Biopsy of lip 40490 at WESTFIELD MEMORIAL HOSPITAL INC
189 EAST MAIN STREET, WESTFIELD, NY · Ahn · · NPI 1942236427
$42.68
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.
$194.00
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.
$38.33 with Amerihealth vs $859.20 with United Healthcare — 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 |
|---|---|---|---|
| Amerihealth | Amerihealth Caritas Medicare (NY) | $38.33 | ↓ -10% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $38.33 | ↓ -10% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $48.18 | ↑ +13% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $52.93 | ↑ +24% |
| Geisinger | Geisinger CHIP | $52.93 | ↑ +24% |
| United Healthcare | United Healthcare Medicaid | $52.93 | ↑ +24% |
| Geisinger | Geisinger Medicaid HC | $52.93 | ↑ +24% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $52.93 | ↑ +24% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $54.75 | ↑ +28% |
| Jefferson Health Plans | Jefferson Health Plans | $55.85 | ↑ +31% |
| Univera | Univera Essential Plan | $56.28 | ↑ +32% |
| Univera | Univera Healthy New York | $56.28 | ↑ +32% |
| Amerihealth | Amerihealth Medicaid HC | $60.22 | ↑ +41% |
| Amerihealth | Amerihealth Medicaid CHC | $60.22 | ↑ +41% |
| Highmark | Highmark Community Blue Medicare | $60.24 | ↑ +41% |
| Life Pittsburgh | Life Pittsburgh Medicare | $64.77 | ↑ +52% |
| Highmark | Highmark Security Blue | $66.71 | ↑ +56% |
| Devoted Medicare | Devoted Health Medicare Advantage | $68.66 | ↑ +61% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $68.66 | ↑ +61% |
| Univera | Univera Medicare | $70.63 | ↑ +65% |
| American Health Plans | American Health Plans Medicare | $71.25 | ↑ +67% |
| Highmark | Highmark Together Blue | $73.17 | ↑ +71% |
| Highmark | Highmark Indemnity | $77.41 | ↑ +81% |
| Highmark | Highmark Managed Care | $77.41 | ↑ +81% |
| Highmark | Highmark My Blue Access | $77.41 | ↑ +81% |
| Highmark | Highmark My Direct Blue | $77.41 | ↑ +81% |
| Highmark | Highmark Performance Blue | $77.41 | ↑ +81% |
| Highmark | Highmark Community Blue | $77.41 | ↑ +81% |
| Highmark | Highmark Connect Blue | $77.41 | ↑ +81% |
| Highmark | Highmark Social Mission Indemnity | $77.41 | ↑ +81% |
| Highmark | Highmark Social Mission Managed Care | $77.41 | ↑ +81% |
| Highmark | Highmark Blue High Performance | $77.41 | ↑ +81% |
| Univera | Univera Commercial | $82.76 | ↑ +94% |
| Cigna | Cigna Commercial | $109.71 | ↑ +157% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $129.08 | ↑ +202% |
| United Healthcare | United Healthcare Of OH Medicaid | $136.08 | ↑ +219% |
| United Healthcare | United Healthcare Commercial | $136.08 | ↑ +219% |
| Highmark | Highmark Complete Blue Medicare | $252.82 | ↑ +492% |
| Highmark | Highmark Community Blue Medicare PPO | $252.82 | ↑ +492% |
| Highmark | Highmark Freedom Blue | $255.56 | ↑ +499% |
| Martin's Point | Martin's Point | $274.80 | ↑ +544% |
| Highmark | Highmark Community Blue Medicare HMO | $285.79 | ↑ +570% |
| Highmark | Highmark Together Blue Medicare | $285.79 | ↑ +570% |
| Aetna | Aetna Medicare | $285.79 | ↑ +570% |
| Amerihealth | Amerihealth Medicare New York | $288.54 | ↑ +576% |
| Humana | Humana Commercial | $291.29 | ↑ +582% |
| United Healthcare | United Healthcare Medicare I-SNP | $294.04 | ↑ +589% |
| United Healthcare | United Healthcare Medicare D-SNP | $296.78 | ↑ +595% |
| Molina | Molina Ohio | $299.53 | ↑ +602% |
| Highmark | Highmark Performance Blue Enhanced | $400.27 | ↑ +838% |
| Aetna | Aetna Commercial | $527.62 | ↑ +1136% |
| United Healthcare | United Healthcare CHIP | $859.20 | ↑ +1913% |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $274.80 | $0.01 – $645.00 |
| Harlem Hospital Center | New York | $274.80 | $0.01 – $645.00 |
| Kings County Hospital Center | Brooklyn | $274.80 | $0.01 – $645.00 |
| Lincoln Medical Center | Bronx | $274.80 | $0.01 – $645.00 |
| Metropolitan Hospital Center | New York | $274.80 | $0.01 – $645.00 |
| Queens Hospital Center | Jamaica | $274.80 | $0.01 – $645.00 |
| Woodhull Medical Center | Brooklyn | $274.80 | $0.01 – $645.00 |
| South Brooklyn Health | Brooklyn | $274.80 | $0.01 – $645.00 |