healthcosts.net
Bx of breast open 19101 at fairview hospital
18101 Lorain Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1215989611
$7,467.20
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.
$11,488.00
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.
$0.01 with UNITED vs $11,488.00 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 |
|---|---|---|---|
| UNITED | ALL PRODUCTS | $0.01 | ↓ -100% |
| ANTHEM | HPN | $357.94 | ↓ -95% |
| OPTUM | Managed Medicaid Transplant | $845.42 | ↓ -89% |
| Paramount | Managed Medicaid | $916.62 | ↓ -88% |
| Buckeye | Managed Medicaid | $934.42 | ↓ -87% |
| MOLINA | Managed Medicaid | $934.42 | ↓ -87% |
| ANTHEM | Managed Medicaid | $934.42 | ↓ -87% |
| United BH | Managed Medicaid | $943.32 | ↓ -87% |
| CARESOURCE | Managed Medicaid | $952.21 | ↓ -87% |
| UNITED | Managed Medicaid | $952.21 | ↓ -87% |
| AMERIHEALTH | Managed Medicaid | $978.91 | ↓ -87% |
| OSCAR | ALL PRODUCTS | $3,248.81 | ↓ -56% |
| AETNA | Acop | $3,265.00 | ↓ -56% |
| HUMANA | Medicare Advantage HMO | $3,306.89 | ↓ -56% |
| OPTUM | Medicare Advantage Transplant | $3,549.90 | ↓ -52% |
| MMO | Medicare Advantage HMO | $3,549.90 | ↓ -52% |
| OPTUM | All Products VA | $3,549.90 | ↓ -52% |
| The Health Plan | MEDICARE ADVANTAGE | $3,549.90 | ↓ -52% |
| UNITED | MEDICARE ADVANTAGE | $3,549.90 | ↓ -52% |
| MMO | Medicare Advantage PPO | $3,656.39 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $3,676.16 | ↓ -51% |
| PHP | ALL PRODUCTS | $3,676.16 | ↓ -51% |
| Summacare | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| UPMC | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| Valor | HMO & PPO | $3,704.30 | ↓ -50% |
| AETNA | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| ANTHEM | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| AETNA | Asa_Whirlpool_Peia | $3,810.00 | ↓ -49% |
| CIGNA | MEDICARE ADVANTAGE | $3,815.43 | ↓ -49% |
| Perennial Health | MEDICARE ADVANTAGE | $3,833.89 | ↓ -49% |
| CC EHP | ALL PRODUCTS | $3,882.94 | ↓ -48% |
| CommuniCare | MEDICARE ADVANTAGE | $3,889.52 | ↓ -48% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $4,000.65 | ↓ -46% |
| AETNA | International | $4,001.00 | ↓ -46% |
| Summacare | Preferred | $4,043.78 | ↓ -46% |
| Zing Health | Medicare Advantage | $4,074.73 | ↓ -45% |
| PPHP | ALL PRODUCTS | $4,074.73 | ↓ -45% |
| Summacare | PREMIER | $4,399.90 | ↓ -41% |
| Aultcare | PPO/HMO | $4,790.50 | ↓ -36% |
| Amish Community Aid Plan | ALL PRODUCTS | $5,169.60 | ↓ -31% |
| OHCP | ALL PRODUCTS | $5,583.17 | ↓ -25% |
| OMAS | ALL PRODUCTS | $5,744.00 | ↓ -23% |
| MMO | NASCO | $5,985.25 | ↓ -20% |
| MMO | TRADITIONAL | $5,985.25 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $6,203.52 | ↓ -17% |
| HEALTHSMART | ALL PRODUCTS | $6,318.40 | ↓ -15% |
| ANTHEM | TRADITIONAL | $6,416.05 | ↓ -14% |
| OPTUM | All Products Transplant | $6,502.21 | ↓ -13% |
| The Health Plan | ALL PRODUCTS | $6,892.80 | ↓ -8% |
| UPMC | ALL PRODUCTS | $6,892.80 | ↓ -8% |
| THREE RIVERS | ALL PRODUCTS | $7,467.20 | ↑ +0% |
| Quality Care Partners | ALL PRODUCTS | $8,041.60 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $8,041.60 | ↑ +8% |
| GMS | ALL PRODUCTS | $8,041.60 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $8,616.00 | ↑ +15% |
| AETNA | ALL PRODUCTS | $8,616.00 | ↑ +15% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $9,190.40 | ↑ +23% |
| Humana Military | ALL PRODUCTS | $9,764.80 | ↑ +31% |
| MULTIPLAN | ALL PRODUCTS | $10,339.20 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $10,339.20 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $10,339.20 | ↑ +38% |
| USA Managed Care | ALL PRODUCTS | $10,339.20 | ↑ +38% |
| FrontPath | TRANSPLANT | $10,339.20 | ↑ +38% |
| ANTHEM | PPO/HMO | $10,684.69 | ↑ +43% |
| MMO | ALL PRODUCTS | $10,746.18 | ↑ +44% |
| AETNA | Qhp/Ipf | $11,488.00 | ↑ +54% |
| United BH | MEDICARE ADVANTAGE | not published by hospital | — |
| United BH | ALL PRODUCTS | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Bx of breast open 19101 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $7,467.20 | $0.01 – $10,339.20 |
| lutheran hospital | Cleveland | $7,467.20 | $0.01 – $10,339.20 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,434.07 – $1,660.51 |
| akron general | Akron | $839.80 | $1.10 – $3,821.23 |
| avon hospital | Avon | $7,467.20 | $0.01 – $10,339.20 |
| euclid hospital | Euclid | $7,467.20 | $0.01 – $10,339.20 |
| hillcrest hospital | Mayfield Heights | $7,467.20 | $0.01 – $10,339.20 |
| marymount hospital | Garfield Heights | $7,467.20 | $0.01 – $10,339.20 |