healthcosts.net
Upper Endoscopy (EGD, with biopsy) at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$1,346.40
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.
$2,244.00
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.
$163.44 with Aetna vs $50,516.93 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 |
|---|---|---|---|
| Aetna | CHIP/Medicaid | $163.44 | ↓ -88% |
| UPMC Health Plan | Managed Medicaid | $163.44 | ↓ -88% |
| United Healthcare Community Plan for Families | Unison Kids | $170.87 | ↓ -87% |
| Geisinger | Medicaid/CHIP | $206.51 | ↓ -85% |
| Highmark Wholecare (prev Gateway) | Medicaid | $220.34 | ↓ -84% |
| AmeriHealth Caritas | Community HealthChoices (CHC)/Medicaid | $231.95 | ↓ -83% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $253.21 | ↓ -81% |
| UPMC Work Partners | Workers Comp | $730.25 | ↓ -46% |
| Focus Healthcare | Workers Compensation | $806.67 | ↓ -40% |
| UPMC Health Plan | Managed Medicare | $830.28 | ↓ -38% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $830.28 | ↓ -38% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $830.28 | ↓ -38% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $830.28 | ↓ -38% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $830.28 | ↓ -38% |
| Highmark Wholecare (prev Gateway) | Medicare | $853.84 | ↓ -37% |
| Aetna of PA | Medicare | $863.49 | ↓ -36% |
| United Healthcare | Unison Advantage Non Special Needs | $871.79 | ↓ -35% |
| AmeriHealth Caritas | Medicare | $896.70 | ↓ -33% |
| United Healthcare | Unison Advantage Special Needs | $913.31 | ↓ -32% |
| UPMC Health Plan | Partners/Select | $979.73 | ↓ -27% |
| United Healthcare | Commercial | $1,099.34 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $1,569.73 | ↑ +17% |
| Highmark BCBS of PA | Managed Care - Social Mission | $1,569.73 | ↑ +17% |
| Horizon Health Plan | Commercial | $1,570.80 | ↑ +17% |
| Cigna | Commercial | $1,570.80 | ↑ +17% |
| Multiplan | Auto/PPO/Worker's Compensation | $1,683.00 | ↑ +25% |
| UPMC Health Plan | Commercial | $1,705.81 | ↑ +27% |
| Health Coalition Partners | PPO | $1,795.20 | ↑ +33% |
| InterGroup | Commercial | $1,795.20 | ↑ +33% |
| Highmark BCBS of PA | Commercial - Indemnity | $1,922.74 | ↑ +43% |
| Highmark BCBS of PA | Managed Care | $1,922.74 | ↑ +43% |
| Focus Healthcare | Disability/PPO/Auto | $2,131.80 | ↑ +58% |
| UPMC Health Plan | CHIP | $2,316.50 | ↑ +72% |
| Cigna | Medicare | $50,516.93 | ↑ +3652% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Upper Endoscopy (EGD, with biopsy) at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Passavant-McCandless | Pittsburgh | $2,214.00 | $163.44 – $3,136.50 |
| UPMC East | Monroeville | $3,055.20 | $163.44 – $4,073.60 |
| UPMC Hamot | Erie | $3,124.20 | $163.44 – $3,644.90 |
| UPMC Carlisle | Carlisle | $2,019.60 | $188.70 – $2,861.10 |
| UPMC Altoona | Altoona | $1,675.80 | $148.58 – $2,234.40 |
| UPMC Bedford | Everett | $1,656.60 | $156.01 – $2,484.90 |
| UPMC Cole | Coudersport | $637.20 | $156.01 – $1,041.88 |
| UPMC Community Osteopathic | Harrisburg | $2,083.20 | $188.70 – $2,861.10 |