healthcosts.net
Shoulder X-ray at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$307.20
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.
$512.00
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.
$16.10 with UPMC Health Plan vs $1,035.55 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 Health Plan | CHIP | $16.10 | ↓ -95% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $17.02 | ↓ -94% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $17.02 | ↓ -94% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $17.02 | ↓ -94% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $17.02 | ↓ -94% |
| UPMC Health Plan | Managed Medicare | $17.02 | ↓ -94% |
| Highmark Wholecare (prev Gateway) | Medicare | $17.50 | ↓ -94% |
| Aetna of PA | Medicare | $17.70 | ↓ -94% |
| United Healthcare | Unison Advantage Non Special Needs | $17.87 | ↓ -94% |
| AmeriHealth Caritas | Medicare | $18.38 | ↓ -94% |
| United Healthcare | Unison Advantage Special Needs | $18.72 | ↓ -94% |
| UPMC Health Plan | Partners/Select | $20.08 | ↓ -93% |
| Geisinger | Medicaid/CHIP | $25.30 | ↓ -92% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $25.30 | ↓ -92% |
| Cigna | Commercial | $32.20 | ↓ -90% |
| Horizon Health Plan | Commercial | $32.20 | ↓ -90% |
| Multiplan | Auto/PPO/Worker's Compensation | $34.50 | ↓ -89% |
| Health Coalition Partners | PPO | $36.80 | ↓ -88% |
| InterGroup | Commercial | $36.80 | ↓ -88% |
| Focus Healthcare | Disability/PPO/Auto | $43.70 | ↓ -86% |
| UPMC Work Partners | Workers Comp | $70.75 | ↓ -77% |
| UPMC Health Plan | Commercial | $75.83 | ↓ -75% |
| Focus Healthcare | Workers Compensation | $78.16 | ↓ -75% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $105.05 | ↓ -66% |
| Highmark BCBS of PA | Managed Care - Social Mission | $105.05 | ↓ -66% |
| United Healthcare | Commercial | $125.90 | ↓ -59% |
| Highmark BCBS of PA | Commercial - Indemnity | $128.68 | ↓ -58% |
| Highmark BCBS of PA | Managed Care | $128.68 | ↓ -58% |
| Cigna | Medicare | $1,035.55 | ↑ +237% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder X-ray at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC East | Monroeville | $436.20 | $28.33 – $581.60 |
| UPMC Passavant-McCandless | Pittsburgh | $419.40 | $28.58 – $594.15 |
| UPMC Hamot | Erie | $341.40 | $21.87 – $398.30 |
| UPMC Carlisle | Carlisle | $188.40 | $21.61 – $419.44 |
| UPMC Altoona | Altoona | $172.80 | $35.47 – $230.40 |
| UPMC Bedford | Everett | $127.80 | $28.72 – $191.70 |
| UPMC Cole | Coudersport | $144.60 | $31.80 – $192.80 |
| UPMC Community Osteopathic | Harrisburg | $188.40 | $21.61 – $266.90 |