Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$496.20
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.
$827.00
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.
$77.78 with Aetna vs $16,253.66 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 | $77.78 | ↓ -84% |
| UPMC Health Plan | Managed Medicaid | $77.78 | ↓ -84% |
| United Healthcare Community Plan for Families | Unison Kids | $81.32 | ↓ -84% |
| Geisinger | Medicaid/CHIP | $98.28 | ↓ -80% |
| Highmark Wholecare (prev Gateway) | Medicaid | $104.86 | ↓ -79% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $110.39 | ↓ -78% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $120.50 | ↓ -76% |
| UPMC Health Plan | CHIP | $252.70 | ↓ -49% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $267.14 | ↓ -46% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $267.14 | ↓ -46% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $267.14 | ↓ -46% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $267.14 | ↓ -46% |
| UPMC Health Plan | Managed Medicare | $267.14 | ↓ -46% |
| Highmark Wholecare (prev Gateway) | Medicare | $274.72 | ↓ -45% |
| Aetna of PA | Medicare | $277.83 | ↓ -44% |
| United Healthcare | Unison Advantage Non Special Needs | $280.50 | ↓ -43% |
| AmeriHealth Caritas | Medicare | $288.51 | ↓ -42% |
| United Healthcare | Unison Advantage Special Needs | $293.85 | ↓ -41% |
| UPMC Health Plan | Partners/Select | $315.23 | ↓ -36% |
| United Healthcare | Commercial | $353.71 | ↓ -29% |
| Horizon Health Plan | Commercial | $505.40 | ↑ +2% |
| Cigna | Commercial | $505.40 | ↑ +2% |
| Multiplan | Auto/PPO/Worker's Compensation | $541.50 | ↑ +9% |
| InterGroup | Commercial | $577.60 | ↑ +16% |
| Health Coalition Partners | PPO | $577.60 | ↑ +16% |
| UPMC Work Partners | Workers Comp | $618.68 | ↑ +25% |
| Focus Healthcare | Workers Compensation | $683.43 | ↑ +38% |
| Focus Healthcare | Disability/PPO/Auto | $685.90 | ↑ +38% |
| UPMC Health Plan | Commercial | $1,030.47 | ↑ +108% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,548.37 | ↑ +212% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,548.37 | ↑ +212% |
| Highmark BCBS of PA | Managed Care | $1,896.57 | ↑ +282% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,896.57 | ↑ +282% |
| Cigna | Medicare | $16,253.66 | ↑ +3176% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $2,606.40 | $70.71 – $3,475.20 |
| UPMC Bedford | Everett | $3,631.80 | $74.25 – $5,447.70 |
| UPMC Carlisle | Carlisle | $1,162.20 | $89.80 – $1,646.45 |
| UPMC Cole | Coudersport | $337.20 | $74.25 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $1,162.20 | $92.63 – $1,646.45 |
| UPMC East | Monroeville | $2,254.20 | $77.78 – $3,005.60 |
| UPMC Hamot | Erie | $1,906.80 | $77.78 – $975.61 |
| UPMC Northwest | Seneca | $1,593.00 | $77.78 – $704.33 |