Excision addl breast lesion 19126 at WESTFIELD MEMORIAL HOSPITAL INC
189 EAST MAIN STREET, WESTFIELD, NY · Ahn · · NPI 1942236427
$98.34
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.
?
What you pay up front if you don't use insurance.
$447.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$127.77 with Univera vs $314.91 with United Healthcare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Univera | Univera Essential Plan | $127.77 | ↑ +30% |
| Univera | Univera Healthy New York | $127.77 | ↑ +30% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $149.24 | ↑ +52% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $149.24 | ↑ +52% |
| Univera | Univera Medicare | $155.13 | ↑ +58% |
| Univera | Univera Commercial | $168.55 | ↑ +71% |
| Highmark | Highmark Together Blue | $181.70 | ↑ +85% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $187.61 | ↑ +91% |
| Highmark | Highmark Social Mission Indemnity | $192.20 | ↑ +95% |
| Highmark | Highmark Social Mission Managed Care | $192.20 | ↑ +95% |
| Highmark | Highmark Performance Blue | $192.20 | ↑ +95% |
| Highmark | Highmark Blue High Performance | $192.20 | ↑ +95% |
| Highmark | Highmark Community Blue | $192.20 | ↑ +95% |
| Highmark | Highmark Connect Blue | $192.20 | ↑ +95% |
| Highmark | Highmark Indemnity | $192.20 | ↑ +95% |
| Highmark | Highmark Managed Care | $192.20 | ↑ +95% |
| Highmark | Highmark My Blue Access | $192.20 | ↑ +95% |
| Highmark | Highmark My Direct Blue | $192.20 | ↑ +95% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $206.09 | ↑ +110% |
| United Healthcare | United Healthcare Medicaid | $206.09 | ↑ +110% |
| Geisinger | Geisinger Medicaid HC | $206.09 | ↑ +110% |
| Geisinger | Geisinger CHIP | $206.09 | ↑ +110% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $206.09 | ↑ +110% |
| United Healthcare | United Healthcare CHIP | $227.41 | ↑ +131% |
| Cigna | Cigna Commercial | $254.41 | ↑ +159% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $298.69 | ↑ +204% |
| United Healthcare | United Healthcare Of OH Medicaid | $314.91 | ↑ +220% |
| United Healthcare | United Healthcare Commercial | $314.91 | ↑ +220% |
Visitor-reported prices
Comments
Excision addl breast lesion 19126 at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| The Unity Hospital of Rochester | Rochester | $2,204.86 | not published |
| Bellevue Hospital Center | NY 10016 | not published | $90.64 – $262.25 |
| Kings County Hospital Center | Brooklyn | not published | $90.64 – $272.59 |
| Lincoln Medical Center | Bronx | not published | $189.30 – $272.59 |
| Metropolitan Hospital Center | New York | not published | $189.30 – $272.59 |
| Queens Hospital Center | Jamaica | not published | $90.64 – $257.27 |
| Woodhull Medical Center | Brooklyn | not published | $90.64 – $272.59 |
| South Brooklyn Health | Brooklyn | not published | $189.30 – $272.59 |