Reconstruct shoulder joint at Kings Mills Hospital
5440 KINGS ISLAND DRIVE, Mason, OH · Mercy · · NPI 1790469146
$58,683.14
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.
$97,805.23
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.
$17,087.06 with UHC MEDICARE [1011] vs $17,428.80 with CARESOURCE MYCARE OHIO [4236] — 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 |
|---|---|---|---|
| UHC MEDICARE [1011] | UHC AARP MEDICARE ADVANTAGE [1011017] | $17,087.06 | ↓ -71% |
| UHC MEDICARE [1011] | UHC MEDICARE COMPLETE [44] | $17,087.06 | ↓ -71% |
| UHC MEDICARE [1011] | UNITEDHEALTHCARE DUAL COMPLETE [1011009] | $17,087.06 | ↓ -71% |
| CARESOURCE MYCARE OHIO [4236] | CARESOURCE MYCARE OHIO DUAL [4236001] | $17,428.80 | ↓ -70% |
Visitor-reported prices
Comments
Reconstruct shoulder joint at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jewish Hospital | Cincinnati | $57,769.41 | $17,087.06 – $17,428.80 |
| Anderson Hospital | Cincinnati | $52,859.06 | $17,087.06 – $17,087.06 |
| Clermont Hospital | Batavia | $62,624.20 | $17,087.06 – $17,428.80 |
| Mercy West Hospital | Cincinnati | $50,742.75 | $17,383.71 – $17,731.38 |
| St Ritas Medical Center | Lima | $63,871.62 | $17,383.71 – $17,383.71 |
| cleveland clinic main campus | Cleveland | $6,329.05 | $1.10 – $17,048.31 |
| akron general | Akron | $6,329.05 | $1.10 – $17,915.41 |
| mercy hospital | Canton | $6,329.05 | $1.10 – $17,085.99 |