Oropharyngeal biopsy 42800 at AHN WEXFORD HOSPITAL
12351 PERRY HIGHWAY, WEXFORD, PA · Ahn · · NPI 1588269898
$86.06
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.
$331.00
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.
$57.23 with Amerihealth vs $4,728.29 with Medical Mutual — 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 |
|---|---|---|---|
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $57.23 | ↓ -33% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $57.23 | ↓ -33% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $71.94 | ↓ -16% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $75.21 | ↓ -13% |
| Geisinger | Geisinger Medicaid HC | $79.03 | ↓ -8% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $79.03 | ↓ -8% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $79.03 | ↓ -8% |
| United Healthcare | United Healthcare Medicaid | $79.03 | ↓ -8% |
| Geisinger | Geisinger CHIP | $79.03 | ↓ -8% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $81.75 | ↓ -5% |
| Amerihealth | Amerihealth Medicaid CHC | $89.93 | ↑ +4% |
| Amerihealth | Amerihealth Medicaid HC | $89.93 | ↑ +4% |
| Highmark | Highmark Community Blue Medicare | $102.46 | ↑ +19% |
| Life Pittsburgh | Life Pittsburgh Medicare | $110.17 | ↑ +28% |
| Highmark | Highmark Security Blue | $113.48 | ↑ +32% |
| Devoted Medicare | Devoted Health Medicare Advantage | $116.78 | ↑ +36% |
| Devoted Medicare | Devoted Duel Plus PA HMO D-SNP | $116.78 | ↑ +36% |
| American Health Plans | American Health Plans Medicare | $121.19 | ↑ +41% |
| Highmark | Highmark Together Blue | $126.10 | ↑ +47% |
| Highmark | Highmark Social Mission Managed Care | $133.40 | ↑ +55% |
| Highmark | Highmark Blue High Performance | $133.40 | ↑ +55% |
| Highmark | Highmark Community Blue | $133.40 | ↑ +55% |
| Highmark | Highmark Connect Blue | $133.40 | ↑ +55% |
| Highmark | Highmark Indemnity | $133.40 | ↑ +55% |
| Highmark | Highmark Managed Care | $133.40 | ↑ +55% |
| Highmark | Highmark My Blue Access | $133.40 | ↑ +55% |
| Highmark | Highmark My Direct Blue | $133.40 | ↑ +55% |
| Highmark | Highmark Performance Blue | $133.40 | ↑ +55% |
| Highmark | Highmark Social Mission Indemnity | $133.40 | ↑ +55% |
| Cigna | Cigna Commercial | $186.41 | ↑ +117% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $202.74 | ↑ +136% |
| United Healthcare | United Healthcare Of OH Medicaid | $213.74 | ↑ +148% |
| United Healthcare | United Healthcare Commercial | $213.74 | ↑ +148% |
| United Healthcare | United Healthcare CHIP | $1,241.60 | ↑ +1343% |
| Highmark | Highmark Community Blue Medicare PPO | $1,311.02 | ↑ +1423% |
| Highmark | Highmark Complete Blue Medicare | $1,311.02 | ↑ +1423% |
| Highmark | Highmark Freedom Blue | $1,325.27 | ↑ +1440% |
| Martin's Point | Martin's Point | $1,425.02 | ↑ +1556% |
| United Healthcare | United Healthcare Medicare | $1,482.02 | ↑ +1622% |
| Highmark | Highmark Together Blue Medicare | $1,482.02 | ↑ +1622% |
| Highmark | Highmark Community Blue Medicare HMO | $1,482.02 | ↑ +1622% |
| Aetna | Aetna Medicare | $1,482.02 | ↑ +1622% |
| Humana | Humana Commercial | $1,510.52 | ↑ +1655% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $1,510.52 | ↑ +1655% |
| United Healthcare | United Healthcare Medicare I-SNP | $1,524.77 | ↑ +1672% |
| Cigna | Cigna Medicare | $1,524.77 | ↑ +1672% |
| United Healthcare | United Healthcare Medicare D-SNP | $1,539.02 | ↑ +1688% |
| Molina | Molina Ohio | $1,553.27 | ↑ +1705% |
| Highmark | Highmark Performance Blue Enhanced | $2,324.49 | ↑ +2601% |
| Aetna | Aetna Commercial | $4,332.06 | ↑ +4934% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $4,728.29 | ↑ +5394% |
Visitor-reported prices
Comments
Oropharyngeal biopsy 42800 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| UPMC Cole | Coudersport | $205.80 | $57.23 – $2,325.85 |
| UPMC Mercy | Pittsburgh | $720.00 | $59.95 – $1,553.44 |
| UPMC Presbyterian | Pittsburgh | $1,012.80 | $59.95 – $1,553.44 |
| UPMC St. Margaret | Pittsburgh | $681.60 | $59.95 – $1,553.44 |
| UPMC Williamsport | Williamsport | $836.40 | $59.95 – $1,511.08 |
| UPMC Community Osteopathic | Harrisburg | not published | $73.58 – $4,217.85 |
| WellSpan Ephrata Community Hospital | Ephrata | not published | $5,627.00 – $5,627.00 |