Reconstruct lip w/local flap 40525 at AHN WEXFORD HOSPITAL
12351 PERRY HIGHWAY, WEXFORD, PA · Ahn · · NPI 1588269898
$402.48
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.
$1,548.00
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.
$512.56 with Amerihealth vs $10,351.98 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 D-SNP Medicare | $512.56 | ↑ +27% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $512.56 | ↑ +27% |
| Highmark | Highmark Together Blue | $592.50 | ↑ +47% |
| Highmark | Highmark Connect Blue | $626.77 | ↑ +56% |
| Highmark | Highmark Social Mission Managed Care | $626.77 | ↑ +56% |
| Highmark | Highmark Social Mission Indemnity | $626.77 | ↑ +56% |
| Highmark | Highmark Performance Blue | $626.77 | ↑ +56% |
| Highmark | Highmark My Direct Blue | $626.77 | ↑ +56% |
| Highmark | Highmark My Blue Access | $626.77 | ↑ +56% |
| Highmark | Highmark Managed Care | $626.77 | ↑ +56% |
| Highmark | Highmark Blue High Performance | $626.77 | ↑ +56% |
| Highmark | Highmark Community Blue | $626.77 | ↑ +56% |
| Highmark | Highmark Indemnity | $626.77 | ↑ +56% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $644.36 | ↑ +60% |
| Geisinger | Geisinger CHIP | $707.82 | ↑ +76% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $707.82 | ↑ +76% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $707.82 | ↑ +76% |
| Geisinger | Geisinger Medicaid HC | $707.82 | ↑ +76% |
| United Healthcare | United Healthcare Medicaid | $707.82 | ↑ +76% |
| Cigna | Cigna Commercial | $879.65 | ↑ +119% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $1,002.71 | ↑ +149% |
| United Healthcare | United Healthcare Commercial | $1,057.15 | ↑ +163% |
| United Healthcare | United Healthcare Of OH Medicaid | $1,057.15 | ↑ +163% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $1,070.88 | ↑ +166% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $1,164.00 | ↑ +189% |
| United Healthcare | United Healthcare CHIP | $1,241.60 | ↑ +208% |
| Amerihealth | Amerihealth Medicaid CHC | $1,280.40 | ↑ +218% |
| Amerihealth | Amerihealth Medicaid HC | $1,280.40 | ↑ +218% |
| Highmark | Highmark Community Blue Medicare PPO | $2,870.31 | ↑ +613% |
| Highmark | Highmark Complete Blue Medicare | $2,870.31 | ↑ +613% |
| Highmark | Highmark Freedom Blue | $2,901.51 | ↑ +621% |
| Life Pittsburgh | Life Pittsburgh Medicare | $3,119.90 | ↑ +675% |
| Martin's Point | Martin's Point | $3,119.90 | ↑ +675% |
| American Health Plans | American Health Plans Medicare | $3,119.90 | ↑ +675% |
| Devoted Medicare | Devoted Health Medicare Advantage | $3,213.50 | ↑ +698% |
| Highmark | Highmark Security Blue | $3,244.69 | ↑ +706% |
| Highmark | Highmark Together Blue Medicare | $3,244.69 | ↑ +706% |
| Aetna | Aetna Medicare | $3,244.69 | ↑ +706% |
| Highmark | Highmark Community Blue Medicare HMO | $3,244.69 | ↑ +706% |
| United Healthcare | United Healthcare Medicare | $3,244.69 | ↑ +706% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $3,307.09 | ↑ +722% |
| Humana | Humana Commercial | $3,307.09 | ↑ +722% |
| Cigna | Cigna Medicare | $3,338.29 | ↑ +729% |
| United Healthcare | United Healthcare Medicare I-SNP | $3,338.29 | ↑ +729% |
| United Healthcare | United Healthcare Medicare D-SNP | $3,369.49 | ↑ +737% |
| Molina | Molina Ohio | $3,400.69 | ↑ +745% |
| Highmark | Highmark Performance Blue Enhanced | $5,089.18 | ↑ +1164% |
| Aetna | Aetna Commercial | $9,484.49 | ↑ +2257% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $10,351.98 | ↑ +2472% |
Visitor-reported prices
Comments
Reconstruct lip w/local flap 40525 at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| GROVE CITY HOSPITAL | GROVE CITY | $356.04 | $40.63 – $8,883.72 |