Bx pleura pq ndl at Kettering Health Miamisburg (Sycamore)
4000 Miamisburg-Centerville Road, Miamisburg, OH · Ketteringhealth · · NPI 1316966518
$646.80
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.
$1,617.00
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.
$1,637.46 with Aetna vs $6,636.00 with Unitedhealthcare — 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 | $1,637.46 | ↑ +153% |
| Molina Healthcare | Medicare Managed Care Plan | $1,719.33 | ↑ +166% |
| Bcbs | Anthem Pathway Hmox Exchange | $2,483.67 | ↑ +284% |
| Caresource | Marketplace Exchange | $2,530.69 | ↑ +291% |
| Unitedhealthcare | Exchange | $2,540.84 | ↑ +293% |
| Molina Healthcare | Exchange | $3,399.69 | ↑ +426% |
| Buckeye Health Plan | Ambetter Exchange | $3,438.66 | ↑ +432% |
| Medical Mutual | New Business Other Commercial Plan | $3,958.00 | ↑ +512% |
| Custom Design Benefits Inc. | All Commercial Plans | $4,399.19 | ↑ +580% |
| Aetna | All Commercial Plans | $4,642.34 | ↑ +618% |
| Aetna | New Business/Oh Ky Preferred Other Commercial Plan | $4,642.34 | ↑ +618% |
| Medical Mutual | Supermed Ppo | $5,653.00 | ↑ +774% |
| Bcbs | Anthem - Blue Access/Blue Preferred Hmo/Ppo | $5,723.16 | ↑ +785% |
| Cigna | All Commercial Plans | $6,165.00 | ↑ +853% |
| Unitedhealthcare | All Commercial Plans | $6,636.00 | ↑ +926% |
| Unitedhealthcare | Employee | $6,636.00 | ↑ +926% |
Visitor-reported prices
Comments
Bx pleura pq ndl at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jewish Hospital | Cincinnati | $2,494.20 | not published |
| Anderson Hospital | Cincinnati | $2,494.20 | not published |
| Clermont Hospital | Batavia | $1,188.00 | not published |
| Kings Mills Hospital | Mason | $2,494.20 | not published |
| Mercy West Hospital | Cincinnati | $2,494.20 | not published |
| St Ritas Medical Center | Lima | $1,585.80 | not published |
| Trinity Medical Center East | Steubenville | $944.75 | $1,143.00 – $1,524.00 |
| cleveland clinic main campus | Cleveland | $4,844.45 | $0.01 – $6,707.70 |