Excision breast lesion at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,841.40
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.
$3,069.00
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.
$773.68 with UPMC Work Partners vs $69,089.33 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 Work Partners | Workers Comp | $773.68 | ↓ -58% |
| Focus Healthcare | Workers Compensation | $854.65 | ↓ -54% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $1,135.53 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,135.53 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $1,135.53 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $1,135.53 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $1,135.53 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,167.75 | ↓ -37% |
| Aetna of PA | Medicare | $1,180.95 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $1,192.31 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $1,226.37 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $1,249.08 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $1,339.93 | ↓ -27% |
| United Healthcare | Commercial | $1,503.50 | ↓ -18% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,687.95 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $1,687.95 | ↓ -8% |
| UPMC Health Plan | Commercial | $1,954.51 | ↑ +6% |
| Horizon Health Plan | Commercial | $2,148.30 | ↑ +17% |
| Cigna | Commercial | $2,148.30 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $2,301.75 | ↑ +25% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,406.08 | ↑ +31% |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,406.08 | ↑ +31% |
| InterGroup | Commercial | $2,455.20 | ↑ +33% |
| Health Coalition Partners | PPO | $2,455.20 | ↑ +33% |
| UPMC Health Plan | CHIP | $2,654.23 | ↑ +44% |
| Focus Healthcare | Disability/PPO/Auto | $2,915.55 | ↑ +58% |
| Highmark BCBS of PA | Managed Care | $2,947.17 | ↑ +60% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,947.17 | ↑ +60% |
| Cigna | Medicare | $69,089.33 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Excision breast lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $666.60 | $307.97 – $1,192.92 |
| Uniontown Hospital | Uniontown | $2,488.00 | $3,795.06 – $8,842.49 |
| UPMC Altoona | Altoona | not published | $773.68 – $3,942.82 |
| UPMC Carlisle | Carlisle | not published | $809.67 – $5,861.07 |
| UPMC Community Osteopathic | Harrisburg | not published | $815.52 – $5,805.45 |
| UPMC East | Monroeville | not published | $844.93 – $4,015.84 |
| UPMC Hamot | Erie | not published | $836.96 – $5,309.76 |
| UPMC Hanover | Hanover | not published | $815.52 – $5,852.98 |