Exc breast duct fistula 19112 at WESTFIELD MEMORIAL HOSPITAL INC
189 EAST MAIN STREET, WESTFIELD, NY · Ahn · · NPI 1942236427
$201.30
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.
$915.00
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.
$17.00 with Amerihealth vs $8,700.32 with Aetna — 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 Medicaid HC | $17.00 | ↓ -92% |
| Amerihealth | Amerihealth Medicaid CHC | $17.00 | ↓ -92% |
| Univera | Univera Healthy New York | $26.32 | ↓ -87% |
| Univera | Univera Essential Plan | $26.32 | ↓ -87% |
| Univera | Univera Medicare | $31.95 | ↓ -84% |
| Univera | Univera Commercial | $34.72 | ↓ -83% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $207.90 | ↑ +3% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $207.90 | ↑ +3% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $261.36 | ↑ +30% |
| Highmark | Highmark Community Blue Medicare | $283.57 | ↑ +41% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $287.10 | ↑ +43% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $287.10 | ↑ +43% |
| Geisinger | Geisinger CHIP | $287.10 | ↑ +43% |
| Geisinger | Geisinger Medicaid HC | $287.10 | ↑ +43% |
| United Healthcare | United Healthcare Medicaid | $287.10 | ↑ +43% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $297.00 | ↑ +48% |
| Jefferson Health Plans | Jefferson Health Plans | $302.94 | ↑ +50% |
| Life Pittsburgh | Life Pittsburgh Medicare | $304.91 | ↑ +51% |
| Highmark | Highmark Security Blue | $314.06 | ↑ +56% |
| Devoted Medicare | Devoted Health Medicare Advantage | $323.20 | ↑ +61% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $323.20 | ↑ +61% |
| American Health Plans | American Health Plans Medicare | $335.40 | ↑ +67% |
| Highmark | Highmark Together Blue | $374.06 | ↑ +86% |
| Highmark | Highmark Managed Care | $395.68 | ↑ +97% |
| Highmark | Highmark My Blue Access | $395.68 | ↑ +97% |
| Highmark | Highmark My Direct Blue | $395.68 | ↑ +97% |
| Highmark | Highmark Performance Blue | $395.68 | ↑ +97% |
| Highmark | Highmark Blue High Performance | $395.68 | ↑ +97% |
| Highmark | Highmark Social Mission Indemnity | $395.68 | ↑ +97% |
| Highmark | Highmark Social Mission Managed Care | $395.68 | ↑ +97% |
| Highmark | Highmark Connect Blue | $395.68 | ↑ +97% |
| Highmark | Highmark Indemnity | $395.68 | ↑ +97% |
| Highmark | Highmark Community Blue | $395.68 | ↑ +97% |
| Cigna | Cigna Commercial | $514.90 | ↑ +156% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $573.67 | ↑ +185% |
| United Healthcare | United Healthcare Commercial | $604.81 | ↑ +200% |
| United Healthcare | United Healthcare Of OH Medicaid | $604.81 | ↑ +200% |
| United Healthcare | United Healthcare CHIP | $1,241.60 | ↑ +517% |
| Highmark | Highmark Community Blue Medicare PPO | $4,168.90 | ↑ +1971% |
| Highmark | Highmark Complete Blue Medicare | $4,168.90 | ↑ +1971% |
| Highmark | Highmark Freedom Blue | $4,214.22 | ↑ +1994% |
| Martin's Point | Martin's Point | $4,531.42 | ↑ +2151% |
| Aetna | Aetna Medicare | $4,712.67 | ↑ +2241% |
| Highmark | Highmark Together Blue Medicare | $4,712.67 | ↑ +2241% |
| Highmark | Highmark Community Blue Medicare HMO | $4,712.67 | ↑ +2241% |
| Amerihealth | Amerihealth Medicare New York | $4,757.99 | ↑ +2264% |
| Humana | Humana Commercial | $4,803.30 | ↑ +2286% |
| United Healthcare | United Healthcare Medicare I-SNP | $4,848.62 | ↑ +2309% |
| United Healthcare | United Healthcare Medicare D-SNP | $4,893.93 | ↑ +2331% |
| Molina | Molina Ohio | $4,939.24 | ↑ +2354% |
| Highmark | Highmark Performance Blue Enhanced | $6,600.46 | ↑ +3179% |
| Aetna | Aetna Commercial | $8,700.32 | ↑ +4222% |
Visitor-reported prices
Comments
Exc breast duct fistula 19112 at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $4,531.42 | $160.00 – $9,775.15 |
| Kings County Hospital Center | Brooklyn | $4,531.42 | $160.00 – $9,775.15 |
| Lincoln Medical Center | Bronx | $4,531.42 | $390.95 – $9,775.15 |
| Metropolitan Hospital Center | New York | $4,531.42 | $390.95 – $9,775.15 |
| Queens Hospital Center | Jamaica | $4,531.42 | $160.00 – $9,775.15 |
| Woodhull Medical Center | Brooklyn | $4,531.42 | $160.00 – $9,775.15 |
| South Brooklyn Health | Brooklyn | $4,531.42 | $390.95 – $9,775.15 |
| North Central Bronx | Bronx | $4,531.42 | $390.95 – $9,775.15 |