healthcosts.net
Breast reconstr w/lat flap 19361 at cleveland clinic main campus
9500 Euclid Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1679525919
$6,073.60
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.
$9,344.00
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.
$1.10 with Zing Health vs $9,344.00 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 |
|---|---|---|---|
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| Aetna | ALL PRODUCTS | $3.19 | ↓ -100% |
| Summacare | Medicare Advantage Lower Level | $957.22 | ↓ -84% |
| Summacare | Medicare Advantage Psych | $1,011.29 | ↓ -83% |
| Optum | Managed Medicaid Transplant | $1,048.12 | ↓ -83% |
| Paramount | Managed Medicaid | $1,136.38 | ↓ -81% |
| Caresource | Managed Medicaid | $1,158.44 | ↓ -81% |
| Buckeye | Managed Medicaid | $1,158.44 | ↓ -81% |
| Molina | Managed Medicaid | $1,213.61 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $1,213.61 | ↓ -80% |
| Summacare | Medicare Advantage CNA | $1,251.74 | ↓ -79% |
| United | Managed Medicaid | $1,287.03 | ↓ -79% |
| The Health Plan | Medicare Advantage | $1,348.38 | ↓ -78% |
| Anthem | Medicare Advantage | $1,348.38 | ↓ -78% |
| Valor | All Products | $1,348.38 | ↓ -78% |
| Optum | Medicare Advantage Transplant | $1,348.38 | ↓ -78% |
| United | Medicare Advantage | $1,348.38 | ↓ -78% |
| UPMC | Medicare Advantage | $1,348.38 | ↓ -78% |
| Aetna | Medicare Advantage Transplant | $1,348.38 | ↓ -78% |
| Humana | Medicare Advantage HMO | $1,348.38 | ↓ -78% |
| Aetna | Medicare Advantage | $1,348.38 | ↓ -78% |
| Cigna | Medicare Advantage | $1,388.83 | ↓ -77% |
| Summacare | Medicare Advantage MD | $1,399.01 | ↓ -77% |
| CommuniCare | Medicare Advantage | $1,415.80 | ↓ -77% |
| Perennial Health | Medicare Advantage | $1,456.25 | ↓ -76% |
| Devoted Health | Medicare Advantage | $1,472.64 | ↓ -76% |
| PPHP | All Products | $1,483.22 | ↓ -76% |
| Humana Military | All Products | $1,895.07 | ↓ -69% |
| Aetna | All Products Transplant | $1,902.99 | ↓ -69% |
| Anthem | All Products Mid-Level Facility | $2,081.07 | ↓ -66% |
| Anthem | All Products Mid-Level Non-Facility | $2,081.07 | ↓ -66% |
| Oscar | All Products | $2,374.31 | ↓ -61% |
| CC EHP | All Products | $2,798.02 | ↓ -54% |
| Summacare | Preferred | $3,233.51 | ↓ -47% |
| Summacare | Premier | $3,523.69 | ↓ -42% |
| OHCP | All Products | $3,634.82 | ↓ -40% |
| MMO | Medicare HMO | $3,656.50 | ↓ -40% |
| Aetna | Acop | $3,675.69 | ↓ -39% |
| Ohio Healthy | Transplant | $3,737.60 | ↓ -38% |
| MMO | Medicare PPO | $3,766.20 | ↓ -38% |
| Aultcare | PPO/HMO | $4,092.67 | ↓ -33% |
| Amish Community Aid Plan | All Products | $4,204.80 | ↓ -31% |
| United | All Products - Mid-Level | $4,209.95 | ↓ -31% |
| Optum | Commercial CRS Care Solutions | $4,382.34 | ↓ -28% |
| MMO | SuperMed | $4,524.16 | ↓ -26% |
| United | All Products | $4,537.49 | ↓ -25% |
| United | HMO & PPO | $4,537.49 | ↓ -25% |
| OMAS | All Products | $4,672.00 | ↓ -23% |
| OPTUM | Managed Medicaid Transplant | $4,882.90 | ↓ -20% |
| The Health Plan | All Products | $5,139.20 | ↓ -15% |
| Healthsmart | All Products | $5,139.20 | ↓ -15% |
| CARESOURCE | Managed Medicaid | $5,139.89 | ↓ -15% |
| Anthem | All Products Physician Non-Facility | $5,285.50 | ↓ -13% |
| Anthem | All Products Physician | $5,285.50 | ↓ -13% |
| Anthem | All Products Physician Facility | $5,285.50 | ↓ -13% |
| ANTHEM | Managed Medicaid | $5,396.88 | ↓ -11% |
| MOLINA | Managed Medicaid | $5,396.88 | ↓ -11% |
| Optum | All Products Transplant | $5,447.55 | ↓ -10% |
| UNITED | Managed Medicaid | $5,499.68 | ↓ -9% |
| UPMC | All Products | $5,606.40 | ↓ -8% |
| PHPHI | All Products | $5,606.40 | ↓ -8% |
| United BH | Managed Medicaid | $5,653.88 | ↓ -7% |
| Optum | Commercial CHD Care Solutions | $5,671.81 | ↓ -7% |
| Clarity Health | All Products | $6,073.60 | ↑ +0% |
| Three Rivers | All Products | $6,073.60 | ↑ +0% |
| Quality Care Partners | All Products | $6,540.80 | ↑ +8% |
| GMS | All Products | $6,540.80 | ↑ +8% |
| Aetna | All Products First Health | $7,008.00 | ↑ +15% |
| Consociate Health | All Products | $7,008.00 | ↑ +15% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $7,475.20 | ↑ +23% |
| Aetna | Asa | $7,475.20 | ↑ +23% |
| MMO | NASCO | $7,475.20 | ↑ +23% |
| USA Managed Care | All Products | $8,409.60 | ↑ +38% |
| Multiplan | All Products | $8,409.60 | ↑ +38% |
| Aetna | Qhp/Ifp | $9,344.00 | ↑ +54% |
| United BH | All Products MA | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| United BH | All Products MD | not published by hospital | — |
| United BH | All Products PHD | not published by hospital | — |
| United BH | All Products RN | not published by hospital | — |
Visitor-reported prices
Comments
Breast reconstr w/lat flap 19361 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $6,786.62 – $7,858.19 |
| fairview hospital | Cleveland | not published | $4,000.93 – $4,632.65 |
| lutheran hospital | Cleveland | not published | $3,809.01 – $4,410.43 |
| akron general | Akron | $6,073.60 | $1.10 – $8,409.60 |
| mercy hospital | Canton | $6,073.60 | $1.10 – $8,409.60 |
| avon hospital | Avon | not published | $4,156.85 – $4,236.02 |
| euclid hospital | Euclid | not published | $4,258.79 – $4,931.23 |
| hillcrest hospital | Mayfield Heights | not published | $4,168.33 – $4,826.49 |