Repair shoulder capsule at AHN WEXFORD HOSPITAL
12351 PERRY HIGHWAY, WEXFORD, PA · Ahn · · NPI 1588269898
$695.50
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.
$2,675.00
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.
$12.00 with Amerihealth vs $22,803.00 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 Medicaid CHC | $12.00 | ↓ -98% |
| Amerihealth | Amerihealth Medicaid HC | $12.00 | ↓ -98% |
| Amerihealth | Amerihealth Caritas Medicare (NY) | $102.38 | ↓ -85% |
| Amerihealth | Amerihealth Caritas D-SNP Medicare | $102.38 | ↓ -85% |
| Pennsylvania Health and Wellness | PA Health and Wellness Medicaid CHC | $128.70 | ↓ -81% |
| Highmark Wholecare | Highmark Wholecare Medicaid HC | $134.55 | ↓ -81% |
| Geisinger | Geisinger CHIP | $141.38 | ↓ -80% |
| United Healthcare | United Healthcare Medicaid | $141.38 | ↓ -80% |
| Amerihealth | Amerihealth Caritas CHC Medicaid | $141.38 | ↓ -80% |
| Amerihealth | Amerihealth Caritas HC Medicaid | $141.38 | ↓ -80% |
| Geisinger | Geisinger Medicaid HC | $141.38 | ↓ -80% |
| Pennsylvania Health and Wellness | Pennsylvania Health and Wellness Medicaid CHC | $146.25 | ↓ -79% |
| Highmark | Highmark Together Blue | $993.97 | ↑ +43% |
| Highmark | Highmark My Direct Blue | $1,051.45 | ↑ +51% |
| Highmark | Highmark Blue High Performance | $1,051.45 | ↑ +51% |
| Highmark | Highmark Community Blue | $1,051.45 | ↑ +51% |
| Highmark | Highmark Connect Blue | $1,051.45 | ↑ +51% |
| Highmark | Highmark Indemnity | $1,051.45 | ↑ +51% |
| Highmark | Highmark Managed Care | $1,051.45 | ↑ +51% |
| Highmark | Highmark My Blue Access | $1,051.45 | ↑ +51% |
| Highmark | Highmark Performance Blue | $1,051.45 | ↑ +51% |
| Highmark | Highmark Social Mission Indemnity | $1,051.45 | ↑ +51% |
| Highmark | Highmark Social Mission Managed Care | $1,051.45 | ↑ +51% |
| United Healthcare | United Healthcare CHIP | $1,241.60 | ↑ +79% |
| Cigna | Cigna Commercial | $1,510.56 | ↑ +117% |
| United Healthcare | United Healthcare Navigate Nexus Commercial | $1,732.13 | ↑ +149% |
| United Healthcare | United Healthcare Commercial | $1,826.18 | ↑ +163% |
| United Healthcare | United Healthcare Of OH Medicaid | $1,826.18 | ↑ +163% |
| Highmark | Highmark Complete Blue Medicare | $6,322.62 | ↑ +809% |
| Highmark | Highmark Community Blue Medicare PPO | $6,322.62 | ↑ +809% |
| Highmark | Highmark Freedom Blue | $6,391.34 | ↑ +819% |
| American Health Plans | American Health Plans Medicare | $6,872.41 | ↑ +888% |
| Martin's Point | Martin's Point | $6,872.41 | ↑ +888% |
| Life Pittsburgh | Life Pittsburgh Medicare | $6,872.41 | ↑ +888% |
| Devoted Medicare | Devoted Health Medicare Advantage | $7,078.58 | ↑ +918% |
| United Healthcare | United Healthcare Medicare | $7,147.31 | ↑ +928% |
| Highmark | Highmark Security Blue | $7,147.31 | ↑ +928% |
| Highmark | Highmark Together Blue Medicare | $7,147.31 | ↑ +928% |
| Highmark | Highmark Community Blue Medicare HMO | $7,147.31 | ↑ +928% |
| Aetna | Aetna Medicare | $7,147.31 | ↑ +928% |
| Highmark Wholecare | Highmark Wholecare Medicare Assured | $7,284.76 | ↑ +947% |
| Humana | Humana Commercial | $7,284.76 | ↑ +947% |
| Cigna | Cigna Medicare | $7,353.48 | ↑ +957% |
| United Healthcare | United Healthcare Medicare I-SNP | $7,353.48 | ↑ +957% |
| United Healthcare | United Healthcare Medicare D-SNP | $7,422.20 | ↑ +967% |
| Molina | Molina Ohio | $7,490.93 | ↑ +977% |
| Highmark | Highmark Performance Blue Enhanced | $11,210.28 | ↑ +1512% |
| Aetna | Aetna Commercial | $20,892.13 | ↑ +2904% |
| Medical Mutual | Medical Mutual Commercial (Cigna Network) | $22,803.00 | ↑ +3179% |
Visitor-reported prices
Comments
Repair shoulder capsule at other Pennsylvania hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| GROVE CITY HOSPITAL | GROVE CITY | $615.25 | $12.00 – $19,568.78 |
| UPMC Cole | Coudersport | $1,881.00 | $511.35 – $2,508.00 |