Biopsy of lip 40490 at AHN WEXFORD HOSPITAL
12351 PERRY HIGHWAY, WEXFORD, PA · Ahn · · NPI 1588269898
$50.44
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 D-SNP Medicare | $38.33 | ↓ -24% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $38.33 | ↓ -24% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $48.18 | ↓ -4% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $50.37 | ↓ -0% |
| Geisinger | Geisinger Medicaid HC | $52.93 | ↑ +5% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $52.93 | ↑ +5% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $52.93 | ↑ +5% |
| United Healthcare | United Healthcare Medicaid | $52.93 | ↑ +5% |
| Geisinger | Geisinger CHIP | $52.93 | ↑ +5% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $54.75 | ↑ +9% |
| Amerihealth | Amerihealth Medicaid CHC | $60.22 | ↑ +19% |
| Amerihealth | Amerihealth Medicaid HC | $60.22 | ↑ +19% |
| Highmark | Highmark Community Blue Medicare | $60.24 | ↑ +19% |
| Life Pittsburgh | Life Pittsburgh Medicare | $64.77 | ↑ +28% |
| Highmark | Highmark Security Blue | $66.71 | ↑ +32% |
| Devoted Medicare | Devoted Health Medicare Advantage | $68.66 | ↑ +36% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $68.66 | ↑ +36% |
| American Health Plans | American Health Plans Medicare | $71.25 | ↑ +41% |
| Highmark | Highmark Together Blue | $73.17 | ↑ +45% |
| Highmark | Highmark Social Mission Managed Care | $77.41 | ↑ +53% |
| Highmark | Highmark Blue High Performance | $77.41 | ↑ +53% |
| Highmark | Highmark Community Blue | $77.41 | ↑ +53% |
| Highmark | Highmark Connect Blue | $77.41 | ↑ +53% |
| Highmark | Highmark Indemnity | $77.41 | ↑ +53% |
| Highmark | Highmark Managed Care | $77.41 | ↑ +53% |
| Highmark | Highmark My Blue Access | $77.41 | ↑ +53% |
| Highmark | Highmark My Direct Blue | $77.41 | ↑ +53% |
| Highmark | Highmark Performance Blue | $77.41 | ↑ +53% |
| Highmark | Highmark Social Mission Indemnity | $77.41 | ↑ +53% |
| Cigna | Cigna Commercial | $109.71 | ↑ +118% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $129.08 | ↑ +156% |
| United Healthcare | United Healthcare Of OH Medicaid | $136.08 | ↑ +170% |
| United Healthcare | United Healthcare Commercial | $136.08 | ↑ +170% |
| Highmark | Highmark Complete Blue Medicare | $205.53 | ↑ +307% |
| Highmark | Highmark Community Blue Medicare PPO | $205.53 | ↑ +307% |
| Highmark | Highmark Freedom Blue | $207.76 | ↑ +312% |
| Martin's Point | Martin's Point | $223.40 | ↑ +343% |
| Aetna | Aetna Medicare | $232.34 | ↑ +361% |
| Highmark | Highmark Together Blue Medicare | $232.34 | ↑ +361% |
| Highmark | Highmark Community Blue Medicare HMO | $232.34 | ↑ +361% |
| United Healthcare | United Healthcare Medicare | $232.34 | ↑ +361% |
| Humana | Humana Commercial | $236.80 | ↑ +369% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $236.80 | ↑ +369% |
| Cigna | Cigna Medicare | $239.04 | ↑ +374% |
| United Healthcare | United Healthcare Medicare I-SNP | $239.04 | ↑ +374% |
| United Healthcare | United Healthcare Medicare D-SNP | $241.27 | ↑ +378% |
| Molina | Molina Ohio | $243.51 | ↑ +383% |
| Highmark | Highmark Performance Blue Enhanced | $364.41 | ↑ +622% |
| Aetna | Aetna Commercial | $679.14 | ↑ +1246% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $741.25 | ↑ +1370% |
| United Healthcare | United Healthcare CHIP | $859.20 | ↑ +1603% |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| GROVE CITY HOSPITAL | GROVE CITY | $44.62 | $36.50 – $636.12 |
| UPMC Magee | Pittsburgh | $543.00 | $40.15 – $239.10 |
| UPMC Muncy | Muncy | $881.40 | $40.15 – $687.36 |
| UPMC Passavant-McCandless | Pittsburgh | $672.00 | $40.15 – $243.53 |
| UPMC Presbyterian | Pittsburgh | $502.20 | $40.15 – $644.40 |
| UPMC St. Margaret | Pittsburgh | $529.20 | $40.15 – $195.13 |
| UPMC Wellsboro | Wellsboro | $1,065.60 | $40.15 – $687.36 |
| Uniontown Hospital | Uniontown | $272.00 | $40.15 – $476.82 |