healthcosts.net
ER Visit (level 5, high severity) at fairview hospital
18101 Lorain Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1215989611
$2,749.50
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.
$4,230.00
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.
$56.32 with OPTUM vs $3,807.00 with USA Managed Care — 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 |
|---|---|---|---|
| OPTUM | Managed Medicaid Transplant | $56.32 | ↓ -98% |
| Paramount | Managed Medicaid | $61.06 | ↓ -98% |
| ANTHEM | Managed Medicaid | $62.24 | ↓ -98% |
| MOLINA | Managed Medicaid | $62.24 | ↓ -98% |
| Buckeye | Managed Medicaid | $62.24 | ↓ -98% |
| United BH | Managed Medicaid | $62.84 | ↓ -98% |
| UNITED | Managed Medicaid | $63.43 | ↓ -98% |
| CARESOURCE | Managed Medicaid | $63.43 | ↓ -98% |
| AMERIHEALTH | Managed Medicaid | $65.21 | ↓ -98% |
| ANTHEM | HPN | $316.59 | ↓ -88% |
| CC EHP | ALL PRODUCTS | $430.00 | ↓ -84% |
| HUMANA | Medicare Advantage HMO | $557.24 | ↓ -80% |
| Summacare | MEDICARE ADVANTAGE | $563.42 | ↓ -80% |
| ANTHEM | MEDICARE ADVANTAGE | $563.42 | ↓ -80% |
| UPMC | MEDICARE ADVANTAGE | $563.42 | ↓ -80% |
| AETNA | MEDICARE ADVANTAGE | $563.42 | ↓ -80% |
| Valor | HMO & PPO | $563.42 | ↓ -80% |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $563.42 | ↓ -80% |
| UNITED | MEDICARE ADVANTAGE | $568.37 | ↓ -79% |
| MMO | Medicare Advantage HMO | $568.37 | ↓ -79% |
| The Health Plan | MEDICARE ADVANTAGE | $568.37 | ↓ -79% |
| OPTUM | All Products VA | $568.37 | ↓ -79% |
| OPTUM | Medicare Advantage Transplant | $568.37 | ↓ -79% |
| CIGNA | MEDICARE ADVANTAGE | $580.32 | ↓ -79% |
| MMO | Medicare Advantage PPO | $585.42 | ↓ -79% |
| CommuniCare | MEDICARE ADVANTAGE | $591.59 | ↓ -78% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $608.49 | ↓ -78% |
| Perennial Health | MEDICARE ADVANTAGE | $613.84 | ↓ -78% |
| Zing Health | Medicare Advantage | $619.76 | ↓ -77% |
| PPHP | ALL PRODUCTS | $619.76 | ↓ -77% |
| AETNA | Acop | $1,145.00 | ↓ -58% |
| OSCAR | ALL PRODUCTS | $1,196.24 | ↓ -56% |
| AETNA | Asa_Whirlpool_Peia | $1,336.00 | ↓ -51% |
| PHP | ALL PRODUCTS | $1,353.60 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $1,353.60 | ↓ -51% |
| AETNA | International | $1,403.00 | ↓ -49% |
| Summacare | Preferred | $1,488.96 | ↓ -46% |
| Summacare | PREMIER | $1,620.09 | ↓ -41% |
| ANTHEM | PPO/HMO | $1,625.12 | ↓ -41% |
| MMO | ALL PRODUCTS | $1,634.48 | ↓ -41% |
| Aultcare | PPO/HMO | $1,763.91 | ↓ -36% |
| Amish Community Aid Plan | ALL PRODUCTS | $1,903.50 | ↓ -31% |
| OHCP | ALL PRODUCTS | $2,055.78 | ↓ -25% |
| OMAS | ALL PRODUCTS | $2,115.00 | ↓ -23% |
| MMO | TRADITIONAL | $2,203.83 | ↓ -20% |
| MMO | NASCO | $2,203.83 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $2,284.20 | ↓ -17% |
| HEALTHSMART | ALL PRODUCTS | $2,326.50 | ↓ -15% |
| ANTHEM | TRADITIONAL | $2,362.46 | ↓ -14% |
| OPTUM | All Products Transplant | $2,394.18 | ↓ -13% |
| The Health Plan | ALL PRODUCTS | $2,538.00 | ↓ -8% |
| UPMC | ALL PRODUCTS | $2,538.00 | ↓ -8% |
| THREE RIVERS | ALL PRODUCTS | $2,749.50 | ↑ +0% |
| UNITED | ALL PRODUCTS | $2,753.00 | ↑ +0% |
| Quality Care Partners | ALL PRODUCTS | $2,961.00 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $2,961.00 | ↑ +8% |
| GMS | ALL PRODUCTS | $2,961.00 | ↑ +8% |
| AETNA | Qhp/Ipf | $2,961.00 | ↑ +8% |
| Humana Military | ALL PRODUCTS | $3,172.50 | ↑ +15% |
| AETNA | ALL PRODUCTS | $3,172.50 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $3,172.50 | ↑ +15% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $3,384.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $3,807.00 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $3,807.00 | ↑ +38% |
| FrontPath | TRANSPLANT | $3,807.00 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $3,807.00 | ↑ +38% |
| USA Managed Care | ALL PRODUCTS | $3,807.00 | ↑ +38% |
| 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
ER Visit (level 5, high severity) at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $2,749.50 | $1.10 – $3,807.00 |
| lutheran hospital | Cleveland | $2,749.50 | $53.61 – $3,807.00 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $95.52 – $110.61 |
| akron general | Akron | $2,749.50 | $1.10 – $3,807.00 |
| avon hospital | Avon | $2,749.50 | $58.51 – $3,807.00 |
| euclid hospital | Euclid | $2,749.50 | $59.95 – $3,807.00 |
| hillcrest hospital | Mayfield Heights | $2,749.50 | $58.67 – $3,807.00 |
| lodi hospital | Lodi | $2,749.50 | $91.53 – $3,807.00 |