healthcosts.net
Tonsillectomy (age 12+) at Lincoln Medical Center
234 E 149th St, Bronx, NY · NYC Health + Hospitals · · NPI 1427063270
not published by hospital
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.
not published by hospital
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.
$269.97 with Healthfirst vs $7,675.44 with Elderplan — 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 |
|---|---|---|---|
| Healthfirst | CHP | $269.97 | — |
| Wellcare | MEDICARE ADVANTAGE | $323.97 | — |
| MetroPlus | Essential Plan 200-250 | $370.41 | — |
| MetroPlus | Essential Plan 1-2 | $370.41 | — |
| MetroPlus | Essential Plan 3-4 | $370.41 | — |
| Fidelis | MAP | $431.96 | — |
| Healthfirst | EXCHANGE | $963.31 | — |
| Healthfirst | MEDICARE ADVANTAGE | $1,157.39 | — |
| Healthfirst | MAP | $1,157.39 | — |
| Healthfirst | Medicare Advantage PPO | $1,157.39 | — |
| UNITED | Managed Medicaid | $1,323.42 | — |
| UNITED | Essential Plan 1-4_200-250 | $1,416.06 | — |
| MetroPlus | HARP | $1,571.73 | — |
| MetroPlus | Managed Medicaid | $1,727.11 | — |
| MetroPlus | CHP | $1,727.11 | — |
| Senior Whole Health | MLTC | $1,727.11 | — |
| MetroPlus | Goldcare 1 & 2 | $1,727.11 | — |
| UNITED | CHP | $1,727.11 | — |
| MetroPlus | Gold | $1,727.11 | — |
| MetroPlus | SNP | $1,727.11 | — |
| Carelon | Managed Medicaid_HARP_CHP | $1,727.11 | — |
| Anthem HealthPlus | Managed Medicaid_HARP_MLTC_MAP | $1,727.11 | — |
| UNITED BEHAVIORAL HEALTH | Managed Medicaid | $1,727.11 | — |
| Fidelis | CHP | $1,727.11 | — |
| Anthem HealthPlus | EXCHANGE | $1,727.11 | — |
| Senior Whole Health | MAP | $1,727.11 | — |
| Fidelis | HARP_Managed Medicaid | $1,727.11 | — |
| Healthfirst | Essential Plan 1-2 | $1,733.96 | — |
| Healthfirst | Essential Plan 3-4 | $1,733.96 | — |
| Healthfirst | Essential Plan 200-250 | $1,733.96 | — |
| VNSNY | Medicaid SNP | $1,761.65 | — |
| UNITED BEHAVIORAL HEALTH | HARP | $1,761.65 | — |
| VNSNY | MAP | $1,761.65 | — |
| Affinity | HARP_Managed Medicaid | $1,761.65 | — |
| Carelon (Amida Care) | Managed Medicaid | $1,761.65 | — |
| UNITED BEHAVIORAL HEALTH | CHP | $1,761.65 | — |
| Affinity | CHP | $1,813.47 | — |
| Anthem HealthPlus | CHP | $1,899.82 | — |
| UNITED BEHAVIORAL HEALTH | Essential Plan | $1,899.82 | — |
| UNITED | HARP | $1,946.20 | — |
| EMBLEM | Essential Plan 3-4 | $2,158.89 | — |
| EMBLEM | Essential Plan 1-2 | $2,331.60 | — |
| Healthfirst | Small Group | $2,372.53 | — |
| Affinity | Essential Plan 1-2 | $3,536.39 | — |
| Affinity | Essential Plan 200-250 | $3,536.39 | — |
| Affinity | Essential Plan 3-4 | $3,536.39 | — |
| VNSNY | Medicare Advantage | $3,837.72 | — |
| ANTHEM | MEDICARE ADVANTAGE | $3,837.72 | — |
| Aetna | MEDICARE ADVANTAGE | $3,837.72 | — |
| VACCN | All Products | $3,837.72 | — |
| VNSNY | Medicare SNP | $3,837.72 | — |
| Fidelis | Essential Plan 1-4_200-250 | $3,886.00 | — |
| Anthem HealthPlus | Essential Plan 3-4 | $3,886.00 | — |
| Anthem HealthPlus | Essential Plan 1-2 | $3,886.00 | — |
| Centers Plan for Healthy Living | MEDICARE ADVANTAGE | $3,991.23 | — |
| EMBLEM | HIP_GHI_CHP | $4,821.00 | — |
| Fidelis | EXCHANGE | $5,449.56 | — |
| OSCAR | ALL PRODUCTS | $5,756.58 | — |
| EMBLEM | MEDICARE ADVANTAGE | $5,756.58 | — |
| Elderplan | MAP_Medicare Advantage_MLTC | $7,675.44 | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jacobi Medical Center | Bronx | not published | $269.97 – $7,675.44 |
| North Central Bronx | Bronx | not published | $269.97 – $7,675.44 |
| Bellevue Hospital Center | NY 10016 | $3,723.23 | $145.80 – $5,756.58 |
| Kings County Hospital Center | Brooklyn | $3,685.50 | $149.99 – $5,756.58 |
| Queens Hospital Center | Jamaica | $3,723.23 | $146.05 – $5,756.58 |
| Woodhull Medical Center | Brooklyn | $3,723.23 | $149.99 – $5,756.58 |
| Elmhurst Hospital Center | NY 11373 | not published | $262.88 – $7,675.44 |
| Harlem Hospital Center | New York | not published | $262.43 – $7,675.44 |