Biopsy roof of mouth at AHN WEXFORD HOSPITAL
12351 PERRY HIGHWAY, WEXFORD, PA · Ahn · · NPI 1588269898
$80.34
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.
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What you pay up front if you don't use insurance.
$309.00
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.
$75.08 with Amerihealth vs $4,728.29 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 |
|---|---|---|---|
| Amerihealth | Amerihealth Caritas Medicare (NY) | $75.08 | ↓ -7% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $75.08 | ↓ -7% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $94.38 | ↑ +17% |
| Highmark | Highmark Community Blue Medicare | $95.90 | ↑ +19% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $98.67 | ↑ +23% |
| Life Pittsburgh | Life Pittsburgh Medicare | $103.12 | ↑ +28% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $103.68 | ↑ +29% |
| Geisinger | Geisinger Medicaid HC | $103.68 | ↑ +29% |
| United Healthcare | United Healthcare Medicaid | $103.68 | ↑ +29% |
| Geisinger | Geisinger CHIP | $103.68 | ↑ +29% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $103.68 | ↑ +29% |
| Highmark | Highmark Security Blue | $106.21 | ↑ +32% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $107.25 | ↑ +33% |
| Devoted Medicare | Devoted Health Medicare Advantage | $109.31 | ↑ +36% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $109.31 | ↑ +36% |
| American Health Plans | American Health Plans Medicare | $113.43 | ↑ +41% |
| Amerihealth | Amerihealth Medicaid HC | $117.98 | ↑ +47% |
| Amerihealth | Amerihealth Medicaid CHC | $117.98 | ↑ +47% |
| Highmark | Highmark Together Blue | $118.28 | ↑ +47% |
| Highmark | Highmark Social Mission Managed Care | $125.13 | ↑ +56% |
| Highmark | Highmark Blue High Performance | $125.13 | ↑ +56% |
| Highmark | Highmark Community Blue | $125.13 | ↑ +56% |
| Highmark | Highmark Connect Blue | $125.13 | ↑ +56% |
| Highmark | Highmark Indemnity | $125.13 | ↑ +56% |
| Highmark | Highmark Managed Care | $125.13 | ↑ +56% |
| Highmark | Highmark My Blue Access | $125.13 | ↑ +56% |
| Highmark | Highmark My Direct Blue | $125.13 | ↑ +56% |
| Highmark | Highmark Performance Blue | $125.13 | ↑ +56% |
| Highmark | Highmark Social Mission Indemnity | $125.13 | ↑ +56% |
| Cigna | Cigna Commercial | $174.89 | ↑ +118% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $193.82 | ↑ +141% |
| United Healthcare | United Healthcare Of OH Medicaid | $204.34 | ↑ +154% |
| United Healthcare | United Healthcare Commercial | $204.34 | ↑ +154% |
| Highmark | Highmark Community Blue Medicare PPO | $1,311.02 | ↑ +1532% |
| Highmark | Highmark Complete Blue Medicare | $1,311.02 | ↑ +1532% |
| Highmark | Highmark Freedom Blue | $1,325.27 | ↑ +1550% |
| United Healthcare | United Healthcare CHIP | $1,352.00 | ↑ +1583% |
| Martin's Point | Martin's Point | $1,425.02 | ↑ +1674% |
| United Healthcare | United Healthcare Medicare | $1,482.02 | ↑ +1745% |
| Highmark | Highmark Together Blue Medicare | $1,482.02 | ↑ +1745% |
| Highmark | Highmark Community Blue Medicare HMO | $1,482.02 | ↑ +1745% |
| Aetna | Aetna Medicare | $1,482.02 | ↑ +1745% |
| Humana | Humana Commercial | $1,510.52 | ↑ +1780% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $1,510.52 | ↑ +1780% |
| United Healthcare | United Healthcare Medicare I-SNP | $1,524.77 | ↑ +1798% |
| Cigna | Cigna Medicare | $1,524.77 | ↑ +1798% |
| United Healthcare | United Healthcare Medicare D-SNP | $1,539.02 | ↑ +1816% |
| Molina | Molina Ohio | $1,553.27 | ↑ +1833% |
| Highmark | Highmark Performance Blue Enhanced | $2,324.49 | ↑ +2793% |
| Aetna | Aetna Commercial | $4,332.06 | ↑ +5292% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $4,728.29 | ↑ +5785% |
Visitor-reported prices
Comments
Biopsy roof of mouth at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Presbyterian | Pittsburgh | $988.80 | $78.65 – $1,553.44 |