Lipoprotein blood high res frac & quant at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$134.40
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.
$224.00
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.
$30.51 with Aetna vs $5,042.69 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 | $30.51 | ↓ -77% |
| UPMC Health Plan | Managed Medicaid | $30.51 | ↓ -77% |
| United Healthcare Community Plan for Families | Unison Kids | $31.90 | ↓ -76% |
| UPMC Work Partners | Workers Comp | $33.46 | ↓ -75% |
| United Healthcare | Commercial | $34.12 | ↓ -75% |
| Focus Healthcare | Workers Compensation | $36.96 | ↓ -73% |
| Geisinger | Medicaid/CHIP | $38.56 | ↓ -71% |
| Highmark Wholecare (prev Gateway) | Medicaid | $41.14 | ↓ -69% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $43.30 | ↓ -68% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $47.27 | ↓ -65% |
| UPMC Health Plan | CHIP | $78.40 | ↓ -42% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $82.88 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $82.88 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $82.88 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $82.88 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $82.88 | ↓ -38% |
| Aetna of PA | Medicare | $86.20 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $87.02 | ↓ -35% |
| Highmark Wholecare (prev Gateway) | Medicare | $89.51 | ↓ -33% |
| AmeriHealth Caritas | Medicare | $89.51 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $91.17 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $97.80 | ↓ -27% |
| UPMC Health Plan | Commercial | $110.68 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $146.14 | ↑ +9% |
| Highmark BCBS of PA | Managed Care - Social Mission | $146.14 | ↑ +9% |
| Horizon Health Plan | Commercial | $156.80 | ↑ +17% |
| Cigna | Commercial | $156.80 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $168.00 | ↑ +25% |
| Highmark BCBS of PA | Managed Care | $179.00 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $179.00 | ↑ +33% |
| Health Coalition Partners | PPO | $179.20 | ↑ +33% |
| InterGroup | Commercial | $179.20 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $212.80 | ↑ +58% |
| Cigna | Medicare | $5,042.69 | ↑ +3652% |
Visitor-reported prices
Comments
Lipoprotein blood high res frac & quant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $381.00 | $12.22 – $571.50 |
| UPMC Hamot | Erie | $361.80 | $27.74 – $64.46 |
| UPMC Jameson | New Castle | $242.40 | $30.51 – $65.60 |
| UPMC Passavant-McCandless | Pittsburgh | $188.40 | $30.51 – $65.08 |
| UPMC Presbyterian | Pittsburgh | $539.40 | $27.74 – $65.08 |
| UPMC Williamsport | Williamsport | $325.20 | $30.51 – $36.96 |