Removal of sperm cord lesion at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,976.40
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.
$3,294.00
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.
$846.72 with UPMC Work Partners vs $74,154.53 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 |
|---|---|---|---|
| UPMC Work Partners | Workers Comp | $846.72 | ↓ -57% |
| Focus Healthcare | Workers Compensation | $935.33 | ↓ -53% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $1,218.78 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $1,218.78 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $1,218.78 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $1,218.78 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $1,218.78 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $1,253.37 | ↓ -37% |
| Aetna of PA | Medicare | $1,267.53 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $1,279.72 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $1,316.28 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $1,340.66 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $1,438.16 | ↓ -27% |
| United Healthcare | Commercial | $1,613.73 | ↓ -18% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $1,811.70 | ↓ -8% |
| Geisinger | Medicaid/CHIP | $1,811.70 | ↓ -8% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,935.29 | ↓ -2% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,935.29 | ↓ -2% |
| Cigna | Commercial | $2,305.80 | ↑ +17% |
| Horizon Health Plan | Commercial | $2,305.80 | ↑ +17% |
| Highmark BCBS of PA | Managed Care | $2,370.51 | ↑ +20% |
| Highmark BCBS of PA | Commercial - Indemnity | $2,370.51 | ↑ +20% |
| UPMC Health Plan | Commercial | $2,405.97 | ↑ +22% |
| Multiplan | Auto/PPO/Worker's Compensation | $2,470.50 | ↑ +25% |
| Health Coalition Partners | PPO | $2,635.20 | ↑ +33% |
| InterGroup | Commercial | $2,635.20 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $3,129.30 | ↑ +58% |
| UPMC Health Plan | CHIP | $3,267.32 | ↑ +65% |
| Cigna | Medicare | $74,154.53 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Removal of sperm cord lesion at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $745.20 | $344.28 – $1,470.59 |
| Uniontown Hospital | Uniontown | $3,999.83 | $3,416.62 – $7,960.72 |
| UPMC Bedford | Everett | not published | $846.72 – $3,551.23 |
| UPMC East | Monroeville | not published | $907.63 – $3,617.00 |
| UPMC Hamot | Erie | not published | $907.63 – $4,782.42 |
| UPMC Northwest | Seneca | not published | $856.21 – $3,551.23 |
| UPMC Memorial | York | not published | $840.28 – $5,291.55 |
| WellSpan Gettysburg Hospital | Gettysburg | not published | $970.00 – $1,101.92 |