Kit lead specify 5-6-5 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$2,910.60
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.
$4,851.00
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.
$267.63 with PA Health & Wellness vs $18,257.23 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 |
|---|---|---|---|
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $267.63 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $267.63 | ↓ -91% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $274.36 | ↓ -91% |
| UPMC Health Plan | CHIP | $283.85 | ↓ -90% |
| UPMC Health Plan | Managed Medicare | $300.07 | ↓ -90% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $300.07 | ↓ -90% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $300.07 | ↓ -90% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $300.07 | ↓ -90% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $300.07 | ↓ -90% |
| Highmark Wholecare (prev Gateway) | Medicare | $308.59 | ↓ -89% |
| Aetna of PA | Medicare | $312.07 | ↓ -89% |
| United Healthcare | Unison Advantage Non Special Needs | $315.07 | ↓ -89% |
| AmeriHealth Caritas | Medicare | $324.08 | ↓ -89% |
| United Healthcare | Unison Advantage Special Needs | $330.08 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $332.51 | ↓ -89% |
| UPMC Health Plan | Partners/Select | $354.08 | ↓ -88% |
| United Healthcare | Commercial | $397.31 | ↓ -86% |
| Cigna | Commercial | $567.70 | ↓ -80% |
| Horizon Health Plan | Commercial | $567.70 | ↓ -80% |
| Multiplan | Auto/PPO/Worker's Compensation | $608.25 | ↓ -79% |
| Health Coalition Partners | PPO | $648.80 | ↓ -78% |
| InterGroup | Commercial | $648.80 | ↓ -78% |
| Focus Healthcare | Disability/PPO/Auto | $770.45 | ↓ -74% |
| UPMC Health Plan | Commercial | $9,698.74 | ↑ +233% |
| Cigna | Medicare | $18,257.23 | ↑ +527% |
| UPMC Work Partners | Workers Comp | not published by hospital | — |
Visitor-reported prices
Comments
Kit lead specify 5-6-5 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $25,039.80 | $37.62 – $13,170.92 |
| UPMC Bedford | Everett | $7,272.00 | $38.00 – $13,170.92 |
| UPMC Cole | Coudersport | $18,036.00 | $5,711.40 – $24,048.00 |
| UPMC East | Monroeville | $21,221.40 | $133.00 – $13,170.92 |
| UPMC Hamot | Erie | $24,616.20 | $2,153.59 – $2,153.59 |
| UPMC Northwest | Seneca | $7,816.20 | $5,589.39 – $15,937.99 |
| UPMC Horizon-Greenville | Greenville | $11,638.80 | $5,488.59 – $13,170.92 |
| UPMC Jameson | New Castle | $7,176.60 | $582.60 – $13,170.92 |