Treatment of retinal lesion at Kettering Health Hamilton (Fort Hamilton)
630 Eaton Avenue, Hamilton, OH · Ketteringhealth · · NPI 1104867167
$585.20
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.
$1,463.00
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.
$545.29 with Aetna vs $17,331.79 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 | $545.29 | ↓ -7% |
| Molina Healthcare | Medicare Managed Care Plan | $572.55 | ↓ -2% |
| Bcbs | Anthem Pathway Hmox Exchange | $822.46 | ↑ +41% |
| Caresource | Marketplace Exchange | $842.74 | ↑ +44% |
| Unitedhealthcare | Exchange | $846.12 | ↑ +45% |
| Molina Healthcare | Exchange | $1,132.13 | ↑ +93% |
| Buckeye Health Plan | Ambetter Exchange | $1,145.11 | ↑ +96% |
| Custom Design Benefits Inc. | All Commercial Plans | $1,464.97 | ↑ +150% |
| Bcbs | Anthem - Blue Access/Blue Preferred Hmo/Ppo | $1,895.22 | ↑ +224% |
| Unitedhealthcare | Employee | $5,437.00 | ↑ +829% |
| Unitedhealthcare | All Commercial Plans | $5,437.00 | ↑ +829% |
| Cigna | All Commercial Plans | $6,165.00 | ↑ +953% |
| Aetna | New Business/Oh Ky Preferred Other Commercial Plan | $17,331.79 | ↑ +2862% |
| Aetna | All Commercial Plans | $17,331.79 | ↑ +2862% |
Visitor-reported prices
Comments
Treatment of retinal lesion at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Mercy West Hospital | Cincinnati | $1,292.40 | not published |
| cleveland clinic main campus | Cleveland | $1,653.60 | $0.01 – $2,289.60 |
| Kettering Health Main Campus (Kettering) | Kettering | $585.20 | $541.92 – $6,165.00 |
| Kettering Health Dayton (Grandview) | Dayton | $585.20 | $541.92 – $6,165.00 |
| Kettering Health Miamisburg (Sycamore) | Miamisburg | $585.20 | $545.29 – $6,165.00 |
| Barnesville Hospital | Barnesville | $513.00 | not published |
| Soin Medical Center | Beaver Creek | $585.20 | $541.92 – $6,165.00 |
| Kettering Health Greene Memorial | Xenia | $585.20 | $539.02 – $6,165.00 |