Complx repair enel addl 5cm/< 13153 at south pointe hospital
20000 Harvard Road, Warrensville Heights, OH · Cleveland Clinic · · NPI 1235183542
$391.95
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.
$603.00
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.
$131.45 with AETNA vs $6,410.00 with AETNA — 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 ADVANTAGE | $131.45 | ↓ -66% |
| OSCAR | ALL PRODUCTS | $170.53 | ↓ -56% |
| PHP | ALL PRODUCTS | $192.96 | ↓ -51% |
| CC EHP | ALL PRODUCTS | $203.81 | ↓ -48% |
| Summacare | Preferred | $211.05 | ↓ -46% |
| Summacare | PREMIER | $229.74 | ↓ -41% |
| ANTHEM | PPO/HMO | $236.82 | ↓ -40% |
| Aultcare | PPO/HMO | $249.64 | ↓ -36% |
| CIGNA | ALL PRODUCTS | $284.62 | ↓ -27% |
| OHCP | ALL PRODUCTS | $293.06 | ↓ -25% |
| OMAS | ALL PRODUCTS | $301.50 | ↓ -23% |
| MMO | NASCO | $315.37 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $325.62 | ↓ -17% |
| HEALTHSMART | ALL PRODUCTS | $331.65 | ↓ -15% |
| ANTHEM | TRADITIONAL | $337.98 | ↓ -14% |
| OPTUM | All Products Transplant | $341.30 | ↓ -13% |
| The Health Plan | ALL PRODUCTS | $361.80 | ↓ -8% |
| UPMC | ALL PRODUCTS | $361.80 | ↓ -8% |
| THREE RIVERS | ALL PRODUCTS | $391.95 | ↑ +0% |
| Quality Care Partners | ALL PRODUCTS | $422.10 | ↑ +8% |
| GMS | ALL PRODUCTS | $422.10 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $422.10 | ↑ +8% |
| Humana Military | ALL PRODUCTS | $452.25 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $452.25 | ↑ +15% |
| AETNA | ALL PRODUCTS | $452.25 | ↑ +15% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $482.40 | ↑ +23% |
| FrontPath | TRANSPLANT | $542.70 | ↑ +38% |
| USA Managed Care | ALL PRODUCTS | $542.70 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $542.70 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $542.70 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $542.70 | ↑ +38% |
| AETNA | Qhp/Ipf | $603.00 | ↑ +54% |
| OPTUM | Managed Medicaid Transplant | $963.80 | ↑ +146% |
| Paramount | Managed Medicaid | $1,044.97 | ↑ +167% |
| MOLINA | Managed Medicaid | $1,065.26 | ↑ +172% |
| Buckeye | Managed Medicaid | $1,065.26 | ↑ +172% |
| ANTHEM | Managed Medicaid | $1,065.26 | ↑ +172% |
| CARESOURCE | Managed Medicaid | $1,085.55 | ↑ +177% |
| UNITED | Managed Medicaid | $1,085.55 | ↑ +177% |
| AMERIHEALTH | Managed Medicaid | $1,115.98 | ↑ +185% |
| MMO | ALL PRODUCTS | $3,321.00 | ↑ +747% |
| AETNA | Acop | $5,355.00 | ↑ +1266% |
| AETNA | Asa_Whirlpool_Peia | $5,653.00 | ↑ +1342% |
| AETNA | International | $6,410.00 | ↑ +1535% |
| OPTUM | Medicare Advantage Transplant | not published by hospital | — |
| PPHP | ALL PRODUCTS | not published by hospital | — |
| OPTUM | All Products VA | not published by hospital | — |
| Summacare | MEDICARE ADVANTAGE | not published by hospital | — |
| ANTHEM | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| The Health Plan | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| Valor | HMO & PPO | not published by hospital | — |
| UPMC | MEDICARE ADVANTAGE | not published by hospital | — |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | not published by hospital | — |
| Perennial Health | HMO I-SNP and HMO C-SNP | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| Perennial Health | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Complx repair enel addl 5cm/< 13153 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Anderson Hospital | Cincinnati | $1,110.60 | not published |
| Clermont Hospital | Batavia | $1,110.60 | not published |
| Kings Mills Hospital | Mason | $1,110.60 | not published |
| Mercy West Hospital | Cincinnati | $1,110.60 | not published |
| cleveland clinic main campus | Cleveland | $618.80 | $0.01 – $1,227.99 |
| akron general | Akron | $618.80 | $0.01 – $974.74 |
| avon hospital | Avon | $391.95 | $131.45 – $920.04 |
| euclid hospital | Euclid | $391.95 | $131.45 – $1,071.04 |