Close lac/mouth vest/2.5 cm or < 40830 at UPMC Chautauqua

207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222

Source: hospital's published price file ↗ · Published unknown · Ingested Aug 13, 2026

$210.60

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$351.00

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$39.38 with UPMC Health Plan vs $987.00 with Univera — 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 →

Payer
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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
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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 $39.38 ↓ -81%
UPMC Health Plan CHIP $39.38 ↓ -81%
Geisinger Medicaid/CHIP $43.78 ↓ -79%
Health Partners Plans (Jefferson Health Plan) Medicaid/CHIP $47.50 ↓ -77%
BCBS of Western NY Medicaid $77.10 ↓ -63%
BCBS of Western NY Commercial $147.69 ↓ -30%
MagnaCare Workers Compensation $173.28 ↓ -18%
MagnaCare No Fault $173.28 ↓ -18%
UPMC Health Plan Commercial $210.60 ↑ +0%
United Healthcare Commercial $224.64 ↑ +7%
Aetna Commercial $228.15 ↑ +8%
Multiplan PPO (Includes PHCS as a Payer) $263.25 ↑ +25%
MagnaCare PPO $263.25 ↑ +25%
MagnaCare Direct Plus $263.25 ↑ +25%
Humana Commercial $263.25 ↑ +25%
Independent Health Commercial $273.17 ↑ +30%
GHI/Emblem Health Commercial $280.80 ↑ +33%
Humana Medicare $283.73 ↑ +35%
Beacon Medicare Advantage $283.73 ↑ +35%
UPMC Health Plan Managed Medicare $283.73 ↑ +35%
Fidelis Medicare $283.73 ↑ +35%
United Healthcare Medicare $283.73 ↑ +35%
UNITED BEHAVIORAL HEALTH MEDICARE $283.73 ↑ +35%
UPMC Health Plan EPO Partners/EPO Select Plan/HMO $289.40 ↑ +37%
Wellcare Medicare $292.24 ↑ +39%
Aetna Medicare $295.08 ↑ +40%
Statewide Independent PPO PPO $308.88 ↑ +47%
Affordable First Health PPO $315.90 ↑ +50%
Independent Health Medicare Advantage $349.61 ↑ +66%
Beacon Commercial $354.66 ↑ +68%
Univera Essential Plan $622.00 ↑ +195%
Univera Medicare Advantage $987.00 ↑ +369%
Tricare East Region not published by hospital
US Family Health Plan Tricare Prime not published by hospital

Visitor-reported prices

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Close lac/mouth vest/2.5 cm or < 40830 at other New-york hospitals

Hospital City Cash price Negotiated range
NewYork-Presbyterian Queens Flushing $395.00 $184.41 – $288.53
Bellevue Hospital Center NY 10016 $274.80 $92.02 – $781.00
Harlem Hospital Center New York $274.80 $165.22 – $781.00
Kings County Hospital Center Brooklyn $274.80 $92.02 – $781.00
Lincoln Medical Center Bronx $274.80 $169.61 – $781.00
Metropolitan Hospital Center New York $274.80 $169.61 – $781.00
Queens Hospital Center Jamaica $274.80 $92.02 – $781.00
Woodhull Medical Center Brooklyn $274.80 $92.02 – $781.00

All New-york hospitals for this procedure →