healthcosts.net
Established Patient Office Visit (level 5) at UPMC Chautauqua
207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222
$165.60
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.
$276.00
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.
$61.00 with Univera vs $248.40 with Affordable First Health — 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 |
|---|---|---|---|
| Univera | Essential Plan | $61.00 | ↓ -63% |
| UNITED BEHAVIORAL HEALTH | Medicaid | $64.50 | ↓ -61% |
| Fidelis | Medicare | $96.00 | ↓ -42% |
| UPMC Health Plan | CHIP | $97.56 | ↓ -41% |
| UPMC Health Plan | Managed Medicaid | $97.56 | ↓ -41% |
| Geisinger | Medicaid/CHIP | $108.48 | ↓ -34% |
| Aetna | Medicare | $115.62 | ↓ -30% |
| Health Partners Plans (Jefferson Health Plan) | Medicaid/CHIP | $117.70 | ↓ -29% |
| CCBHN | UPMC Health Plan Commercial | $121.00 | ↓ -27% |
| CCBHN | UPMC Health Plan Value | $121.00 | ↓ -27% |
| CCBHN | UPMC Health Plan Value Select | $121.00 | ↓ -27% |
| CCBHN | UPMC Partner | $121.00 | ↓ -27% |
| Univera | Medicare Advantage | $126.14 | ↓ -24% |
| MagnaCare | No Fault | $150.74 | ↓ -9% |
| MagnaCare | Workers Compensation | $150.74 | ↓ -9% |
| UPMC Health Plan | Commercial | $165.60 | ↑ +0% |
| Independent Health | Medicare Advantage | $169.36 | ↑ +2% |
| United Healthcare | Commercial | $176.64 | ↑ +7% |
| Aetna | Commercial | $179.40 | ↑ +8% |
| Independent Health | Commercial | $198.52 | ↑ +20% |
| Humana | Commercial | $207.00 | ↑ +25% |
| MagnaCare | Direct Plus | $207.00 | ↑ +25% |
| MagnaCare | PPO | $207.00 | ↑ +25% |
| Multiplan | PPO (Includes PHCS as a Payer) | $207.00 | ↑ +25% |
| GHI/Emblem Health | Commercial | $220.80 | ↑ +33% |
| Statewide Independent PPO | PPO | $242.88 | ↑ +47% |
| Affordable First Health | PPO | $248.40 | ↑ +50% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Henry J. Carter Specialty Hospital | New York | not published | not published |
| Bellevue Hospital Center | NY 10016 | not published | $0.01 – $1,035.30 |
| Elmhurst Hospital Center | NY 11373 | not published | $0.01 – $1,035.30 |
| Harlem Hospital Center | New York | not published | $0.01 – $1,035.30 |
| Jacobi Medical Center | Bronx | not published | $0.01 – $1,035.30 |
| Kings County Hospital Center | Brooklyn | not published | $0.01 – $1,035.30 |
| Lincoln Medical Center | Bronx | not published | $0.01 – $1,035.30 |
| Metropolitan Hospital Center | New York | not published | $0.01 – $1,035.30 |