healthcosts.net
Breast Biopsy (ultrasound-guided, percutaneous) at UPMC Chautauqua
207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222
$975.00
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.
?
What you pay up front if you don't use insurance.
$1,625.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$173.61 with UPMC Health Plan vs $2,474.55 with Beacon — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $173.61 | ↓ -82% |
| UPMC Health Plan | CHIP | $173.61 | ↓ -82% |
| Geisinger | Medicaid/CHIP | $193.04 | ↓ -80% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $209.45 | ↓ -79% |
| Univera | Essential Plan | $622.00 | ↓ -36% |
| MagnaCare | No Fault | $788.16 | ↓ -19% |
| MagnaCare | Workers Compensation | $788.16 | ↓ -19% |
| UPMC Health Plan | Commercial | $975.00 | ↑ +0% |
| Univera | Medicare Advantage | $987.00 | ↑ +1% |
| BCBS of Western NY | Medicaid | $1,033.67 | ↑ +6% |
| United Healthcare | Commercial | $1,040.00 | ↑ +7% |
| Aetna | Commercial | $1,056.25 | ↑ +8% |
| MagnaCare | PPO | $1,218.75 | ↑ +25% |
| Humana | Commercial | $1,218.75 | ↑ +25% |
| MagnaCare | Direct Plus | $1,218.75 | ↑ +25% |
| Multiplan | PPO (Includes PHCS as a Payer) | $1,218.75 | ↑ +25% |
| GHI/Emblem Health | Commercial | $1,300.00 | ↑ +33% |
| Statewide Independent PPO | PPO | $1,430.00 | ↑ +47% |
| Affordable First Health | PPO | $1,462.50 | ↑ +50% |
| Independent Health | Commercial | $1,971.05 | ↑ +102% |
| UPMC Health Plan | Managed Medicare | $1,979.64 | ↑ +103% |
| United Healthcare | Medicare | $1,979.64 | ↑ +103% |
| UNITED BEHAVIORAL HEALTH | MEDICARE | $1,979.64 | ↑ +103% |
| Fidelis | Medicare | $1,979.64 | ↑ +103% |
| Humana | Medicare | $1,979.64 | ↑ +103% |
| Beacon | Medicare Advantage | $1,979.64 | ↑ +103% |
| BCBS of Western NY | Commercial | $1,986.93 | ↑ +104% |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $2,019.23 | ↑ +107% |
| Wellcare | Medicare | $2,039.03 | ↑ +109% |
| Aetna | Medicare | $2,058.83 | ↑ +111% |
| Independent Health | Medicare Advantage | $2,439.31 | ↑ +150% |
| Beacon | Commercial | $2,474.55 | ↑ +154% |
| Tricare | East Region | not published by hospital | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
Visitor-reported prices
Comments
Breast Biopsy (ultrasound-guided, percutaneous) at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $1,874.89 | $0.01 – $3,924.06 |
| Kings County Hospital Center | Brooklyn | $1,855.89 | $84.60 – $4,169.31 |
| Queens Hospital Center | Jamaica | $1,874.89 | $82.33 – $4,169.31 |
| Woodhull Medical Center | Brooklyn | $1,874.89 | $84.60 – $4,169.31 |
| Elmhurst Hospital Center | NY 11373 | not published | $0.01 – $3,733.02 |
| Harlem Hospital Center | New York | not published | $132.38 – $3,733.02 |
| Henry J. Carter Specialty Hospital | New York | not published | not published |
| Jacobi Medical Center | Bronx | not published | $135.36 – $4,169.31 |