Treatment of toe fracture 28510 at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$595.20
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.
$992.00
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.
$189.47 with UPMC Work Partners vs $22,331.90 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 | $189.47 | ↓ -68% |
| Focus Healthcare | Workers Compensation | $209.29 | ↓ -65% |
| UPMC Health Plan | Commercial | $222.31 | ↓ -63% |
| UPMC Health Plan | CHIP | $301.90 | ↓ -49% |
| UPMC Health Plan | Managed Medicare | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $367.04 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $377.46 | ↓ -37% |
| Aetna of PA | Medicare | $381.72 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $385.39 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $396.40 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $403.74 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $433.11 | ↓ -27% |
| United Healthcare | Commercial | $485.98 | ↓ -18% |
| Highmark BCBS of PA | Managed Care - Social Mission | $511.70 | ↓ -14% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $511.70 | ↓ -14% |
| Geisinger | Medicaid/CHIP | $545.60 | ↓ -8% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $545.60 | ↓ -8% |
| Highmark BCBS of PA | Managed Care | $626.78 | ↑ +5% |
| Highmark BCBS of PA | Commercial - Indemnity | $626.78 | ↑ +5% |
| Cigna | Commercial | $694.40 | ↑ +17% |
| Horizon Health Plan | Commercial | $694.40 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $744.00 | ↑ +25% |
| Health Coalition Partners | PPO | $793.60 | ↑ +33% |
| InterGroup | Commercial | $793.60 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $942.40 | ↑ +58% |
| Cigna | Medicare | $22,331.90 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of toe fracture 28510 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Carlisle | Carlisle | $371.40 | $84.80 – $1,016.56 |
| UPMC Cole | Coudersport | $394.20 | $30.77 – $189.47 |
| UPMC Community Osteopathic | Harrisburg | $371.40 | $123.80 – $1,016.56 |
| UPMC Hanover | Hanover | $371.40 | $199.98 – $1,016.56 |
| UPMC Lititz | Lititz | $371.40 | $198.28 – $1,016.56 |
| UPMC Memorial | York | $371.40 | $75.75 – $1,016.56 |
| UPMC Muncy | Muncy | $825.60 | $198.03 – $993.28 |
| UPMC Passavant-McCandless | Pittsburgh | $766.20 | $93.83 – $251.57 |