healthcosts.net
Valvuloplasty mitral at University Hospitals St. John Medical Center
29000 Center Ridge Road, Westlake OH, OH · University Hospitals · · NPI 1841264868
$9,472.50
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.
$12,630.00
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.
$3,094.35 with Medical Mutual of Ohio vs $21,229.61 with Ambetter — 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 of Ohio | Northern Ohio Commercial | $3,094.35 | ↓ -67% |
| United Healthcare | Nexus Commercial | $5,734.02 | ↓ -39% |
| Amish Church Fund and Workers Aid Plan | Fund | $5,809.80 | ↓ -39% |
| Amish Aid Community Plan | Fund | $5,809.80 | ↓ -39% |
| Buckeye Plain Ministries | Fund | $5,809.80 | ↓ -39% |
| JP Farley | Commercial | $5,936.10 | ↓ -37% |
| Immergrun | Commercial | $6,315.00 | ↓ -33% |
| Christian Healthcare Ministries | Fund | $6,315.00 | ↓ -33% |
| Sunrise Plan Communities | Fund | $6,315.00 | ↓ -33% |
| United Healthcare | Commercial | $6,365.52 | ↓ -33% |
| Anthem | Traditional Commercial | $6,378.15 | ↓ -33% |
| SummaCare | Commercial | $6,441.30 | ↓ -32% |
| Cigna | PPO Commercial | $7,009.65 | ↓ -26% |
| Anthem | Commercial | $7,084.58 | ↓ -25% |
| Ohio Health Choice | Preferred Health Choice Plus Commercial | $8,209.50 | ↓ -13% |
| HealthSmart | Commercial | $8,209.50 | ↓ -13% |
| The Health Plan | Commercial | $8,335.80 | ↓ -12% |
| Medical Mutual of Ohio | MedFlex Commercial | $8,405.00 | ↓ -11% |
| Aetna | Commercial | $8,424.21 | ↓ -11% |
| Medical Mutual Traditional/Health Ohio | Commercial | $8,841.00 | ↓ -7% |
| Medical Mutual of Ohio | SuperMed Commercial | $9,339.00 | ↓ -1% |
| Ohio Preferred Network | Commercial | $10,104.00 | ↑ +7% |
| Beech Street | Commercial | $10,104.00 | ↑ +7% |
| Medical Mutual of Ohio | NAS Commercial | $10,273.00 | ↑ +8% |
| First Health | Commercial | $10,482.90 | ↑ +11% |
| Century Health Network | Commercial | $10,735.50 | ↑ +13% |
| Private Healthcare System | Commercial | $10,861.80 | ↑ +15% |
| Ohio Health Choice | Commercial | $11,367.00 | ↑ +20% |
| Fortified Provider Network | Commercial | $11,367.00 | ↑ +20% |
| MultiPlan | Commercial | $11,367.00 | ↑ +20% |
| Molina | Medicare Advantage | $11,794.23 | ↑ +25% |
| Anthem | Medicare Advantage | $11,794.23 | ↑ +25% |
| Primetime Health Plan | Medicare Advantage | $11,794.23 | ↑ +25% |
| WellCare by AllWell | Medicare Advantage | $11,794.23 | ↑ +25% |
| Cigna | Medicare Advantage | $11,794.23 | ↑ +25% |
| SummaCare | Medicare Advantage | $11,794.23 | ↑ +25% |
| Devoted Health | Medicare Advantage | $11,794.23 | ↑ +25% |
| Aetna | Medicare Advantage | $11,794.23 | ↑ +25% |
| Humana | Medicare Advantage | $11,794.23 | ↑ +25% |
| United Healthcare | Medicare Advantage | $11,794.23 | ↑ +25% |
| The Health Plan | Medicare Advantage | $11,794.23 | ↑ +25% |
| Paramount | Medicare Advantage | $12,148.06 | ↑ +28% |
| Valor Health Plans | Medicare Advantage | $12,383.94 | ↑ +31% |
| Perennial Advantage of Ohio | Medicare Advantage | $12,383.94 | ↑ +31% |
| University Health Employee Plan (Contigo) | Commercial | $14,352.00 | ↑ +52% |
| Cigna | OAP Commercial | $15,000.00 | ↑ +58% |
| AultCare | Commercial | $17,103.00 | ↑ +81% |
| CareSource | Marketplace | $21,229.61 | ↑ +124% |
| Ambetter | Commercial | $21,229.61 | ↑ +124% |
| Humana | Managed Medicaid | not published by hospital | — |
| Amerihealth Caritas | Managed Medicaid | not published by hospital | — |
| Buckeye | Managed Medicaid | not published by hospital | — |
| Aetna (Ohio Rise) | Managed Medicaid | not published by hospital | — |
| CareSource | Managed Medicaid | not published by hospital | — |
| United Healthcare | Managed Medicaid | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |