Removal of intranasal lesion at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$547.80
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.
$913.00
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.
$95.15 with Aetna vs $20,553.46 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 | $95.15 | ↓ -83% |
| UPMC Health Plan | Managed Medicaid | $95.15 | ↓ -83% |
| United Healthcare Community Plan for Families | Unison Kids | $99.47 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $120.23 | ↓ -78% |
| Highmark Wholecare (prev Gateway) | Medicaid | $128.28 | ↓ -77% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $135.04 | ↓ -75% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $147.41 | ↓ -73% |
| UPMC Health Plan | CHIP | $319.55 | ↓ -42% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $337.81 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $337.81 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $337.81 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $337.81 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $337.81 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $347.40 | ↓ -37% |
| Aetna of PA | Medicare | $351.32 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $354.70 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $364.83 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $371.59 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $398.62 | ↓ -27% |
| UPMC Work Partners | Workers Comp | $479.78 | ↓ -12% |
| Focus Healthcare | Workers Compensation | $529.99 | ↓ -3% |
| Cigna | Commercial | $639.10 | ↑ +17% |
| Horizon Health Plan | Commercial | $639.10 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $684.75 | ↑ +25% |
| InterGroup | Commercial | $730.40 | ↑ +33% |
| Health Coalition Partners | PPO | $730.40 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $867.35 | ↑ +58% |
| UPMC Health Plan | Commercial | $1,943.00 | ↑ +255% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $4,040.64 | ↑ +638% |
| Highmark BCBS of PA | Managed Care - Social Mission | $4,040.64 | ↑ +638% |
| Highmark BCBS of PA | Commercial - Indemnity | $4,949.31 | ↑ +803% |
| Highmark BCBS of PA | Managed Care | $4,949.31 | ↑ +803% |
| Cigna | Medicare | $20,553.46 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Removal of intranasal lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $939.00 | $90.83 – $1,252.00 |
| Uniontown Hospital | Uniontown | $3,811.00 | $95.15 – $6,674.52 |
| UPMC Altoona | Altoona | not published | $86.50 – $3,339.23 |
| UPMC Hamot | Erie | not published | $95.15 – $4,496.91 |
| UPMC Somerset | Somerset | not published | $95.15 – $3,091.88 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $3,132.16 – $10,638.00 |