Repair of tibia at WESTFIELD MEMORIAL HOSPITAL INC
189 EAST MAIN STREET, WESTFIELD, NY · Ahn · · NPI 1942236427
$543.62
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.
$2,471.00
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.
$71.25 with Univera vs $16,230.92 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 |
|---|---|---|---|
| Univera | Univera Essential Plan | $71.25 | ↓ -87% |
| Univera | Univera Healthy New York | $71.25 | ↓ -87% |
| Univera | Univera Medicare | $93.31 | ↓ -83% |
| Univera | Univera Commercial | $104.78 | ↓ -81% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $141.75 | ↓ -74% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $141.75 | ↓ -74% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $178.20 | ↓ -67% |
| Geisinger | Geisinger CHIP | $195.75 | ↓ -64% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $195.75 | ↓ -64% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $195.75 | ↓ -64% |
| Geisinger | Geisinger Medicaid HC | $195.75 | ↓ -64% |
| United Healthcare | United Healthcare Medicaid | $195.75 | ↓ -64% |
| Highmark | Highmark Together Blue | $917.88 | ↑ +69% |
| Highmark | Highmark Community Blue | $970.96 | ↑ +79% |
| Highmark | Highmark Social Mission Managed Care | $970.96 | ↑ +79% |
| Highmark | Highmark Social Mission Indemnity | $970.96 | ↑ +79% |
| Highmark | Highmark Blue High Performance | $970.96 | ↑ +79% |
| Highmark | Highmark Performance Blue | $970.96 | ↑ +79% |
| Highmark | Highmark Connect Blue | $970.96 | ↑ +79% |
| Highmark | Highmark My Direct Blue | $970.96 | ↑ +79% |
| Highmark | Highmark Indemnity | $970.96 | ↑ +79% |
| Highmark | Highmark My Blue Access | $970.96 | ↑ +79% |
| Highmark | Highmark Managed Care | $970.96 | ↑ +79% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $1,164.00 | ↑ +114% |
| Jefferson Health Plans | Jefferson Health Plans | $1,187.28 | ↑ +118% |
| United Healthcare | United Healthcare CHIP | $1,241.60 | ↑ +128% |
| Amerihealth | Amerihealth Medicaid CHC | $1,280.40 | ↑ +136% |
| Amerihealth | Amerihealth Medicaid HC | $1,280.40 | ↑ +136% |
| Cigna | Cigna Commercial | $1,393.79 | ↑ +156% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $1,597.30 | ↑ +194% |
| United Healthcare | United Healthcare Of OH Medicaid | $1,684.02 | ↑ +210% |
| United Healthcare | United Healthcare Commercial | $1,684.02 | ↑ +210% |
| Highmark | Highmark Complete Blue Medicare | $7,777.32 | ↑ +1331% |
| Highmark | Highmark Community Blue Medicare PPO | $7,777.32 | ↑ +1331% |
| Highmark | Highmark Freedom Blue | $7,861.85 | ↑ +1346% |
| Life Pittsburgh | Life Pittsburgh Medicare | $8,453.60 | ↑ +1455% |
| Martin's Point | Martin's Point | $8,453.60 | ↑ +1455% |
| American Health Plans | American Health Plans Medicare | $8,453.60 | ↑ +1455% |
| Devoted Medicare | Devoted Health Medicare Advantage | $8,707.21 | ↑ +1502% |
| Highmark | Highmark Together Blue Medicare | $8,791.75 | ↑ +1517% |
| Highmark | Highmark Community Blue Medicare HMO | $8,791.75 | ↑ +1517% |
| Highmark | Highmark Security Blue | $8,791.75 | ↑ +1517% |
| Aetna | Aetna Medicare | $8,791.75 | ↑ +1517% |
| Amerihealth | Amerihealth Medicare New York | $8,876.28 | ↑ +1533% |
| Humana | Humana Commercial | $8,960.82 | ↑ +1548% |
| United Healthcare | United Healthcare Medicare I-SNP | $9,045.36 | ↑ +1564% |
| United Healthcare | United Healthcare Medicare D-SNP | $9,129.89 | ↑ +1579% |
| Molina | Molina Ohio | $9,214.43 | ↑ +1595% |
| Highmark | Highmark Performance Blue Enhanced | $12,313.52 | ↑ +2165% |
| Aetna | Aetna Commercial | $16,230.92 | ↑ +2886% |
Visitor-reported prices
Comments
Repair of tibia at other New-york hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Bellevue Hospital Center | NY 10016 | $8,453.60 | $513.86 – $18,115.63 |
| Harlem Hospital Center | New York | $8,453.60 | $1,003.01 – $18,115.63 |
| Kings County Hospital Center | Brooklyn | $8,453.60 | $513.86 – $18,115.63 |
| Lincoln Medical Center | Bronx | $8,453.60 | $1,035.82 – $18,115.63 |
| Metropolitan Hospital Center | New York | $8,453.60 | $1,035.82 – $18,115.63 |
| Queens Hospital Center | Jamaica | $8,453.60 | $513.86 – $18,115.63 |
| Woodhull Medical Center | Brooklyn | $8,453.60 | $513.86 – $18,115.63 |
| South Brooklyn Health | Brooklyn | $8,453.60 | $1,035.82 – $18,115.63 |