Optx medial ankle fx at Anderson Hospital
7500 State Rd., Cincinnati, OH · Mercy · · NPI 1235239211
$40,416.72
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.
$67,361.20
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.
$7,071.33 with AETNA MEDICARE [1003] vs $12,761.78 with CARESOURCE MYCARE OHIO [4236] — 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 HMO [103003] | $7,071.33 | ↓ -83% |
| AETNA MEDICARE [1003] | AETNA MEDICARE-ADVANTAGE PPO [103002] | $7,071.33 | ↓ -83% |
| HUMANA MEDICARE [1010] | HUMANA GOLD PLUS HMO [101001] | $7,071.33 | ↓ -83% |
| UHC MEDICARE [1011] | UHC AARP MEDICARE ADVANTAGE [1011017] | $7,071.33 | ↓ -83% |
| UHC MEDICARE [1011] | UHC MEDICARE COMPLETE [44] | $7,071.33 | ↓ -83% |
| HUMANA MEDICARE [1010] | HUMANA CHOICE-PPO MEDICARE [101003] | $12,511.55 | ↓ -69% |
| UHC MEDICARE [1011] | UNITEDHEALTHCARE DUAL COMPLETE [1011009] | $12,511.55 | ↓ -69% |
| CARESOURCE MYCARE OHIO [4236] | CARESOURCE MYCARE OHIO DUAL [4236001] | $12,761.78 | ↓ -68% |
Visitor-reported prices
Comments
Optx medial ankle fx at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| St Ritas Medical Center | Lima | $27,476.54 | $7,194.09 – $7,337.97 |
| cleveland clinic main campus | Cleveland | $2,051.40 | $1.10 – $6,864.94 |
| akron general | Akron | $2,051.40 | $1.10 – $7,128.72 |
| mercy hospital | Canton | $2,051.40 | $1.10 – $7,070.89 |
| Fairfield Hospital | Fairfield | $27,649.88 | $7,194.09 – $7,194.09 |
| St Elizabeth Youngstown Hospital | Youngstown | $13,658.59 | $7,018.84 – $7,159.22 |
| St Joseph Warren Hospital | Warren | $17,862.89 | $6,864.94 – $7,002.24 |
| Barnesville Hospital | Barnesville | $695.50 | not published |