New Patient Office Visit (level 3) at Clifton Springs Hospital and Clinic
2 Coulter Road, Clifton Springs, NY · Rochesterregional · · NPI 1366505463
$356.62
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.
$548.65
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.
$29.75 with MH OPTUM vs $132.16 with HIGHMARK — 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 |
|---|---|---|---|
| MH OPTUM | COMMERCIAL | $29.75 | ↓ -92% |
| EXCELLUS | MEDICARE ADVANTAGE | $59.56 | ↓ -83% |
| MVP - CIGNA | MEDICARE ADVANTAGE DUAL DSNP | $109.59 | ↓ -69% |
| MVP - CIGNA | MEDICARE ADVANTAGE GOLD HMO | $109.59 | ↓ -69% |
| MVP - CIGNA | MEDICARE ADVANTAGE GOLD PPO | $109.59 | ↓ -69% |
| HIGHMARK | COMMERCIAL | $132.16 | ↓ -63% |
Visitor-reported prices
Comments
New Patient Office Visit (level 3) at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Chautauqua | Jamestown | $129.60 | $43.29 – $194.40 |
| NewYork-Presbyterian Queens | Flushing | $1,014.00 | $707.15 – $741.69 |
| NewYork-Presbyterian Columbia University Irving Medical Center | New York | $715.00 | $720.96 – $720.96 |
| Rochester General Hospital | Rochester | $356.62 | $72.00 – $72.00 |
| Gouverneur Hospital | Gouverneur | $313.92 | $43.29 – $142.01 |
| Massena Hospital | Massena | $315.56 | $43.29 – $142.01 |
| Canton-Potsdam Hospital | Potsdam | $320.08 | $62.33 – $142.01 |
| The Unity Hospital of Rochester | Rochester | $438.92 | $109.59 – $109.59 |