Kettering Health Dayton
405 Grand Avenue, Dayton, OH 45405 · 120 Priced Procedures · 70% Patient Recommendation
Typical commercial prices here are +20% above the fair benchmark (1.20×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.20× fair market pricing.
Aligned Regional Benchmark Peer
Kettering Health Dayton prices shoppable and inpatient services (1.7× to 1.2× Medicare, divergence 0.71×) in alignment with regional hospital peers (1.20× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.14× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 8% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 70% patient recommendation (68/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (9.7% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
- Commercial insurance median sits at 1.20× Fair BaseRate (1.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.43×) jump +19% above the median procedure ratio (Q50 1.20×)
- Consolidated metro market (HHI 2,470) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Kettering Health Dayton
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 120 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $35,130 | 1.1× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $22,114 | 1.2× |
| Total hip replacement CPT Code: 27130 | $21,749 | 1.6× |
| Total knee replacement CPT Code: 27447 | $21,749 | 1.6× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $21,560 | 1.1× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $20,321 | 1.1× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $15,814 | 2.6× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $9,288 | 1.1× |
| Inguinal hernia repair CPT Code: 49505 | $8,560 | 2.4× |
| Breast lump removal CPT Code: 19120 | $8,413 | 2.2× |
| Trauma team activation HCPCS Code: G0390 | $8,268 | 5.7× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $8,152 | 2.4× |
| Bunion correction surgery CPT Code: 28296 | $7,716 | 2.2× |
| Cataract surgery with lens implant CPT Code: 66984 | $6,972 | unverified |
| Colonoscopy with biopsy CPT Code: 45380 | $2,822 | 2.2× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,740 | 2.8× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,193 | 2.2× |
| Injection procedure for pain management HCPCS Code: G0260 | $2,132 | 2.5× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $1,862 | 1.8× |
| Blood transfusion CPT Code: 36430 | $1,333 | 2.7× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $832 | 1.4× |
| Hospital observation (per hour) HCPCS Code: G0378 | $695 | 8.1× |
| Psychological testing by technician CPT Code: 96138 | $683 | 1.7× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $531 | 1.2× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $531 | 1.0× |
Audit a Bill or Quote at Kettering Health Dayton (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $8,212
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (9.7% of gross = $8,212).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Kettering Health Dayton's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($84,312) is $53,537 above the denoised Fair BaseRate ($30,775) and 3.6× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (9.7% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Kettering Health Dayton. Prior administrative notices do not necessarily reflect current compliance status.
- 2026-02-13·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare (1,408 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Kettering Health Dayton.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.