Kyleena, 19.5 mg at Rochester General Hospital
1425 Portland Avenue, Rochester, NY · Rochesterregional · · NPI 1255360517
$2,565.91
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.
$3,947.55
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.
$1,133.18 with HIGHMARK vs $3,394.05 with EXCELLUS — 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 |
|---|---|---|---|
| HIGHMARK | MEDICARE ADVANTAGE | $1,133.18 | ↓ -56% |
| HIGHMARK | COMMERCIAL | $1,133.18 | ↓ -56% |
| EXCELLUS | MEDICAID | $1,287.51 | ↓ -50% |
| FIDELIS CARE NEW YORK | MEDICAID | $1,447.95 | ↓ -44% |
| FIDELIS CARE NEW YORK | EXCHANGE | $1,888.64 | ↓ -26% |
| FIDELIS CARE NEW YORK | ESSENTIAL | $2,644.09 | ↑ +3% |
| EXCELLUS | COMMERCIAL | $3,394.05 | ↑ +32% |
Visitor-reported prices
Comments
Kyleena, 19.5 mg at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| The Unity Hospital of Rochester | Rochester | $3,158.04 | $1,133.18 – $1,287.51 |
| NewYork-Presbyterian Hudson Valley Hospital | Cortlandt Manor | $4,048.77 | $443.41 – $3,534.57 |
| NewYork-Presbyterian Queens | Flushing | $4,048.77 | $443.69 – $3,510.28 |
| NewYork-Presbyterian Columbia University Irving Medical Center | New York | $4,048.77 | $357.94 – $3,534.57 |
| Clifton Springs Hospital and Clinic | Clifton Springs | $2,565.91 | $1,214.63 – $1,287.51 |
| Gouverneur Hospital | Gouverneur | $1,611.43 | $1,214.63 – $1,259.09 |
| Massena Hospital | Massena | $1,611.58 | not published |
| Canton-Potsdam Hospital | Potsdam | $1,611.58 | $1,259.09 – $1,259.09 |