Shoulder Arthroscopy (Rotator Cuff Repair) at Kings Mills Hospital
5440 KINGS ISLAND DRIVE, Mason, OH · Mercy · · NPI 1790469146
$34,743.31
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.
$57,905.52
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.
$7,071.33 with HUMANA MEDICARE [1010] vs $7,071.33 with UHC MEDICARE [1011] — 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 |
|---|---|---|---|
| HUMANA MEDICARE [1010] | HUMANA GOLD PLUS HMO [101001] | $7,071.33 | ↓ -80% |
| UHC MEDICARE [1011] | UHC AARP MEDICARE ADVANTAGE [1011017] | $7,071.33 | ↓ -80% |
| UHC MEDICARE [1011] | UHC MEDICARE COMPLETE [44] | $7,071.33 | ↓ -80% |
| UHC MEDICARE [1011] | UNITEDHEALTHCARE DUAL COMPLETE [1011009] | $7,071.33 | ↓ -80% |
Visitor-reported prices
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Shoulder Arthroscopy (Rotator Cuff Repair) at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jewish Hospital | Cincinnati | $51,993.75 | $7,071.33 – $7,212.75 |
| Anderson Hospital | Cincinnati | $38,822.47 | $7,071.33 – $7,212.75 |
| Clermont Hospital | Batavia | $39,212.26 | $7,071.33 – $7,071.33 |
| Mercy West Hospital | Cincinnati | $26,988.45 | $7,194.09 – $7,337.97 |
| St Ritas Medical Center | Lima | $28,535.67 | $7,194.09 – $7,337.97 |
| cleveland clinic main campus | Cleveland | $4,053.40 | $1.10 – $6,864.94 |
| akron general | Akron | $4,053.40 | $1.10 – $7,128.72 |
| mercy hospital | Canton | $4,053.40 | $1.10 – $7,070.89 |