healthcosts.net
Tonsillectomy (age 12+) at cleveland clinic main campus
9500 Euclid Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1679525919
$897.00
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.
$1,380.00
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 $10,789.00 with MMO — 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 | $157.52 | ↓ -82% |
| Summacare | Medicare Advantage Psych | $167.80 | ↓ -81% |
| Optum | Managed Medicaid Transplant | $193.48 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $205.99 | ↓ -77% |
| Paramount | Managed Medicaid | $209.77 | ↓ -77% |
| United | Managed Medicaid | $213.64 | ↓ -76% |
| Caresource | Managed Medicaid | $213.84 | ↓ -76% |
| Buckeye | Managed Medicaid | $213.84 | ↓ -76% |
| UPMC | Medicare Advantage | $223.73 | ↓ -75% |
| United | Medicare Advantage | $223.73 | ↓ -75% |
| Anthem | Medicare Advantage | $223.73 | ↓ -75% |
| Aetna | Medicare Advantage Transplant | $223.73 | ↓ -75% |
| Valor | All Products | $223.73 | ↓ -75% |
| Optum | Medicare Advantage Transplant | $223.73 | ↓ -75% |
| Humana | Medicare Advantage HMO | $223.73 | ↓ -75% |
| Aetna | Medicare Advantage | $223.73 | ↓ -75% |
| The Health Plan | Medicare Advantage | $223.73 | ↓ -75% |
| Molina | Managed Medicaid | $224.03 | ↓ -75% |
| AmeriHealth | Managed Medicaid | $224.03 | ↓ -75% |
| Summacare | Medicare Advantage MD | $230.22 | ↓ -74% |
| Cigna | Medicare Advantage | $230.44 | ↓ -74% |
| CommuniCare | Medicare Advantage | $234.92 | ↓ -74% |
| Perennial Health | Medicare Advantage | $241.63 | ↓ -73% |
| Devoted Health | Medicare Advantage | $242.34 | ↓ -73% |
| PPHP | All Products | $246.10 | ↓ -73% |
| Humana Military | All Products | $312.29 | ↓ -65% |
| Aetna | All Products Transplant | $314.71 | ↓ -65% |
| Anthem | All Products Mid-Level Facility | $341.64 | ↓ -62% |
| Anthem | All Products Mid-Level Non-Facility | $341.64 | ↓ -62% |
| Oscar | All Products | $350.66 | ↓ -61% |
| CC EHP | All Products | $460.45 | ↓ -49% |
| OHCP | All Products | $536.82 | ↓ -40% |
| Summacare | Preferred | $541.57 | ↓ -40% |
| Ohio Healthy | Transplant | $552.00 | ↓ -38% |
| Summacare | Premier | $590.17 | ↓ -34% |
| Aultcare | PPO/HMO | $604.44 | ↓ -33% |
| Aetna | Acop | $615.63 | ↓ -31% |
| Amish Community Aid Plan | All Products | $621.00 | ↓ -31% |
| Optum | Commercial CRS Care Solutions | $647.22 | ↓ -28% |
| OMAS | All Products | $690.00 | ↓ -23% |
| United | All Products - Mid-Level | $695.40 | ↓ -22% |
| MMO | Medicare HMO | $702.15 | ↓ -22% |
| MMO | Medicare PPO | $723.21 | ↓ -19% |
| United | All Products | $749.50 | ↓ -16% |
| United | HMO & PPO | $749.50 | ↓ -16% |
| The Health Plan | All Products | $759.00 | ↓ -15% |
| Healthsmart | All Products | $759.00 | ↓ -15% |
| Optum | All Products Transplant | $804.54 | ↓ -10% |
| UPMC | All Products | $828.00 | ↓ -8% |
| PHPHI | All Products | $828.00 | ↓ -8% |
| Optum | Commercial CHD Care Solutions | $837.66 | ↓ -7% |
| Anthem | All Products Physician | $867.71 | ↓ -3% |
| Anthem | All Products Physician Facility | $867.71 | ↓ -3% |
| Anthem | All Products Physician Non-Facility | $867.71 | ↓ -3% |
| Clarity Health | All Products | $897.00 | ↑ +0% |
| Three Rivers | All Products | $897.00 | ↑ +0% |
| Quality Care Partners | All Products | $966.00 | ↑ +8% |
| GMS | All Products | $966.00 | ↑ +8% |
| Consociate Health | All Products | $1,035.00 | ↑ +15% |
| Aetna | All Products First Health | $1,035.00 | ↑ +15% |
| Aetna | Asa | $1,104.00 | ↑ +23% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $1,104.00 | ↑ +23% |
| MMO | NASCO | $1,104.00 | ↑ +23% |
| USA Managed Care | All Products | $1,242.00 | ↑ +38% |
| Multiplan | All Products | $1,242.00 | ↑ +38% |
| Aetna | Qhp/Ifp | $1,380.00 | ↑ +54% |
| OPTUM | Managed Medicaid Transplant | $1,434.54 | ↑ +60% |
| CARESOURCE | Managed Medicaid | $1,510.04 | ↑ +68% |
| ANTHEM | Managed Medicaid | $1,585.54 | ↑ +77% |
| MOLINA | Managed Medicaid | $1,585.54 | ↑ +77% |
| UNITED | Managed Medicaid | $1,615.74 | ↑ +80% |
| United BH | Managed Medicaid | $1,661.04 | ↑ +85% |
| UNITED | MEDICARE ADVANTAGE | $2,793.19 | ↑ +211% |
| MMO | Medicare Advantage HMO | $3,006.46 | ↑ +235% |
| The Health Plan | MEDICARE ADVANTAGE | $3,006.46 | ↑ +235% |
| OPTUM | All Products VA | $3,006.46 | ↑ +235% |
| HUMANA | Medicare Advantage HMO | $3,006.46 | ↑ +235% |
| OPTUM | Medicare Advantage Transplant | $3,006.46 | ↑ +235% |
| MMO | Medicare Advantage PPO | $3,096.65 | ↑ +245% |
| CIGNA | Medicare Advantage Lifesource | $3,136.68 | ↑ +250% |
| Valor | ALL PRODUCTS | $3,136.68 | ↑ +250% |
| Summacare | MEDICARE ADVANTAGE | $3,136.68 | ↑ +250% |
| ANTHEM | MEDICARE ADVANTAGE | $3,136.68 | ↑ +250% |
| UPMC | MEDICARE ADVANTAGE | $3,136.68 | ↑ +250% |
| AETNA | MEDICARE ADVANTAGE | $3,136.68 | ↑ +250% |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $3,136.68 | ↑ +250% |
| CIGNA | MEDICARE ADVANTAGE | $3,230.78 | ↑ +260% |
| Perennial Health | MEDICARE ADVANTAGE | $3,246.97 | ↑ +262% |
| CommuniCare | MEDICARE ADVANTAGE | $3,293.51 | ↑ +267% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,387.61 | ↑ +278% |
| PPHP | ALL PRODUCTS | $3,450.35 | ↑ +285% |
| ANTHEM | PPO/HMO | $4,315.00 | ↑ +381% |
| UNITED | ALL PRODUCTS | $6,238.00 | ↑ +595% |
| CIGNA | ALL PRODUCTS | $7,948.00 | ↑ +786% |
| MMO | SuperMed | $9,391.15 | ↑ +947% |
| MMO | ALL PRODUCTS | $10,789.00 | ↑ +1103% |
| United BH | All Products PHD | not published by hospital | — |
| United BH | All Products MD | not published by hospital | — |
| United BH | All Products RN | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| United BH | All Products MA | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,993.83 – $2,308.65 |
| fairview hospital | Cleveland | not published | $1,175.43 – $3,450.35 |
| lutheran hospital | Cleveland | not published | $1,119.04 – $3,450.35 |
| akron general | Akron | $897.00 | $1.10 – $3,236.25 |
| mercy hospital | Canton | $897.00 | $1.10 – $3,230.78 |
| avon hospital | Avon | not published | $1,221.23 – $3,450.35 |
| euclid hospital | Euclid | not published | $1,251.18 – $3,450.35 |
| hillcrest hospital | Mayfield Heights | not published | $1,224.61 – $3,450.35 |