Biopsy of salivary glnd;incisional 42405 at GROVE CITY HOSPITAL
631 NORTH BROAD STREET EXT, GROVE CITY, PA · Ahn · · NPI 1023000296
$146.97
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.
$639.00
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.
$18.61 with Univera vs $4,057.66 with Medical Mutual — 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 | $18.61 | ↓ -87% |
| Univera | Univera Healthy New York | $18.61 | ↓ -87% |
| Univera | Univera Medicare | $23.36 | ↓ -84% |
| Univera | Univera Commercial | $27.37 | ↓ -81% |
| Aetna | Aetna Better Health CHIP | $73.50 | ↓ -50% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $77.18 | ↓ -47% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $77.18 | ↓ -47% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid HC | $84.53 | ↓ -42% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Kids | $84.53 | ↓ -42% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for You Medicaid CHC | $84.53 | ↓ -42% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $97.02 | ↓ -34% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $101.43 | ↓ -31% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $106.58 | ↓ -27% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $106.58 | ↓ -27% |
| Geisinger | Geisinger CHIP | $106.58 | ↓ -27% |
| Geisinger | Geisinger Medicaid HC | $106.58 | ↓ -27% |
| United Healthcare | United Healthcare Medicaid | $106.58 | ↓ -27% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $110.25 | ↓ -25% |
| Amerihealth | Amerihealth Medicaid CHC | $121.27 | ↓ -17% |
| Amerihealth | Amerihealth Medicaid HC | $121.27 | ↓ -17% |
| Highmark | Highmark Community Blue Medicare | $198.24 | ↑ +35% |
| Life Pittsburgh | Life Pittsburgh Medicare | $213.16 | ↑ +45% |
| Allwell | Allwell by Wellcare | $213.16 | ↑ +45% |
| Highmark | Highmark Security Blue | $219.55 | ↑ +49% |
| Devoted Medicare | Devoted Health Medicare Advantage | $225.95 | ↑ +54% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $225.95 | ↑ +54% |
| American Health Plans | American Health Plans Medicare | $234.48 | ↑ +60% |
| Highmark | Highmark Together Blue | $243.68 | ↑ +66% |
| Highmark | Highmark Performance Blue | $257.77 | ↑ +75% |
| Highmark | Highmark Social Mission Indemnity | $257.77 | ↑ +75% |
| Highmark | Highmark Social Mission Managed Care | $257.77 | ↑ +75% |
| Highmark | Highmark Blue High Performance | $257.77 | ↑ +75% |
| Highmark | Highmark Connect Blue | $257.77 | ↑ +75% |
| Highmark | Highmark Community Blue | $257.77 | ↑ +75% |
| Highmark | Highmark Indemnity | $257.77 | ↑ +75% |
| Highmark | Highmark Managed Care | $257.77 | ↑ +75% |
| Highmark | Highmark My Blue Access | $257.77 | ↑ +75% |
| Highmark | Highmark My Direct Blue | $257.77 | ↑ +75% |
| Cigna | Cigna Commercial | $362.44 | ↑ +147% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $409.92 | ↑ +179% |
| United Healthcare | United Healthcare Of OH Medicaid | $432.17 | ↑ +194% |
| United Healthcare | United Healthcare Commercial | $432.17 | ↑ +194% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center Commercial | $589.88 | ↑ +301% |
| United Healthcare | United Healthcare CHIP | $915.20 | ↑ +523% |
| Highmark | Highmark Community Blue Medicare PPO | $1,311.02 | ↑ +792% |
| Highmark | Highmark Complete Blue Medicare | $1,311.02 | ↑ +792% |
| Highmark | Highmark Freedom Blue | $1,325.27 | ↑ +802% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Life Medicare HMO | $1,425.02 | ↑ +870% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Life Medicare PPO | $1,425.02 | ↑ +870% |
| University of Pittsburgh Medical Center | University of Pittsburgh Medical Center for Life Medicare Specialty Plan D-SNP | $1,425.02 | ↑ +870% |
| Aetna | Aetna Medicare | $1,482.02 | ↑ +908% |
| United Healthcare | United Healthcare Medicare | $1,482.02 | ↑ +908% |
| Highmark | Highmark Together Blue Medicare | $1,482.02 | ↑ +908% |
| Highmark | Highmark Community Blue Medicare HMO | $1,482.02 | ↑ +908% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $1,510.52 | ↑ +928% |
| Humana | Humana Commercial | $1,510.52 | ↑ +928% |
| United Healthcare | United Healthcare Medicare I-SNP | $1,524.77 | ↑ +937% |
| Cigna | Cigna Medicare | $1,524.77 | ↑ +937% |
| United Healthcare | United Healthcare Medicare D-SNP | $1,539.02 | ↑ +947% |
| Molina | Molina Ohio | $1,553.27 | ↑ +957% |
| Highmark | Highmark Performance Blue Enhanced | $2,810.57 | ↑ +1812% |
| Aetna | Aetna Commercial | $3,031.02 | ↑ +1962% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $4,057.66 | ↑ +2661% |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| AHN WEXFORD HOSPITAL | WEXFORD | $166.14 | $77.18 – $4,728.29 |
| UPMC Cole | Coudersport | $347.40 | $77.17 – $1,041.88 |
| Uniontown Hospital | Uniontown | $4,252.00 | $80.85 – $3,123.56 |
| UPMC Hamot | Erie | not published | $80.85 – $2,053.97 |
| UPMC Memorial | York | not published | $93.34 – $2,272.64 |
| UPMC Presbyterian | Pittsburgh | not published | $80.85 – $1,553.44 |
| WellSpan Chambersburg Hospital | Chambersburg | not published | $970.00 – $6,812.57 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $1,430.62 – $8,754.00 |