Biopsy skin incisional single lesion at Canton-Potsdam Hospital
50 Leroy Street, Potsdam, NY · Rochesterregional · · NPI 156854878|
$1,453.52
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.
$2,236.19
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.
$40.28 with CHAMPUS-TRICARE vs $46.99 with HUMANA — 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 |
|---|---|---|---|
| CHAMPUS-TRICARE | COMMERCIAL | $40.28 | ↓ -97% |
| UNITED HEALTHCARE | MEDICARE ADVANTAGE | $44.75 | ↓ -97% |
| UNITED HEALTHCARE | MEDICARE ADVANTAGE DUAL | $44.75 | ↓ -97% |
| CDPHP | MEDICARE ADVANTAGE | $44.75 | ↓ -97% |
| AETNA | MEDICARE ADVANTAGE | $44.75 | ↓ -97% |
| WELLCARE | MEDICARE ADVANTAGE DUAL | $45.64 | ↓ -97% |
| FIDELIS CARE NEW YORK | MEDICARE ADVANTAGE | $45.64 | ↓ -97% |
| WELLCARE | MEDICARE ADVANTAGE | $45.64 | ↓ -97% |
| HUMANA | MEDICARE ADVANTAGE | $46.99 | ↓ -97% |
Visitor-reported prices
Comments
Biopsy skin incisional single lesion at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $755.08 | $40.21 – $1,383.86 |
| Harlem Hospital Center | New York | $724.37 | $62.50 – $1,042.51 |
| Kings County Hospital Center | Brooklyn | $755.08 | $40.21 – $1,383.86 |
| Lincoln Medical Center | Bronx | $724.37 | $64.18 – $1,042.51 |
| Metropolitan Hospital Center | New York | $724.37 | $64.18 – $1,042.51 |
| UPMC Chautauqua | Jamestown | $498.00 | $47.31 – $2,904.64 |
| Queens Hospital Center | Jamaica | $755.08 | $40.21 – $1,383.86 |
| Woodhull Medical Center | Brooklyn | $755.08 | $40.21 – $1,383.86 |