Biopsy of heart lining at Kettering Health Hamilton (Fort Hamilton)
630 Eaton Avenue, Hamilton, OH · Ketteringhealth · · NPI 1104867167
$2,842.00
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.
$7,105.00
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.
$3,130.45 with Aetna vs $23,576.00 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 |
|---|---|---|---|
| Aetna | Medicare Managed Care Plan | $3,130.45 | ↑ +10% |
| Molina Healthcare | Medicare Managed Care Plan | $3,286.97 | ↑ +16% |
| Bcbs | Anthem Pathway Hmox Exchange | $4,721.67 | ↑ +66% |
| Caresource | Marketplace Exchange | $4,838.11 | ↑ +70% |
| Unitedhealthcare | Exchange | $4,857.52 | ↑ +71% |
| Molina Healthcare | Exchange | $6,499.44 | ↑ +129% |
| Buckeye Health Plan | Ambetter Exchange | $6,573.94 | ↑ +131% |
| Custom Design Benefits Inc. | All Commercial Plans | $8,410.26 | ↑ +196% |
| Unitedhealthcare | All Commercial Plans | $10,499.00 | ↑ +269% |
| Unitedhealthcare | Employee | $10,499.00 | ↑ +269% |
| Bcbs | Anthem - Blue Access/Blue Preferred Hmo/Ppo | $10,880.25 | ↑ +283% |
| Aetna | All Commercial Plans | $23,576.00 | ↑ +730% |
| Aetna | New Business/Oh Ky Preferred Other Commercial Plan | $23,576.00 | ↑ +730% |
Visitor-reported prices
Comments
Biopsy of heart lining at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $12,942.15 | $1.10 – $16,288.20 |
| akron general | Akron | $12,942.15 | $1.10 – $16,288.20 |
| avon hospital | Avon | $11,763.70 | $1,398.18 – $16,288.20 |
| euclid hospital | Euclid | $11,763.70 | $831.05 – $16,288.20 |
| fairview hospital | Cleveland | $11,763.70 | $794.04 – $16,288.20 |
| lutheran hospital | Cleveland | $11,763.70 | $794.04 – $16,288.20 |
| hillcrest hospital | Mayfield Heights | $11,763.70 | $794.04 – $16,288.20 |
| marymount hospital | Garfield Heights | $11,763.70 | $794.04 – $16,288.20 |