Our hospital pricing document outlines the charges for services at Cincinnati Children’s. Download a pdf copy of the price disclosure required under Ohio law.

The Center for Medicare and Medicaid Services (CMS) requires providers to publish the pricing or provide patient estimates for 300 shoppable services that will provide patients with their estimated out-of-pocket expenses. These 300 services include outpatient visits, diagnostic testing, radiology, labs and certain outpatient procedures that represent some of the services named by CMS and others that were considered shoppable by Cincinnati Children's Hospital Medical Center because they are high volume services provided by our organization. Click here to obtain an estimate for one of these 300 shoppable services.

In addition, you may click here to download a copy of our standard charges for items and services for hospital patients required under the Affordable Care Act. This contains current prices in Cincinnati Children’s chargemaster plus reimbursement by payer for clinical services as required by federal rules that are effective January 1, 2022.

Cincinnati Children’s chargemaster is a list of billable services charged by the hospital for services rendered at the main location at 3333 Burnet Ave. as well as our neighborhood hospital locations. Prices for supplies, drugs and miscellaneous items not included in the chargemaster are also provided in the downloadable copy of our standard charges.

Reimbursement by payer is the amount paid by a third-party payers under the terms of their contract with Cincinnati Children’s. For Medicaid third-party payers who pay under DRG or EAPG payments systems, the average payment amount for each DRG displayed for the time period July 1, 2020 through June 30, 2021 and for EAPG displayed for the time period January 1, 2021 through June 30, 2021. Additionally, January 1, 2021, Cincinnati Children’s and CareSource launched a collaboration named HealthVine aimed at improving care for 125,000 Medicaid-covered children currently enrolled in CareSource who reside in eight counties in Southwest Ohio. Under this collaboration, Cincinnati Children’s will assume accountability for care management and utilization management for these children. Cincinnati Children’s is reimbursed for hospital services under a capitated model which resulted in a Per Member Per Month (PMPM) rate of $121.71 for the last fiscal year ending June 30, 2021.

Supplies, drugs and miscellaneous items are priced at the time they are dispensed to patients based on their acquisition costs and will vary over time. Prices for these three categories shown in the attached file are snapshots of most recent prices based upon:

  • Average prices for the most recent 5-month period prior to July 1 for drugs
  • Prices as of July for supplies and miscellaneous items

Total hospital charges for a service or a procedure for an individual patient will vary based on the combination of hospital services provided, including drugs, supplies, lab tests, or radiology procedures.

As required by Kentucky Administrative Regulation 311A.032, fees for ambulance services can be found here.

Hospital prices do not reflect what patients pay for services. This is determined by your insurance coverage that includes out-of-pocket requirements and contracted rates and discounts based on agreements between payers and Cincinnati Children’s.

To obtain an estimate of the price you would pay for a service, you may contact our Customer Service Department at 1-877-430-8495 or 1-513-636-4427. You can also create an estimate using our new Guest Estimate feature. Prior to calling for a price estimate, you will need the following information:

  • Description of services or the CPT procedure codes, which may be obtained from your referring physician
  • Name of your insurance plan