Ins/rplc spi npg/rcvr pocket at Kettering Health Troy
600 W. Main Street, Troy, OH · Ketteringhealth · · NPI 1023587045
$14,026.40
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.
$35,066.00
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.
$4,830.00 with Medical Mutual vs $105,942.84 with Bcbs — 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 |
|---|---|---|---|
| Medical Mutual | New Business Other Commercial Plan | $4,830.00 | ↓ -66% |
| Medical Mutual | Supermed Ppo | $6,900.00 | ↓ -51% |
| Aetna | All Commercial Plans | $8,386.90 | ↓ -40% |
| Aetna | New Business/Oh Ky Preferred Other Commercial Plan | $8,386.90 | ↓ -40% |
| Cigna | All Commercial Plans | $11,143.00 | ↓ -21% |
| Unitedhealthcare | Employee | $30,111.00 | ↑ +115% |
| Unitedhealthcare | All Commercial Plans | $30,111.00 | ↑ +115% |
| Aetna | Medicare Managed Care Plan | $30,241.69 | ↑ +116% |
| Molina Healthcare | Medicare Managed Care Plan | $31,753.77 | ↑ +126% |
| Bcbs | Anthem Pathway Hmox Exchange | $45,975.74 | ↑ +228% |
| Caresource | Marketplace Exchange | $46,738.53 | ↑ +233% |
| Unitedhealthcare | Exchange | $46,926.03 | ↑ +235% |
| Molina Healthcare | Exchange | $62,787.79 | ↑ +348% |
| Buckeye Health Plan | Ambetter Exchange | $63,507.55 | ↑ +353% |
| Custom Design Benefits Inc. | All Commercial Plans | $81,247.32 | ↑ +479% |
| Bcbs | Anthem - Blue Access/Blue Preferred Hmo/Ppo | $105,942.84 | ↑ +655% |
Visitor-reported prices
Comments
Ins/rplc spi npg/rcvr pocket at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jewish Hospital | Cincinnati | $68,063.63 | $30,071.45 – $30,672.88 |
| Anderson Hospital | Cincinnati | $76,459.72 | $30,071.45 – $30,672.88 |
| St Ritas Medical Center | Lima | $111,458.28 | $30,593.52 – $30,593.52 |
| cleveland clinic main campus | Cleveland | $26,310.05 | $1.10 – $36,429.30 |
| akron general | Akron | $1,484.60 | $1.10 – $30,409.55 |
| mercy hospital | Canton | $1,484.60 | $1.10 – $30,069.57 |
| University Hospitals Ahuja Medical Center | Beachwood | $36,000.00 | $900.00 – $52,548.77 |
| University Hospitals Beachwood Medical Center | Beachwood | $36,000.00 | $900.00 – $73,939.59 |