Nuclear exam of tear flow at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$358.80
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.
$598.00
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.
$90.62 with Aetna vs $13,462.18 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 | $90.62 | ↓ -75% |
| UPMC Health Plan | Managed Medicaid | $90.62 | ↓ -75% |
| United Healthcare Community Plan for Families | Unison Kids | $94.74 | ↓ -74% |
| Geisinger | Medicaid/CHIP | $114.50 | ↓ -68% |
| Highmark Wholecare (prev Gateway) | Medicaid | $122.17 | ↓ -66% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $128.60 | ↓ -64% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $140.39 | ↓ -61% |
| UPMC Health Plan | CHIP | $209.30 | ↓ -42% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $221.26 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $221.26 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $221.26 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $221.26 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $221.26 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $227.54 | ↓ -37% |
| UPMC Work Partners | Workers Comp | $228.62 | ↓ -36% |
| Aetna of PA | Medicare | $230.11 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $232.32 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $238.96 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $243.39 | ↓ -32% |
| Focus Healthcare | Workers Compensation | $252.55 | ↓ -30% |
| UPMC Health Plan | Partners/Select | $261.09 | ↓ -27% |
| UPMC Health Plan | Commercial | $282.56 | ↓ -21% |
| United Healthcare | Commercial | $292.96 | ↓ -18% |
| Horizon Health Plan | Commercial | $418.60 | ↑ +17% |
| Cigna | Commercial | $418.60 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $448.50 | ↑ +25% |
| InterGroup | Commercial | $478.40 | ↑ +33% |
| Health Coalition Partners | PPO | $478.40 | ↑ +33% |
| Highmark BCBS of PA | Managed Care - Social Mission | $501.99 | ↑ +40% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $501.99 | ↑ +40% |
| Focus Healthcare | Disability/PPO/Auto | $568.10 | ↑ +58% |
| Highmark BCBS of PA | Managed Care | $614.88 | ↑ +71% |
| Highmark BCBS of PA | Commercial - Indemnity | $614.88 | ↑ +71% |
| Cigna | Medicare | $13,462.18 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Nuclear exam of tear flow at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $1,228.80 | $75.33 – $1,740.80 |
| UPMC Community Osteopathic | Harrisburg | $1,228.80 | $75.33 – $1,740.80 |
| UPMC Hanover | Hanover | $1,228.80 | $75.33 – $614.19 |
| UPMC Lititz | Lititz | $1,228.80 | $75.33 – $617.50 |
| UPMC Magee | Pittsburgh | $869.40 | $90.62 – $413.75 |
| UPMC Memorial | York | $1,228.80 | $75.33 – $809.24 |
| UPMC Muncy | Muncy | $637.20 | $73.60 – $262.24 |
| UPMC Somerset | Somerset | $1,228.80 | $66.12 – $383.10 |