Removal of breast lesion at Clermont Hospital
3000 Hospital Dr., Batavia, OH · Mercy · · NPI 1568562551
$7,958.64
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.
$13,264.40
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.
$3,815.67 with AETNA MEDICARE [1003] vs $3,815.67 with UHC MEDICARE [1011] — 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 |
|---|---|---|---|
| AETNA MEDICARE [1003] | AETNA MEDICARE-ADVANTAGE PPO [103002] | $3,815.67 | ↓ -52% |
| UHC MEDICARE [1011] | UHC AARP MEDICARE ADVANTAGE [1011017] | $3,815.67 | ↓ -52% |
| UHC MEDICARE [1011] | UHC MEDICARE COMPLETE [44] | $3,815.67 | ↓ -52% |
| UHC MEDICARE [1011] | UNITEDHEALTHCARE DUAL COMPLETE [1011009] | $3,815.67 | ↓ -52% |
Visitor-reported prices
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Removal of breast lesion at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jewish Hospital | Cincinnati | $19,774.56 | $3,815.67 – $3,891.98 |
| Anderson Hospital | Cincinnati | $14,783.46 | $3,815.67 – $3,891.98 |
| Kings Mills Hospital | Mason | $15,433.62 | $3,815.67 – $3,815.67 |
| Mercy West Hospital | Cincinnati | $20,818.37 | $3,881.91 – $3,959.55 |
| St Ritas Medical Center | Lima | $22,569.24 | $3,881.91 – $3,881.91 |
| cleveland clinic main campus | Cleveland | $7,467.20 | $0.01 – $10,339.20 |
| akron general | Akron | $7,467.20 | $0.01 – $10,339.20 |
| avon hospital | Avon | $7,467.20 | $0.01 – $10,339.20 |