Biopsy of salivary gland 42400 at UPMC Chautauqua
207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222
$696.00
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.
$1,160.00
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.
$43.75 with UPMC Health Plan vs $5,586.63 with BCBS of Western NY — 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 | Managed Medicaid | $43.75 | ↓ -94% |
| UPMC Health Plan | CHIP | $43.75 | ↓ -94% |
| Univera | Essential Plan | $44.04 | ↓ -94% |
| Geisinger | Medicaid/CHIP | $48.65 | ↓ -93% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $52.78 | ↓ -92% |
| Univera | Medicare Advantage | $54.40 | ↓ -92% |
| MagnaCare | Workers Compensation | $130.43 | ↓ -81% |
| MagnaCare | No Fault | $130.43 | ↓ -81% |
| UPMC Health Plan | Commercial | $696.00 | ↑ +0% |
| United Healthcare | Commercial | $742.40 | ↑ +7% |
| Aetna | Commercial | $754.00 | ↑ +8% |
| Independent Health | Commercial | $853.03 | ↑ +23% |
| United Healthcare | Medicare | $859.66 | ↑ +24% |
| Beacon | Medicare Advantage | $859.66 | ↑ +24% |
| Fidelis | Medicare | $859.66 | ↑ +24% |
| UNITED BEHAVIORAL HEALTH | MEDICARE | $859.66 | ↑ +24% |
| UPMC Health Plan | Managed Medicare | $859.66 | ↑ +24% |
| Humana | Medicare | $859.66 | ↑ +24% |
| MagnaCare | PPO | $870.00 | ↑ +25% |
| Humana | Commercial | $870.00 | ↑ +25% |
| MagnaCare | Direct Plus | $870.00 | ↑ +25% |
| Multiplan | PPO (Includes PHCS as a Payer) | $870.00 | ↑ +25% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $876.85 | ↑ +26% |
| Wellcare | Medicare | $885.45 | ↑ +27% |
| Aetna | Medicare | $894.05 | ↑ +28% |
| GHI/Emblem Health | Commercial | $928.00 | ↑ +33% |
| Statewide Independent PPO | PPO | $1,020.80 | ↑ +47% |
| Affordable First Health | PPO | $1,044.00 | ↑ +50% |
| Independent Health | Medicare Advantage | $1,059.27 | ↑ +52% |
| Beacon | Commercial | $1,074.58 | ↑ +54% |
| BCBS of Western NY | Medicaid | $2,904.64 | ↑ +317% |
| BCBS of Western NY | Commercial | $5,586.63 | ↑ +703% |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $832.60 | $0.01 – $1,325.93 |
| Harlem Hospital Center | New York | $832.60 | $0.01 – $998.86 |
| Kings County Hospital Center | Brooklyn | $832.60 | $0.01 – $1,325.93 |
| Lincoln Medical Center | Bronx | $832.60 | $0.01 – $998.86 |
| Metropolitan Hospital Center | New York | $832.60 | $0.01 – $998.86 |
| Queens Hospital Center | Jamaica | $832.60 | $0.01 – $1,325.93 |
| Woodhull Medical Center | Brooklyn | $832.60 | $0.01 – $1,325.93 |
| South Brooklyn Health | Brooklyn | $832.60 | $0.01 – $998.86 |