
| UPMC Presbyterian | Pittsburgh | $4,057.80 | $94.05 – $931.20 |