healthcosts.net
Tonsillectomy (age 12+) at UPMC Chautauqua
207 Foote Avenue, Jamestown, NY · UPMC · · NPI 1770573222
not published by hospital
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.
not published by hospital
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.
$642.83 with MagnaCare vs $4,953.06 with Beacon — 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 |
|---|---|---|---|
| MagnaCare | No Fault | $642.83 | — |
| MagnaCare | Workers Compensation | $642.83 | — |
| Univera | Essential Plan | $1,198.00 | — |
| BCBS of Western NY | Medicaid | $1,580.63 | — |
| Univera | Medicare Advantage | $1,902.00 | — |
| BCBS of Western NY | Commercial | $3,040.44 | — |
| Independent Health | Commercial | $3,739.59 | — |
| Beacon | Medicare Advantage | $3,962.45 | — |
| Fidelis | Medicare | $3,962.45 | — |
| Humana | Medicare | $3,962.45 | — |
| UNITED BEHAVIORAL HEALTH | MEDICARE | $3,962.45 | — |
| UPMC Health Plan | Managed Medicare | $3,962.45 | — |
| United Healthcare | Medicare | $3,962.45 | — |
| UPMC Health Plan | EPO Partners/EPO Select Plan/HMO | $4,041.70 | — |
| Wellcare | Medicare | $4,081.32 | — |
| Aetna | Medicare | $4,120.95 | — |
| Independent Health | Medicare Advantage | $4,882.53 | — |
| Beacon | Commercial | $4,953.06 | — |
| US Family Health Plan | Tricare Prime | not published by hospital | — |
| Tricare | East Region | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $3,723.23 | $145.80 – $5,756.58 |
| Kings County Hospital Center | Brooklyn | $3,685.50 | $149.99 – $5,756.58 |
| Queens Hospital Center | Jamaica | $3,723.23 | $146.05 – $5,756.58 |
| Woodhull Medical Center | Brooklyn | $3,723.23 | $149.99 – $5,756.58 |
| Elmhurst Hospital Center | NY 11373 | not published | $262.88 – $7,675.44 |
| Harlem Hospital Center | New York | not published | $262.43 – $7,675.44 |
| Jacobi Medical Center | Bronx | not published | $269.97 – $7,675.44 |
| Lincoln Medical Center | Bronx | not published | $269.97 – $7,675.44 |