Oropharyngeal biopsy 42800 at NewYork-Presbyterian Columbia University Irving Medical Center
622 West 168th Street, New York, NY · NewYork-Presbyterian · · NPI 1952332801
$4,921.00
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.
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.
$1,665.16 with Anthem BCBS vs $13,583.76 with Anthem BCBS — 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 |
|---|---|---|---|
| Anthem BCBS | Medicare Advantage | $1,665.16 | ↓ -66% |
| Anthem BCBS Healthplus | nystateofhealth plans | $1,688.56 | ↓ -66% |
| VNS Health | Medicaid | $1,688.56 | ↓ -66% |
| MVP Health | Medicaid/Child Health Plus | $1,688.56 | ↓ -66% |
| Fidelis Care | Medicaid/Child Health Plus | $1,688.56 | ↓ -66% |
| Affinity by Molina Healthcare | Medicaid/Child Health Plus | $1,688.56 | ↓ -66% |
| Anthem BCBS Healthplus | Medicaid | $1,688.56 | ↓ -66% |
| Anthem BCBS Healthplus | Medicare Advantage | $1,715.11 | ↓ -65% |
| EmblemHealth | Medicare Advantage | $1,752.80 | ↓ -64% |
| Cigna Healthcare | Medicare Advantage | $1,752.80 | ↓ -64% |
| Fidelis Care | Medicare Advantage | $1,752.80 | ↓ -64% |
| United Healthcare | Medicaid | $1,799.83 | ↓ -63% |
| VNS Health | Medicare Advantage | $1,805.38 | ↓ -63% |
| Oxford Health Plans | Medicare Advantage | $1,805.38 | ↓ -63% |
| Aetna | Medicare Advantage | $1,805.38 | ↓ -63% |
| United Healthcare | Medicare Advantage | $1,805.38 | ↓ -63% |
| HealthFirst | Medicaid/Child Health Plus | $1,806.76 | ↓ -63% |
| WellCare | Medicare Advantage | $1,814.15 | ↓ -63% |
| HealthFirst | Medicare Advantage | $1,840.44 | ↓ -63% |
| EmblemHealth | Medicaid/Child Health Plus | $1,941.84 | ↓ -61% |
| Amida Care | Medicaid | $1,941.84 | ↓ -61% |
| 1199SEIU Funds | All Commercial Plans | $1,951.00 | ↓ -60% |
| Senior Whole Health | Medicare Advantage | $2,191.00 | ↓ -55% |
| Anthem BCBS Healthplus | Child Health Plus | $2,532.84 | ↓ -49% |
| HealthFirst | nystateofhealth plans | $3,011.65 | ↓ -39% |
| MVP Health | All NYS Essential Plans | $3,630.40 | ↓ -26% |
| Worldwide | All Commercial Plans | $3,739.96 | ↓ -24% |
| MagnaCare | All Commercial Plans | $3,739.96 | ↓ -24% |
| Affinity by Molina Healthcare | All NYS Essential Plans | $3,799.26 | ↓ -23% |
| QHM | All Commercial Plans | $4,182.85 | ↓ -15% |
| Claritev dba MultiPlan | All Commercial Plans | $4,182.85 | ↓ -15% |
| United Healthcare | Child Health Plus | $4,182.85 | ↓ -15% |
| Fidelis Care | nystateofhealth plans | $4,221.40 | ↓ -14% |
| Fidelis Care | All NYS Essential Plans | $4,221.40 | ↓ -14% |
| First Health Coventry | All Commercial Plans | $4,281.27 | ↓ -13% |
| Devon | All Commercial Plans | $4,428.90 | ↓ -10% |
| Beech Street | All Commercial Plans | $4,428.90 | ↓ -10% |
| First Health | All Commercial Plans | $4,576.53 | ↓ -7% |
| Consumer Health Network | All Commercial Plans | $4,625.74 | ↓ -6% |
| Oxford Health Plans | All Commercial Plans | $4,698.56 | ↓ -5% |
| United Healthcare | All Commercial Plans | $5,124.00 | ↑ +4% |
| Anthem BCBS Healthplus | All NYS Essential Plans | $5,606.01 | ↑ +14% |
| United Healthcare | All NYS Essential Plans | $6,175.90 | ↑ +26% |
| HealthFirst | All Essential Plans | $6,837.65 | ↑ +39% |
| EmblemHealth | All NYS Essential Plans | $7,207.20 | ↑ +46% |
| Cigna Healthcare | All Commercial Plans | $9,433.91 | ↑ +92% |
| Aetna | Commercial | $11,977.24 | ↑ +143% |
| EmblemHealth | All Commercial Plans | $12,700.68 | ↑ +158% |
| Anthem BCBS | All Commercial Plans | $13,583.76 | ↑ +176% |
Visitor-reported prices
Comments
Oropharyngeal biopsy 42800 at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Harlem Hospital Center | New York | $1,752.89 | $0.01 – $2,188.60 |
| Metropolitan Hospital Center | New York | $1,752.89 | $0.01 – $2,188.60 |
| Henry J. Carter Specialty Hospital | New York | not published | not published |
| NewYork-Presbyterian Queens | Flushing | $4,921.00 | $181.00 – $1,840.44 |
| Bellevue Hospital Center | NY 10016 | $1,752.89 | $0.01 – $2,905.23 |
| Kings County Hospital Center | Brooklyn | $1,752.89 | $0.01 – $2,905.23 |
| Lincoln Medical Center | Bronx | $1,752.89 | $0.01 – $2,188.60 |
| Queens Hospital Center | Jamaica | $1,752.89 | $0.01 – $2,905.23 |