Plc pq device breast ea addl lesion Ultrasound guide at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$433.20
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.
$722.00
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.
$37.38 with Aetna vs $4,547.42 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 | $37.38 | ↓ -91% |
| UPMC Health Plan | Managed Medicaid | $37.38 | ↓ -91% |
| United Healthcare Community Plan for Families | Unison Kids | $39.08 | ↓ -91% |
| Geisinger | Medicaid/CHIP | $47.23 | ↓ -89% |
| Highmark Wholecare (prev Gateway) | Medicaid | $50.39 | ↓ -88% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $53.05 | ↓ -88% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $57.91 | ↓ -87% |
| UPMC Health Plan | CHIP | $70.70 | ↓ -84% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $74.74 | ↓ -83% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $74.74 | ↓ -83% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $74.74 | ↓ -83% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $74.74 | ↓ -83% |
| UPMC Health Plan | Managed Medicare | $74.74 | ↓ -83% |
| Highmark Wholecare (prev Gateway) | Medicare | $76.86 | ↓ -82% |
| Aetna of PA | Medicare | $77.73 | ↓ -82% |
| United Healthcare | Unison Advantage Non Special Needs | $78.48 | ↓ -82% |
| AmeriHealth Caritas | Medicare | $80.72 | ↓ -81% |
| United Healthcare | Unison Advantage Special Needs | $82.21 | ↓ -81% |
| UPMC Health Plan | Partners/Select | $88.19 | ↓ -80% |
| United Healthcare | Commercial | $98.96 | ↓ -77% |
| Horizon Health Plan | Commercial | $141.40 | ↓ -67% |
| Cigna | Commercial | $141.40 | ↓ -67% |
| Multiplan | Auto/PPO/Worker's Compensation | $151.50 | ↓ -65% |
| InterGroup | Commercial | $161.60 | ↓ -63% |
| Health Coalition Partners | PPO | $161.60 | ↓ -63% |
| Focus Healthcare | Disability/PPO/Auto | $191.90 | ↓ -56% |
| UPMC Health Plan | Commercial | $301.98 | ↓ -30% |
| UPMC Work Partners | Workers Comp | $515.71 | ↑ +19% |
| Focus Healthcare | Workers Compensation | $569.68 | ↑ +32% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,266.06 | ↑ +192% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,266.06 | ↑ +192% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,550.77 | ↑ +258% |
| Highmark BCBS of PA | Managed Care | $1,550.77 | ↑ +258% |
| Cigna | Medicare | $4,547.42 | ↑ +950% |
Visitor-reported prices
Comments
Plc pq device breast ea addl lesion Ultrasound guide at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $592.20 | $33.98 – $789.60 |
| UPMC Bedford | Everett | $3,631.80 | $35.68 – $5,447.70 |
| UPMC Carlisle | Carlisle | $969.00 | $43.15 – $9,539.00 |
| UPMC Cole | Coudersport | $76.80 | $35.48 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $969.00 | $44.51 – $1,372.75 |
| UPMC Hamot | Erie | $1,438.20 | $37.38 – $515.71 |
| UPMC Hanover | Hanover | $969.00 | $43.15 – $539.69 |
| UPMC Horizon-Greenville | Greenville | $1,337.40 | $35.68 – $526.81 |