X-ray exam of arm infant at UPMC Kane
4372 Route 6, Kane, PA · UPMC · · NPI 146763537
$94.80
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.
$158.00
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.
$10.50 with UPMC Health Plan vs $675.36 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 | $10.50 | ↓ -89% |
| Highmark BCBS of PA | Freedom Blue Medicare Advantage | $11.10 | ↓ -88% |
| UPMC Health Plan | Managed Medicare | $11.10 | ↓ -88% |
| Highmark BCBS of PA | Community Blue Medicare Advantage/Complete Blue Medicare Advantage | $11.10 | ↓ -88% |
| Highmark BCBS of PA | Together Blue Medicare Advantage | $11.10 | ↓ -88% |
| Highmark BCBS of PA | Security Blue Medicare Advantage | $11.10 | ↓ -88% |
| Highmark Wholecare (prev Gateway) | Medicare | $11.41 | ↓ -88% |
| Aetna of PA | Medicare | $11.54 | ↓ -88% |
| United Healthcare | Unison Advantage Non Special Needs | $11.65 | ↓ -88% |
| AmeriHealth Caritas | Medicare | $11.99 | ↓ -87% |
| United Healthcare | Unison Advantage Special Needs | $12.21 | ↓ -87% |
| UPMC Health Plan | Partners/Select | $13.10 | ↓ -86% |
| Geisinger | Medicaid/CHIP | $16.50 | ↓ -83% |
| PA Health & Wellness | Community Health Choices/PA Medicaid HMO | $16.50 | ↓ -83% |
| Horizon Health Plan | Commercial | $21.00 | ↓ -78% |
| Cigna | Commercial | $21.00 | ↓ -78% |
| Multiplan | Auto/PPO/Worker's Compensation | $22.50 | ↓ -76% |
| Health Coalition Partners | PPO | $24.00 | ↓ -75% |
| InterGroup | Commercial | $24.00 | ↓ -75% |
| Focus Healthcare | Disability/PPO/Auto | $28.50 | ↓ -70% |
| UPMC Work Partners | Workers Comp | $61.64 | ↓ -35% |
| Focus Healthcare | Workers Compensation | $68.10 | ↓ -28% |
| UPMC Health Plan | Commercial | $77.28 | ↓ -18% |
| United Healthcare | Commercial | $77.40 | ↓ -18% |
| Highmark BCBS of PA | Commercial - Social Mission Indemnity | $98.19 | ↑ +4% |
| Highmark BCBS of PA | Managed Care - Social Mission | $98.19 | ↑ +4% |
| Highmark BCBS of PA | Commercial - Indemnity | $120.27 | ↑ +27% |
| Highmark BCBS of PA | Managed Care | $120.27 | ↑ +27% |
| Cigna | Medicare | $675.36 | ↑ +612% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
X-ray exam of arm infant at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Altoona | Altoona | $179.40 | $30.84 – $239.20 |
| UPMC Carlisle | Carlisle | $262.80 | $14.41 – $589.04 |
| UPMC Cole | Coudersport | $129.60 | $29.17 – $172.80 |
| UPMC Community Osteopathic | Harrisburg | $262.80 | $14.41 – $372.30 |
| UPMC East | Monroeville | $436.20 | $28.87 – $581.60 |
| UPMC Hamot | Erie | $245.40 | $18.61 – $166.40 |
| UPMC Northwest | Seneca | $176.40 | $29.14 – $109.49 |
| UPMC Hanover | Hanover | $262.80 | $14.41 – $589.04 |