Pml/raralpha 1 breakpoint at Elmhurst Hospital Center
7901 Broadway Elmhurst, NY 11373, NY · NYC Health + Hospitals · · NPI 1063426377
$207.31
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.
$165.85 with Hamaspik vs $790.85 with ANTHEM — 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 |
|---|---|---|---|
| Hamaspik | MEDICARE ADVANTAGE | $165.85 | ↓ -20% |
| Healthfirst | Medicare Advantage PPO | $172.07 | ↓ -17% |
| Healthfirst | MAP | $203.16 | ↓ -2% |
| Healthfirst | MEDICARE ADVANTAGE | $203.16 | ↓ -2% |
| VNSNY | Medicare SNP | $207.31 | ↑ +0% |
| VillageCare Max | MEDICARE ADVANTAGE | $207.31 | ↑ +0% |
| VillageCare Max | MAP | $207.31 | ↑ +0% |
| VACCN | All Products | $207.31 | ↑ +0% |
| ANTHEM | MEDICARE ADVANTAGE | $207.31 | ↑ +0% |
| Fidelis | MAP | $207.31 | ↑ +0% |
| VNSNY | Medicare Advantage | $207.31 | ↑ +0% |
| Senior Whole Health | MLTC | $207.31 | ↑ +0% |
| Centerlight | PACE | $207.31 | ↑ +0% |
| Senior Whole Health | MAP | $207.31 | ↑ +0% |
| Local 1199 | ALL PRODUCTS | $207.31 | ↑ +0% |
| Amidacare | Managed Medicaid | $207.31 | ↑ +0% |
| Aetna | MEDICARE ADVANTAGE | $207.31 | ↑ +0% |
| EMBLEM | MEDICARE ADVANTAGE | $207.31 | ↑ +0% |
| UNITED | MEDICARE ADVANTAGE | $217.68 | ↑ +5% |
| OXFORD | MEDICARE ADVANTAGE | $217.68 | ↑ +5% |
| MetroPlus | MEDICARE ADVANTAGE | $234.26 | ↑ +13% |
| MetroPlus | EXCHANGE | $234.26 | ↑ +13% |
| MetroPlus | MAP | $234.26 | ↑ +13% |
| MAGNACARE | PPO Non-FPP | $248.77 | ↑ +20% |
| MAGNACARE | Direct Plus FPP | $248.77 | ↑ +20% |
| MAGNACARE | Direct Plus Non-FPP | $248.77 | ↑ +20% |
| MAGNACARE | PPO FPP | $248.77 | ↑ +20% |
| MetroPlus | Essential Plan 3-4 | $250.84 | ↑ +21% |
| MetroPlus | Essential Plan 1-2 | $250.84 | ↑ +21% |
| MetroPlus | Essential Plan 200-250 | $250.84 | ↑ +21% |
| EMBLEM | Essential Plan 3-4 | $259.14 | ↑ +25% |
| EMBLEM | Essential Plan 1-2 | $279.87 | ↑ +35% |
| Emblem | Essential Plan 200-250 | $279.87 | ↑ +35% |
| Wellcare | MEDICARE ADVANTAGE | $306.82 | ↑ +48% |
| OSCAR | ALL PRODUCTS | $310.97 | ↑ +50% |
| Aetna | ALL PRODUCTS | $408.47 | ↑ +97% |
| Elderplan | MAP_Medicare Advantage_MLTC | $414.62 | ↑ +100% |
| OXFORD | Liberty | $431.39 | ↑ +108% |
| UNITED | ALL PRODUCTS | $431.39 | ↑ +108% |
| OXFORD | Freedom | $431.39 | ↑ +108% |
| CIGNA | ALL PRODUCTS | $517.37 | ↑ +150% |
| ANTHEM | Blue Access Small Group | $711.51 | ↑ +243% |
| ANTHEM | Small Group EPO_PPO | $711.51 | ↑ +243% |
| ANTHEM | Blue Access Large Group | $731.99 | ↑ +253% |
| ANTHEM | EPO | $790.85 | ↑ +281% |
| ANTHEM | HMO | $790.85 | ↑ +281% |
| ANTHEM | INDEMNITY | $790.85 | ↑ +281% |
| ANTHEM | PPO | $790.85 | ↑ +281% |
Visitor-reported prices
Comments
Pml/raralpha 1 breakpoint at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $207.31 | $165.85 – $517.37 |
| Harlem Hospital Center | New York | $207.31 | $165.85 – $517.37 |
| Kings County Hospital Center | Brooklyn | $207.31 | $165.85 – $517.37 |
| Lincoln Medical Center | Bronx | $207.31 | $165.85 – $517.37 |
| Metropolitan Hospital Center | New York | $207.31 | $165.85 – $517.37 |
| Queens Hospital Center | Jamaica | $207.31 | $165.85 – $517.37 |
| Woodhull Medical Center | Brooklyn | $207.31 | $165.85 – $517.37 |
| South Brooklyn Health | Brooklyn | $207.31 | $165.85 – $517.37 |