Delayed breast prosthesis 19342 at south pointe hospital
20000 Harvard Road, Warrensville Heights, OH · Cleveland Clinic · · NPI 1235183542
not published by hospital
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.
not published by hospital
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.
$2,798.25 with OPTUM vs $16,740.43 with ANTHEM — 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 |
|---|---|---|---|
| OPTUM | Managed Medicaid Transplant | $2,798.25 | — |
| Paramount | Managed Medicaid | $3,033.90 | — |
| Buckeye | Managed Medicaid | $3,092.81 | — |
| MOLINA | Managed Medicaid | $3,092.81 | — |
| ANTHEM | Managed Medicaid | $3,092.81 | — |
| CARESOURCE | Managed Medicaid | $3,151.72 | — |
| UNITED | Managed Medicaid | $3,151.72 | — |
| AMERIHEALTH | Managed Medicaid | $3,240.08 | — |
| CIGNA | ALL PRODUCTS | $5,520.00 | — |
| AETNA | MEDICARE ADVANTAGE | $7,732.66 | — |
| ANTHEM | MEDICARE ADVANTAGE | $7,732.66 | — |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $7,732.66 | — |
| Summacare | MEDICARE ADVANTAGE | $7,732.66 | — |
| UPMC | MEDICARE ADVANTAGE | $7,732.66 | — |
| Valor | HMO & PPO | $7,732.66 | — |
| CIGNA | MEDICARE ADVANTAGE | $7,964.64 | — |
| CommuniCare | MEDICARE ADVANTAGE | $8,119.29 | — |
| UNITED | MEDICARE ADVANTAGE | $8,178.12 | — |
| Perennial Health | HMO I-SNP and HMO C-SNP | $8,351.27 | — |
| UNITED | ALL PRODUCTS | $8,434.00 | — |
| PPHP | ALL PRODUCTS | $8,505.92 | — |
| The Health Plan | MEDICARE ADVANTAGE | $8,870.89 | — |
| OPTUM | Medicare Advantage Transplant | $8,870.89 | — |
| HUMANA | Medicare Advantage HMO | $8,870.89 | — |
| OPTUM | All Products VA | $8,870.89 | — |
| Perennial Health | MEDICARE ADVANTAGE | $9,580.56 | — |
| ANTHEM | PPO/HMO | $16,740.43 | — |
Visitor-reported prices
Comments
Delayed breast prosthesis 19342 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Kings Mills Hospital | Mason | $20,178.78 | $7,965.13 – $8,124.43 |
| St Ritas Medical Center | Lima | $64,285.93 | $8,103.41 – $8,103.41 |
| cleveland clinic main campus | Cleveland | $2,997.15 | $1.10 – $8,870.89 |
| akron general | Akron | $2,997.15 | $1.10 – $8,841.61 |
| mercy hospital | Canton | $2,997.15 | $1.10 – $8,841.61 |
| Fairfield Hospital | Fairfield | $24,747.73 | $7,194.09 – $8,103.41 |
| Lorain Hospital | Lorain | $31,250.30 | $6,864.94 – $7,887.31 |
| St Elizabeth Youngstown Hospital | Youngstown | $30,756.19 | $7,906.01 – $7,906.01 |