Sho arthrs srg lss&rescj ads at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
not published by hospital
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.
not published by hospital
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.
$572.51 with Aetna vs $3,044.66 with Highmark BCBS of PA — 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 | $572.51 | — |
| UPMC Health Plan | Managed Medicaid | $572.51 | — |
| United Healthcare Community Plan for Families | Unison Kids | $598.53 | — |
| Geisinger | Medicaid/CHIP | $723.39 | — |
| Highmark Wholecare (prev Gateway) | Medicaid | $771.84 | — |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $812.49 | — |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $886.97 | — |
| UPMC Work Partners | Workers Comp | $1,857.83 | — |
| UPMC Health Plan | Commercial | $1,941.85 | — |
| Focus Healthcare | Workers Compensation | $2,052.26 | — |
| Highmark BCBS of PA | Managed Care - Social Mission | $2,485.67 | — |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $2,485.67 | — |
| UPMC Health Plan | CHIP | $2,637.04 | — |
| Highmark BCBS of PA | Managed Care | $3,044.66 | — |
| Highmark BCBS of PA | Commercial - Indemnity | $3,044.66 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
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Sho arthrs srg lss&rescj ads at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $1,155.00 | $533.61 – $1,857.83 |
| Uniontown Hospital | Uniontown | $2,879.67 | $91.60 – $6,587.02 |
| UPMC Altoona | Altoona | not published | $520.46 – $3,340.82 |
| UPMC East | Monroeville | not published | $572.51 – $3,402.68 |
| UPMC Lititz | Lititz | not published | $660.98 – $4,986.11 |
| UPMC Magee | Pittsburgh | not published | $572.51 – $3,340.82 |
| UPMC Somerset | Somerset | not published | $572.51 – $3,093.35 |
| WellSpan Surgery & Rehabilitation Hospital | York PA 17403 | not published | $970.00 – $1,165.00 |