healthcosts.net
Unlisted reprod med lab proc at avon hospital
33300 Cleveland Clinic Blvd, Avon, OH · Cleveland Clinic · · NPI 1346607017
$245.70
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.
$378.00
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.
$38.70 with ANTHEM vs $378.00 with AETNA — 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 |
|---|---|---|---|
| ANTHEM | Managed Medicaid | $38.70 | ↓ -84% |
| Buckeye | Managed Medicaid | $38.70 | ↓ -84% |
| MOLINA | Managed Medicaid | $38.70 | ↓ -84% |
| UNITED | Managed Medicaid | $39.44 | ↓ -84% |
| CARESOURCE | Managed Medicaid | $39.44 | ↓ -84% |
| Valor | HMO & PPO | $49.30 | ↓ -80% |
| Summacare | MEDICARE ADVANTAGE | $49.30 | ↓ -80% |
| UPMC | MEDICARE ADVANTAGE | $49.30 | ↓ -80% |
| AETNA | MEDICARE ADVANTAGE | $49.30 | ↓ -80% |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $49.30 | ↓ -80% |
| ANTHEM | MEDICARE ADVANTAGE | $49.30 | ↓ -80% |
| OPTUM | All Products VA | $49.53 | ↓ -80% |
| UNITED | MEDICARE ADVANTAGE | $49.53 | ↓ -80% |
| The Health Plan | MEDICARE ADVANTAGE | $49.53 | ↓ -80% |
| HUMANA | Medicare Advantage HMO | $49.53 | ↓ -80% |
| OPTUM | Medicare Advantage Transplant | $49.53 | ↓ -80% |
| MMO | Medicare Advantage HMO | $49.53 | ↓ -80% |
| CIGNA | MEDICARE ADVANTAGE | $50.78 | ↓ -79% |
| MMO | Medicare Advantage PPO | $51.02 | ↓ -79% |
| CommuniCare | MEDICARE ADVANTAGE | $51.77 | ↓ -79% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $53.25 | ↓ -78% |
| Perennial Health | MEDICARE ADVANTAGE | $53.49 | ↓ -78% |
| Zing Health | Medicare Advantage | $54.23 | ↓ -78% |
| PPHP | ALL PRODUCTS | $54.23 | ↓ -78% |
| ANTHEM | PPO/HMO | $106.73 | ↓ -57% |
| OSCAR | ALL PRODUCTS | $106.90 | ↓ -56% |
| UNITED | ALL PRODUCTS | $111.96 | ↓ -54% |
| PHP | ALL PRODUCTS | $120.96 | ↓ -51% |
| CC EHP | ALL PRODUCTS | $127.76 | ↓ -48% |
| Summacare | Preferred | $132.30 | ↓ -46% |
| AETNA | Acop | $138.73 | ↓ -44% |
| Summacare | PREMIER | $144.02 | ↓ -41% |
| AETNA | International | $151.96 | ↓ -38% |
| Aultcare | PPO/HMO | $156.49 | ↓ -36% |
| AETNA | Asa_Whirlpool_Peia | $157.63 | ↓ -36% |
| Amish Community Aid Plan | ALL PRODUCTS | $170.10 | ↓ -31% |
| CIGNA | ALL PRODUCTS | $178.42 | ↓ -27% |
| OHCP | ALL PRODUCTS | $183.71 | ↓ -25% |
| OMAS | ALL PRODUCTS | $189.00 | ↓ -23% |
| MMO | TRADITIONAL | $197.69 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $204.12 | ↓ -17% |
| MMO | ALL PRODUCTS | $206.01 | ↓ -16% |
| ANTHEM | TRADITIONAL | $211.87 | ↓ -14% |
| OPTUM | All Products Transplant | $213.95 | ↓ -13% |
| UPMC | ALL PRODUCTS | $226.80 | ↓ -8% |
| The Health Plan | ALL PRODUCTS | $226.80 | ↓ -8% |
| GMS | ALL PRODUCTS | $264.60 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $264.60 | ↑ +8% |
| AETNA | ALL PRODUCTS | $283.50 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $283.50 | ↑ +15% |
| Tertiary Care Network | TRANSPLANT | $340.20 | ↑ +38% |
| FrontPath | TRANSPLANT | $340.20 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $340.20 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $340.20 | ↑ +38% |
| AETNA | Qhp/Ipf | $378.00 | ↑ +54% |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Unlisted reprod med lab proc at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $386.75 | $0.01 – $535.50 |
| euclid hospital | Euclid | $245.70 | $39.65 – $340.20 |
| fairview hospital | Cleveland | $245.70 | $37.26 – $340.20 |
| lutheran hospital | Cleveland | $245.70 | $35.46 – $340.20 |
| hillcrest hospital | Mayfield Heights | $245.70 | $38.82 – $340.20 |
| marymount hospital | Garfield Heights | $245.70 | $35.02 – $340.20 |
| medina hospital | Medina | $245.70 | $36.33 – $340.20 |
| mercy hospital | Canton | $245.70 | $37.07 – $340.20 |