healthcosts.net
Ins/rpl pm gen exist dual lead at hillcrest hospital
6780 Mayfield Road, Mayfield Heights, OH · Cleveland Clinic · · NPI 1902858152
$16,998.80
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.
$26,152.00
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.
$513.98 with ANTHEM vs $28,686.23 with MMO — 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 |
|---|---|---|---|
| ANTHEM | HPN | $513.98 | ↓ -97% |
| AETNA | Acop | $5,355.00 | ↓ -68% |
| OPTUM | Managed Medicaid Transplant | $5,381.26 | ↓ -68% |
| Paramount | Managed Medicaid | $5,834.41 | ↓ -66% |
| Buckeye | Managed Medicaid | $5,947.70 | ↓ -65% |
| ANTHEM | Managed Medicaid | $5,947.70 | ↓ -65% |
| MOLINA | Managed Medicaid | $5,947.70 | ↓ -65% |
| UNITED | Managed Medicaid | $6,060.99 | ↓ -64% |
| CARESOURCE | Managed Medicaid | $6,060.99 | ↓ -64% |
| AMERIHEALTH | Managed Medicaid | $6,230.93 | ↓ -63% |
| AETNA | Asa_Whirlpool_Peia | $6,249.00 | ↓ -63% |
| AETNA | International | $6,561.00 | ↓ -61% |
| OSCAR | ALL PRODUCTS | $7,395.79 | ↓ -56% |
| PHP | ALL PRODUCTS | $8,368.64 | ↓ -51% |
| CC EHP | ALL PRODUCTS | $8,839.38 | ↓ -48% |
| Summacare | Preferred | $9,205.50 | ↓ -46% |
| The Health Plan | MEDICARE ADVANTAGE | $9,263.98 | ↓ -46% |
| MMO | Medicare Advantage HMO | $9,701.78 | ↓ -43% |
| OPTUM | Medicare Advantage Transplant | $9,701.78 | ↓ -43% |
| OPTUM | All Products VA | $9,701.78 | ↓ -43% |
| HUMANA | Medicare Advantage HMO | $9,701.78 | ↓ -43% |
| UNITED | MEDICARE ADVANTAGE | $9,701.78 | ↓ -43% |
| AETNA | MEDICARE ADVANTAGE | $9,888.39 | ↓ -42% |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $9,888.39 | ↓ -42% |
| UPMC | MEDICARE ADVANTAGE | $9,888.39 | ↓ -42% |
| Valor | HMO & PPO | $9,888.39 | ↓ -42% |
| Summacare | MEDICARE ADVANTAGE | $9,888.39 | ↓ -42% |
| ANTHEM | MEDICARE ADVANTAGE | $9,888.39 | ↓ -42% |
| MMO | Medicare Advantage PPO | $9,992.83 | ↓ -41% |
| Summacare | PREMIER | $10,016.22 | ↓ -41% |
| CIGNA | MEDICARE ADVANTAGE | $10,185.05 | ↓ -40% |
| CommuniCare | MEDICARE ADVANTAGE | $10,382.81 | ↓ -39% |
| Perennial Health | MEDICARE ADVANTAGE | $10,477.92 | ↓ -38% |
| Aultcare | PPO/HMO | $10,670.02 | ↓ -37% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $10,679.46 | ↓ -37% |
| PPHP | ALL PRODUCTS | $10,877.23 | ↓ -36% |
| Amish Community Aid Plan | ALL PRODUCTS | $11,768.40 | ↓ -31% |
| UNITED | ALL PRODUCTS | $12,230.00 | ↓ -28% |
| OHCP | ALL PRODUCTS | $12,709.87 | ↓ -25% |
| OMAS | ALL PRODUCTS | $13,076.00 | ↓ -23% |
| MMO | TRADITIONAL | $13,625.19 | ↓ -20% |
| MMO | NASCO | $13,625.19 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $14,122.08 | ↓ -17% |
| HEALTHSMART | ALL PRODUCTS | $14,383.60 | ↓ -15% |
| ANTHEM | TRADITIONAL | $14,605.89 | ↓ -14% |
| OPTUM | All Products Transplant | $14,802.03 | ↓ -13% |
| The Health Plan | ALL PRODUCTS | $15,691.20 | ↓ -8% |
| UPMC | ALL PRODUCTS | $15,691.20 | ↓ -8% |
| THREE RIVERS | ALL PRODUCTS | $16,998.80 | ↑ +0% |
| Quality Care Partners | ALL PRODUCTS | $18,306.40 | ↑ +8% |
| GMS | ALL PRODUCTS | $18,306.40 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $18,306.40 | ↑ +8% |
| AETNA | ALL PRODUCTS | $19,614.00 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $19,614.00 | ↑ +15% |
| Humana Military | ALL PRODUCTS | $22,229.20 | ↑ +31% |
| Tertiary Care Network | TRANSPLANT | $23,536.80 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $23,536.80 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $23,536.80 | ↑ +38% |
| USA Managed Care | ALL PRODUCTS | $23,536.80 | ↑ +38% |
| FrontPath | TRANSPLANT | $23,536.80 | ↑ +38% |
| AETNA | Qhp/Ipf | $26,152.00 | ↑ +54% |
| ANTHEM | PPO/HMO | $28,522.08 | ↑ +68% |
| MMO | ALL PRODUCTS | $28,686.23 | ↑ +69% |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl pm gen exist dual lead at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $16,998.80 | $1.10 – $23,536.80 |
| akron general | Akron | $16,998.80 | $1.10 – $23,536.80 |
| avon hospital | Avon | $16,998.80 | $601.72 – $23,536.80 |
| euclid hospital | Euclid | $16,998.80 | $601.72 – $23,536.80 |
| fairview hospital | Cleveland | $16,998.80 | $513.98 – $23,536.80 |
| lutheran hospital | Cleveland | $16,998.80 | $601.72 – $23,536.80 |
| marymount hospital | Garfield Heights | $16,998.80 | $601.72 – $23,536.80 |
| medina hospital | Medina | $16,998.80 | $408.31 – $23,536.80 |