Crtj pericardial window/prtl resecj w/drg/bx at south pointe hospital
20000 Harvard Road, Warrensville Heights, OH · Cleveland Clinic · · NPI 1235183542
$5,785.00
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.
$8,900.00
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.
$1,468.56 with ANTHEM vs $8,900.00 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 |
|---|---|---|---|
| ANTHEM | PPO/HMO | $1,468.56 | ↓ -75% |
| AETNA | MEDICARE ADVANTAGE | $1,940.20 | ↓ -66% |
| OSCAR | ALL PRODUCTS | $2,516.92 | ↓ -56% |
| OPTUM | Managed Medicaid Transplant | $2,767.28 | ↓ -52% |
| PHP | ALL PRODUCTS | $2,848.00 | ↓ -51% |
| Paramount | Managed Medicaid | $3,000.32 | ↓ -48% |
| CC EHP | ALL PRODUCTS | $3,008.20 | ↓ -48% |
| MOLINA | Managed Medicaid | $3,058.58 | ↓ -47% |
| ANTHEM | Managed Medicaid | $3,058.58 | ↓ -47% |
| Buckeye | Managed Medicaid | $3,058.58 | ↓ -47% |
| Summacare | Preferred | $3,115.00 | ↓ -46% |
| CARESOURCE | Managed Medicaid | $3,116.84 | ↓ -46% |
| UNITED | Managed Medicaid | $3,116.84 | ↓ -46% |
| AMERIHEALTH | Managed Medicaid | $3,204.22 | ↓ -45% |
| Summacare | PREMIER | $3,390.90 | ↓ -41% |
| Aultcare | PPO/HMO | $3,684.60 | ↓ -36% |
| CIGNA | ALL PRODUCTS | $4,200.80 | ↓ -27% |
| OHCP | ALL PRODUCTS | $4,325.40 | ↓ -25% |
| UNITED | ALL PRODUCTS | $4,338.00 | ↓ -25% |
| OMAS | ALL PRODUCTS | $4,450.00 | ↓ -23% |
| MMO | NASCO | $4,654.70 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $4,806.00 | ↓ -17% |
| MMO | ALL PRODUCTS | $4,850.50 | ↓ -16% |
| HEALTHSMART | ALL PRODUCTS | $4,895.00 | ↓ -15% |
| ANTHEM | TRADITIONAL | $4,988.45 | ↓ -14% |
| OPTUM | All Products Transplant | $5,037.40 | ↓ -13% |
| AETNA | Acop | $5,340.00 | ↓ -8% |
| The Health Plan | ALL PRODUCTS | $5,340.00 | ↓ -8% |
| UPMC | ALL PRODUCTS | $5,340.00 | ↓ -8% |
| AETNA | International | $5,713.80 | ↓ -1% |
| THREE RIVERS | ALL PRODUCTS | $5,785.00 | ↑ +0% |
| Quality Care Partners | ALL PRODUCTS | $6,230.00 | ↑ +8% |
| AETNA | Asa_Whirlpool_Peia | $6,230.00 | ↑ +8% |
| GMS | ALL PRODUCTS | $6,230.00 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $6,230.00 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $6,675.00 | ↑ +15% |
| AETNA | ALL PRODUCTS | $6,675.00 | ↑ +15% |
| Humana Military | ALL PRODUCTS | $6,675.00 | ↑ +15% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $7,120.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $8,010.00 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $8,010.00 | ↑ +38% |
| FrontPath | TRANSPLANT | $8,010.00 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $8,010.00 | ↑ +38% |
| USA Managed Care | ALL PRODUCTS | $8,010.00 | ↑ +38% |
| AETNA | Qhp/Ipf | $8,900.00 | ↑ +54% |
| PPHP | ALL PRODUCTS | not published by hospital | — |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | not published by hospital | — |
| Summacare | MEDICARE ADVANTAGE | not published by hospital | — |
| OPTUM | Medicare Advantage Transplant | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| Valor | HMO & PPO | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| The Health Plan | MEDICARE ADVANTAGE | not published by hospital | — |
| ANTHEM | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| OPTUM | All Products VA | not published by hospital | — |
| UPMC | MEDICARE ADVANTAGE | not published by hospital | — |
| Perennial Health | HMO I-SNP and HMO C-SNP | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| Perennial Health | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Crtj pericardial window/prtl resecj w/drg/bx at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $5,785.00 | $1.10 – $8,010.00 |
| akron general | Akron | $5,785.00 | $1.10 – $8,010.00 |
| avon hospital | Avon | $5,785.00 | $1,468.56 – $8,010.00 |
| euclid hospital | Euclid | $5,785.00 | $1,468.56 – $8,010.00 |
| fairview hospital | Cleveland | $5,785.00 | $1,254.41 – $8,010.00 |
| lutheran hospital | Cleveland | $5,785.00 | $1,468.56 – $8,010.00 |
| hillcrest hospital | Mayfield Heights | $5,785.00 | $1,254.41 – $8,010.00 |
| marymount hospital | Garfield Heights | $5,785.00 | $1,468.56 – $8,010.00 |