How many shoppable procedure prices are published for Nationwide Children's Hospital Toledo, LLC?

Nationwide Children's Hospital Toledo, LLC in Toledo, OH currently has 140 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Nationwide Children's Hospital Toledo, LLC's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Nationwide Children's Hospital Toledo, LLC's median negotiated commercial rate is 1.0× the regionally adjusted fair BaseRate benchmark.

Hospital Profile Children's Hospital Voluntary non-profit - Private 46 Beds · urban Updated: 4/1/2026

Nationwide Children's Hospital Toledo, LLC

2213 Cherry Street, Toledo, OH 43608 · 140 Priced Procedures

CMS Overall Rating No CMS Rating

Near Fair BaseRate Benchmark

1.03×vs. Fair Market Price

Typical commercial prices here are +3% above the fair benchmark (1.03×) even after accounting for local nurse/doctor wages and patient complexity.

80/100 · Corroborated

80/100Self-Pay Cash Beats Insurance 15% of the Time

File Completeness60

Price Logic94

Peer Alignment67

Clean Billing81

Real Cash Discount100

Regional Value Leader

Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Nationwide Children's Hospital Toledo, LLC prices shoppable and inpatient services (1.0× to 1.4× Medicare, divergence 1.40×) in alignment with regional hospital peers (1.03× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#62 of 137 in OH · 44th State Percentile#1,437 of 3,385 in U.S. · 42nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.70× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 15% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (54/100 safety score) with 72% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (32.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
Captive ER (1.4×) & laboratory (0.7×) services average 1.40× higher multiples than routine shoppable care (1.0×)
Upper-quartile procedures (Q75 1.27×) jump +30% above the median procedure ratio (Q50 0.98×)
Consolidated metro market (HHI 3,219) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

1.0× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.40× Divergence

1.4× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+30% Upper Tail

Q25 0.70× · Q50 0.98× · Q75 1.27×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.0× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.2× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

0.8× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.4× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

0.7× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.5× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

15% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 54/100Elevated

Procedure Prices at Nationwide Children's Hospital Toledo, LLC

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 140 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$53,237	$30,775	1.7×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$32,012	$19,087	1.7×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$31,788	$19,432	1.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$29,054	$17,936	1.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$12,848	$8,223	1.6×
Total knee replacement CPT Code: `27447`	$3,789	$3,789	$13,523	0.3×
Total hip replacement CPT Code: `27130`	$3,548	$3,548	$13,413	0.3×
C-section delivery (full package) CPT Code: `59510`	$5,842	$2,479	$2,975	0.8×
Bunion correction surgery CPT Code: `28296`	$1,435	$2,392	$3,446	0.7×
Vaginal delivery (full package) CPT Code: `59400`	$5,282	$2,217	$2,680	0.8×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$1,513	$2,091	$3,372	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$1,729	$1,729	$6,109	0.3×
Inguinal hernia repair CPT Code: `49505`	$1,615	$1,615	$3,629	unverified
Cataract surgery with lens implant CPT Code: `66984`	$1,736	$1,507	$2,540	0.6×
Trauma team activation HCPCS Code: `G0390`	—	$1,362	$1,453	0.9×
Breast lump removal CPT Code: `19120`	$1,018	$1,167	$3,875	0.3×
Colonoscopy with biopsy CPT Code: `45380`	$1,244	$1,011	$1,256	0.8×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,106	$950	$981	unverified
Upper endoscopy with biopsy CPT Code: `43239`	$850	$891	$987	0.9×
Injection procedure for pain management HCPCS Code: `G0260`	$1,834	$721	$855	0.8×
Rabies immune globulin HCPCS Code: `90375`	$2,011	$534	$322	1.7×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,769	$445	$448	1.0×
Blood transfusion CPT Code: `36430`	$1,274	$451	$498	0.9×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$4,297	$401	$583	0.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$4,140	$367	$511	0.7×
Sleep study (overnight, in lab) CPT Code: `95810`	$362	$362	$1,021	0.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,277	$376	$303	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$3,140	$251	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$3,130	$251	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$3,140	$251	$369	0.7×
Hepatitis B immune globulin HCPCS Code: `90371`	$464	$266	$151	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$148	$231	$86	2.7×
Mental health services (assessment) HCPCS Code: `H0031`	$218	$198	$140	1.4×
Behavioral health assessment HCPCS Code: `H0001`	—	$198	$157	1.3×
Psychiatric evaluation (first visit) CPT Code: `90791`	$203	$190	$185	1.0×
Neurobehavioral status check CPT Code: `96116`	$235	$205	$231	0.9×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$652	$213	$148	unverified
CT scan, head (with contrast) CPT Code: `70460`	$2,204	$185	$242	0.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,534	$187	$258	0.7×
Care planning with family CPT Code: `90887`	—	$159	$107	1.5×
Psychotherapy session (60 minutes) CPT Code: `90837`	$269	$181	$181	1.0×
Psychological testing by technician CPT Code: `96138`	$569	$206	$395	0.5×
Family therapy session CPT Code: `90847`	$222	$158	$173	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$2,167	$172	$272	0.6×
Screening mammogram (both breasts) CPT Code: `77067`	$665	$172	$123	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$973	$107	$126	0.8×
Ultrasound, pelvis CPT Code: `76856`	$1,508	$107	$130	0.8×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,251	$107	$132	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,294	$108	$134	0.8×
Psychotherapy session (45 minutes) CPT Code: `90834`	$230	$126	$166	0.8×
Behavioral health counseling (per session) HCPCS Code: `H0008`	—	$148	$257	0.6×
Behavioral health counseling (group) HCPCS Code: `H0009`	—	$148	$269	0.6×
Behavioral health day treatment HCPCS Code: `H0010`	—	$148	$343	0.4×
Behavioral health residential care HCPCS Code: `H0011`	—	$148	$364	0.4×
Behavioral health living support HCPCS Code: `H2019`	$77	$95	$34	2.8×
Speech therapy (language evaluation) CPT Code: `92507`	$175	$98	$86	1.1×
Residential substance abuse treatment HCPCS Code: `H2035`	—	$95	$88	1.1×
CT scan, head (no contrast) CPT Code: `70450`	$1,916	$112	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$2,185	$112	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$1,916	$112	$166	0.7×
CT scan, chest (no contrast) CPT Code: `71250`	$2,185	$112	$167	0.7×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,185	$112	$168	0.7×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,185	$112	$169	0.7×
Office visit, established patient (30-39 min) CPT Code: `99214`	$177	$83	$123	0.7×
Residential mental health treatment HCPCS Code: `H2036`	—	$86	$406	0.2×
X-ray, chest (two views) CPT Code: `71046`	$666	$89	$93	unverified
X-ray, hip CPT Code: `73502`	$611	$89	$93	unverified
Group therapy session CPT Code: `90853`	$134	$104	$100	unverified
Typhoid vaccine HCPCS Code: `90675`	$938	$320	$347	0.9×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$192	$188	$203	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$125	$141	$140	1.0×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$73	$33	2.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$99	$97	$111	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	$154	$73	$87	0.8×
Drug screening test HCPCS Code: `G0480`	$100	$92	$116	0.8×
X-ray, chest (single view) CPT Code: `71045`	$666	$72	$92	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$179	$78	$110	0.7×
X-ray, shoulder CPT Code: `73030`	$611	$65	$92	0.7×
X-ray, foot CPT Code: `73630`	$611	$65	$92	0.7×
X-ray, neck (cervical spine) CPT Code: `72040`	$611	$65	$93	0.7×
X-ray, hand CPT Code: `73130`	$611	$65	$93	0.7×
X-ray, ankle CPT Code: `73610`	$611	$65	$93	0.7×
Psychological testing evaluation CPT Code: `96136`	$182	$76	$128	0.6×
X-ray, pelvis CPT Code: `72170`	$582	$65	$110	0.6×
X-ray, lower back CPT Code: `72110`	$1,008	$65	$112	0.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$139	$73	$201	0.4×
Physical therapy (functional capacity test) CPT Code: `97750`	$158	$45	$38	1.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$161	$47	$40	1.2×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$158	$44	$38	1.2×
Blood test, lipase CPT Code: `83690`	$120	$10	$7	1.4×
Blood test, calcium CPT Code: `82310`	$96	$7	$5	1.4×
Blood test, creatinine (kidney) CPT Code: `82565`	$97	$7	$5	1.4×
Blood test, sodium CPT Code: `84295`	$86	$7	$5	1.4×
Blood test, basic metabolic panel CPT Code: `80048`	$225	$12	$9	1.3×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$65	$13	$10	1.3×
Electrical stimulation therapy HCPCS Code: `G0283`	$212	$18	$14	1.3×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$83	$23	$20	1.1×
Diagnostic procedure preparation HCPCS Code: `G0279`	$24	$40	$35	1.1×
Physical therapy (gait training) CPT Code: `97116`	$134	$37	$33	1.1×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$151	$39	$35	1.1×
Physical therapy (manual therapy) CPT Code: `97140`	$95	$37	$34	1.1×
Occupational therapy (self-care training) CPT Code: `97535`	$108	$41	$38	1.1×
Hepatitis B vaccine HCPCS Code: `90744`	$47	$37	$37	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$29	$48	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$35	$48	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$47	$48	$49	1.0×
Blood test, vitamin D CPT Code: `82306`	$131	$30	$31	1.0×
Mental health services (therapy) HCPCS Code: `H0032`	$218	$47	$65	0.7×
Behavioral health day program HCPCS Code: `H2012`	$304	$66	$100	0.7×
Review of medical records for care CPT Code: `90889`	—	$47	$114	0.4×
Blood antibody screen CPT Code: `86850`	$235	$53	$46	unverified
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$49	$47	$39	unverified
Orthotic fitting and training CPT Code: `97760`	$170	$61	$51	unverified
Prosthetic fitting and training CPT Code: `97761`	$161	$54	$45	unverified
Urinalysis (automated, with microscopy) CPT Code: `81001`	$53	$4	$3	1.3×
Blood test, hemoglobin CPT Code: `85018`	$16	$4	$3	1.3×
Blood test, clotting time (PTT) CPT Code: `85730`	$104	$8	$6	1.3×
Hepatitis C antibody test CPT Code: `86803`	$123	$20	$15	1.3×
Culture, bacterial CPT Code: `87070`	$109	$12	$9	1.3×
Blood test, vitamin B12 CPT Code: `82607`	$82	$21	$16	1.3×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$157	$18	$14	1.3×
Blood test, amylase CPT Code: `82150`	$113	$9	$7	1.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$122	$18	$14	1.3×
Blood test, magnesium CPT Code: `83735`	$76	$9	$7	1.3×
Blood test, thyroid (TSH) CPT Code: `84443`	$203	$23	$18	1.3×
Culture, blood CPT Code: `87040`	$127	$14	$11	1.3×
Speech therapy (group session) CPT Code: `92508`	$301	$32	$27	1.2×
Blood test, glucose (blood sugar) CPT Code: `82947`	$61	$5	$4	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$75	$5	$4	1.3×
Blood test, liver function panel CPT Code: `80076`	$114	$11	$9	1.2×
Blood test, potassium CPT Code: `84132`	$80	$6	$5	1.2×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$71	$6	$5	1.2×
Blood test, complete blood count (CBC) CPT Code: `85025`	$137	$9	$8	1.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$74	$21	$19	1.1×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$50	$27	$25	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$79	$26	$27	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$25	$11	$25	0.4×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$213	$27	$64	0.4×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$49	$20	$56	0.4×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$269	$15	$11	unverified

Showing top 25 high-impact procedures of 140 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 32.0%

Audit a Bill or Quote at Nationwide Children's Hospital Toledo, LLC (Zero PHI Required)

CMS CCN: 363309

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $53,237

1. Amount on Your Bill or Quote ($) Pre-filled with Nationwide Children's Hospital Toledo, LLC’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $40,835 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $40,835

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (32.0% of gross = $40,835).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Nationwide Children's Hospital Toledo, LLC's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$96,994 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($127,769) is $96,994 above the denoised Fair BaseRate ($30,775) and 5.4× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (32.0% 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.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Nationwide Children's Hospital Toledo, LLC.

Price Index: 1.00× regional baseline

Quality: 54/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Paramount

-77.0%

Median Household Income$60,095U.S. Census ACS

Local Uninsured Share5.3%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 80/100 · Corroborated CMS CCN 363309

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (toledo) Verify on CMS Medicare.gov (CCN 363309) ↗ CMS HCRIS Cost Reports ↗

Published MRF Filetoledo

Publication / Vintage4/1/2026 · 149.42 MB

Validated Rate Rows4,966 (CMS v3.0.0)

File Integrity DigestVerified · CCN 363309

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.

Submit MRF Update Correction Policy