healthcosts.net
Aco cmplx chron care without pt visit, 60 min 99487aco at fairview hospital
18101 Lorain Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1215989611
not published by hospital
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.
not published by hospital
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.
$138.32 with HUMANA vs $484.36 with ANTHEM — 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 |
|---|---|---|---|
| HUMANA | Medicare Advantage HMO | $138.32 | — |
| MMO | Medicare Advantage HMO | $148.95 | — |
| The Health Plan | MEDICARE ADVANTAGE | $148.95 | — |
| OPTUM | All Products VA | $148.95 | — |
| OPTUM | Medicare Advantage Transplant | $148.95 | — |
| UNITED | MEDICARE ADVANTAGE | $148.95 | — |
| MMO | Medicare Advantage PPO | $153.42 | — |
| Perennial Health | MEDICARE ADVANTAGE | $160.86 | — |
| AETNA | MEDICARE ADVANTAGE | $167.92 | — |
| ANTHEM | MEDICARE ADVANTAGE | $167.92 | — |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $167.92 | — |
| Summacare | MEDICARE ADVANTAGE | $167.92 | — |
| UPMC | MEDICARE ADVANTAGE | $167.92 | — |
| Valor | HMO & PPO | $167.92 | — |
| CIGNA | MEDICARE ADVANTAGE | $172.96 | — |
| CommuniCare | MEDICARE ADVANTAGE | $176.32 | — |
| Perennial Health | HMO I-SNP and HMO C-SNP | $181.36 | — |
| Zing Health | Medicare Advantage | $184.72 | — |
| PPHP | ALL PRODUCTS | $184.72 | — |
| ANTHEM | HPN | $411.70 | — |
| MMO | ALL PRODUCTS | $461.79 | — |
| ANTHEM | PPO/HMO | $484.36 | — |
Visitor-reported prices
Comments
Aco cmplx chron care without pt visit, 60 min 99487aco at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $470.60 | $1.10 – $651.60 |
| lutheran hospital | Cleveland | not published | $148.95 – $184.72 |
| akron general | Akron | $470.60 | $1.10 – $651.60 |
| mercy hospital | Canton | $470.60 | $1.10 – $651.60 |
| avon hospital | Avon | not published | $148.95 – $184.72 |
| euclid hospital | Euclid | not published | $138.32 – $184.72 |
| hillcrest hospital | Mayfield Heights | not published | $138.32 – $184.72 |
| lodi hospital | Lodi | not published | $160.67 – $181.34 |