Tx closed tib shaft fx without manip at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$345.60
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.
$576.00
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.
$156.75 with UPMC Health Plan vs $12,966.91 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 | Managed Medicaid | $156.75 | ↓ -55% |
| Aetna | CHIP/Medicaid | $156.75 | ↓ -55% |
| United Healthcare Community Plan for Families | Unison Kids | $163.88 | ↓ -53% |
| Geisinger | Medicaid/CHIP | $198.06 | ↓ -43% |
| UPMC Health Plan | CHIP | $201.60 | ↓ -42% |
| Highmark Wholecare (prev Gateway) | Medicaid | $211.33 | ↓ -39% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $213.12 | ↓ -38% |
| UPMC Health Plan | Managed Medicare | $213.12 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $213.12 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $213.12 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $213.12 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $219.17 | ↓ -37% |
| Aetna of PA | Medicare | $221.64 | ↓ -36% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $222.46 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $223.78 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $230.17 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $234.43 | ↓ -32% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $242.85 | ↓ -30% |
| UPMC Health Plan | Partners/Select | $251.48 | ↓ -27% |
| Cigna | Commercial | $403.20 | ↑ +17% |
| Horizon Health Plan | Commercial | $403.20 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $432.00 | ↑ +25% |
| InterGroup | Commercial | $460.80 | ↑ +33% |
| Health Coalition Partners | PPO | $460.80 | ↑ +33% |
| Focus Healthcare | Disability/PPO/Auto | $547.20 | ↑ +58% |
| UPMC Work Partners | Workers Comp | $709.98 | ↑ +105% |
| Focus Healthcare | Workers Compensation | $784.28 | ↑ +127% |
| UPMC Health Plan | Commercial | $1,262.22 | ↑ +265% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,489.19 | ↑ +331% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,489.19 | ↑ +331% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,824.09 | ↑ +428% |
| Highmark BCBS of PA | Managed Care | $1,824.09 | ↑ +428% |
| Cigna | Medicare | $12,966.91 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Tx closed tib shaft fx without manip at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Bedford | Everett | $1,689.60 | $82.51 – $2,534.40 |
| UPMC Carlisle | Carlisle | $1,408.20 | $180.97 – $1,994.95 |
| UPMC Cole | Coudersport | $1,266.00 | $79.28 – $771.51 |
| UPMC Community Osteopathic | Harrisburg | $1,408.20 | $180.97 – $1,994.95 |
| UPMC Hanover | Hanover | $1,408.20 | $180.97 – $699.63 |
| UPMC Lititz | Lititz | $1,408.20 | $180.97 – $743.00 |
| UPMC Memorial | York | $1,408.20 | $180.97 – $699.63 |
| UPMC Muncy | Muncy | $718.20 | $156.75 – $880.43 |