CMS Price Transparency Data

Office visit, established patient (20-29 min)

Facility: UPMC Kane

Billing Code: 99213 (CPT)

The BaseRate · fair price high confidence
A fair price for this
$63
about 0.7× the $95 Medicare rate · typically $45–$129
modeled estimate · not a bill or quote
What this hospital charges insurers
$50
Below the fair price — a good deal
about $13 under the fair price · 0.5× Medicare
Medicare pays $95 Fair price $63 This hospital $50 Cash price $62 Hospital's list price $104

How we calculate the fair BaseRate →

How this hospital compares to other PA hospitals

Highest price of the 9 PA hospitals we have prices for — worth calling around.

Cheapest $25 Priciest $50

Black dot = this hospital, among the 9 PA hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (20-29 min) is about $63 (about 0.7× the $95 Medicare rate). UPMC Kane charges insurers about $50, or about $62 in cash — below the fair price — a good deal. Located in Kane, PA.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

4 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna HumanaKaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $29 - $54 30%
Blue Cross Blue Shieldmajor $28 - $52 29%
Aetnamajor $29 - $51 30%
Cignamajor $52 - $2,972 55%
AmeriHealth $30 - $55 32%
Geisinger $49 51%
UPMC Health Plan $26 - $115 27%
+ 5 smaller / regional plans $52 - $125
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

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Facility Profile & Credentials

  • Address: 4372 Route 6, Kane, PA 16735
  • CMS Rating: No CMS Rating
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Critical Access Hospitals