HOLLIDAYSBURG, Pa. — Accused CEO killer Luigi Mangione ranted and raved Tuesday as he was brought to a Pennsylvania court hearing — where he grinned at his lawyer and revealed he would fight extradition to the Big Apple.

“It’s completely out of touch and an insult to the intelligence of the American people and the lived experience!” the 26-year-old Ivy League university grad shouted to reporters outside the Blair County Courthouse.

Cops hurriedly pushed the seething handcuffed suspect — dressed in an orange prison jumpsuit and white canvas booties — through a door to the building as he raged.

Mangione — a onetime prep-school valedictorian from a prominent family in Towson, Md. — is facing murder charges in Manhattan for allegedly fatally shooting UnitedHealthcare CEO Brian Thompson on a Midtown sidewalk last week.

The shooting was allegedly fueled by Mangione’s vendetta against the medical industry, possibly involving his yearslong battle with back issues that kept him from even having sex.

Mangione was being held in Pennsylvania on weapons raps — after being recognized as the wanted killer and nabbed with a ghost gun at a McDonald’s in nearby Altoona on Monday.

The Manhattan District Attorney’s Office swiftly charged him as a fugitive with murder  and now wants him back in New York so he can be prosecuted on the charge.

But the standout tech whiz’s lawyer, local attorney Tom Dickey, told Judge David Consiglio on Tuesday, “My client is not waiving extradition.

“He is contesting it,’’ the lawyer said, setting up a legal showdown with New York authorities that could take weeks to settle.

The lawyer even tried to argue for bail for his scruffy-looking client —who grinned at Dickey at times during the hearing as the pair privately conferred at the defense table.

Dickey suggested to the judge that the suspect’s face-mask disguise at the time of his capture was donned out of COVID fears, as opposed to eluding authorities.

“Actually, I bought the mask …’’ Mangione began to say — before Dickey quickly hushed him.

“No, no, don’t say a word,’’ the lawyer advised, and his client clammed up.

The anti-capitalist slay suspect was apparently at least partly captured because he lowered his face mask to munch on some hash browns at the Mickey D’s and a customer recognized him from surveillance photos released during the manhunt for him.

Blair County District Attorney Peter Weeks, in arguing for Mangione to be held without bail, noted that $8,000 in cash, plus another $200 in foreign money, was found in Mangione’s backpack when he was nabbed.

That prompted Mangione to shake his head no from the sidelines.

The suspect appeared generally fidgety during the hearing, tapping the table and swiveling in his chair to look around the courtroom with his distinctive eyebrows raised as if to see who was watching the proceeding.

Asked by the judge early on if he understood his rights, Mangione replied, “Yes, Sir.’’

His refusal to be extradited kicks off a process in which his lawyer has two weeks to file a formal challenge to his detention.

What we know about the shooting of UnitedHealthcare CEO Brian Thompson

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• Brian Thompson, the CEO of insurance giant UnitedHealthcare, was gunned down Wednesday outside a luxury Midtown hotel in a “brazen, targeted attack,” police said.
• Thompson was named CEO of UnitedHealth in April 2021. He joined the company in 2004. He was one of several senior executives at the company under investigation by the Department of Justice.
• Thompson’s wife, Paulette, said her husband had been getting threats before he was killed.
• Thompson’s shooting led to sick support online, and even spurred a tasteless lookalike competition in NYC.
• A person of interest has been nabbed by police officers inside a McDonald’s in Altoona, Pa.
• The suspect has been identified as Luigi Mangione, 26, originally from Towson, Md. He’s an Ivy League graduate who hated the medical community.

Follow along with The Post’s live updates on the news surrounding Brian Thompson’s murder.

New York Gov. Kathy Hochul’s office also has 30 days to submit a warrant to Pennsylvania Gov. Josh Shapiro seeking to bring Mangione to Gotham. Hochul’s office said Tuesday afternoon that it was already working on the request.

Meanwhile, the suspect is being held at a state prison in Huntington, Pa., about 45 minutes from where he was busted.

When caught, Mangione had with him a three-page hand-written manifesto ripping the healthcare industry, sources said.

He called its leaders “mafiosa’’ and indicated he considers himself a “hero’’ for allegedly killing one of their CEOs in a “symbolic takedown,’’ sources said.

He suggested that Thompson’s murder should be looked at as “a direct challenge” to the company’s corruption and “power games,” according to law-enforcement sources who reviewed the diatribe.

“Frankly these parasites simply had it coming,” he allegedly seethed.