Lead capillary at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$66.00
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.
$110.00
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.
$11.00 with Aetna vs $2,386.27 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 | $11.00 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $11.00 | ↓ -83% |
| United Healthcare Community Plan for Families | Unison Kids | $11.50 | ↓ -83% |
| UPMC Work Partners | Workers Comp | $11.96 | ↓ -82% |
| Focus Healthcare | Workers Compensation | $13.21 | ↓ -80% |
| Geisinger | Medicaid/CHIP | $13.90 | ↓ -79% |
| Highmark Wholecare (prev Gateway) | Medicaid | $14.83 | ↓ -78% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $15.61 | ↓ -76% |
| United Healthcare | Commercial | $16.64 | ↓ -75% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $17.04 | ↓ -74% |
| UPMC Health Plan | CHIP | $37.10 | ↓ -44% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $39.22 | ↓ -41% |
| UPMC Health Plan | Managed Medicare | $39.22 | ↓ -41% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $39.22 | ↓ -41% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $39.22 | ↓ -41% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $39.22 | ↓ -41% |
| Aetna of PA | Medicare | $40.79 | ↓ -38% |
| United Healthcare | Unison Advantage Non Special Needs | $41.18 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $42.36 | ↓ -36% |
| AmeriHealth Caritas | Medicare | $42.36 | ↓ -36% |
| United Healthcare | Unison Advantage Special Needs | $43.14 | ↓ -35% |
| UPMC Health Plan | Partners/Select | $46.28 | ↓ -30% |
| Highmark BCBS of PA | Managed Care - Social Mission | $52.27 | ↓ -21% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $52.27 | ↓ -21% |
| UPMC Health Plan | Commercial | $56.21 | ↓ -15% |
| Highmark BCBS of PA | Managed Care | $64.02 | ↓ -3% |
| Highmark BCBS of PA | Commercial - Indemnity | $64.02 | ↓ -3% |
| Horizon Health Plan | Commercial | $74.20 | ↑ +12% |
| Cigna | Commercial | $74.20 | ↑ +12% |
| Multiplan | Auto/PPO/Worker's Compensation | $79.50 | ↑ +20% |
| Health Coalition Partners | PPO | $84.80 | ↑ +28% |
| InterGroup | Commercial | $84.80 | ↑ +28% |
| Focus Healthcare | Disability/PPO/Auto | $100.70 | ↑ +53% |
| Cigna | Medicare | $2,386.27 | ↑ +3516% |
Visitor-reported prices
Comments
Lead capillary at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $100.80 | $10.00 – $134.40 |
| UPMC Bedford | Everett | $66.60 | $4.37 – $99.90 |
| UPMC Carlisle | Carlisle | $62.40 | $10.00 – $88.40 |
| UPMC Cole | Coudersport | $150.60 | $7.87 – $200.80 |
| UPMC Community Osteopathic | Harrisburg | $62.40 | $10.00 – $88.40 |
| UPMC East | Monroeville | $181.20 | $10.00 – $241.60 |
| UPMC Hamot | Erie | $182.40 | $10.00 – $34.09 |
| UPMC Northwest | Seneca | $85.20 | $10.98 – $13.08 |