Open Cleveland Clinic Standard Charges File
The Cleveland Clinic Standard Charges file is a publicly available data file that lists the Cleveland Clinic prices charged for all items and services and breaks down the differences in negotiated prices across health plans and payers.
Hospital Price Transparency regulations require U.S. hospitals to publish hospital standard charges files each year in a standard format. However, given the size and complexity of the files, they can't be opened in a traditional spreadsheet like Excel. Row Zero is a next-gen spreadsheet built for big data that makes it easy to open and analyze very large files in an easy-to-use spreadsheet. Simply click the link to open Cleveland Clinic standard charges. We've already uploaded and formatted the file and have done a basic analysis.
In this post we'll show how to access and open the Cleveland Clinic standard charges files in a spreadsheet and analyze the data and share some interesting findings.
- How to Open the Cleveland Clinic Standard Charges File
- Analyzing Cleveland Clinic Standard Charges
- Prices for Common Medications
- Prices for Common Procedures
- Look Up and Chart Any Item
- Cleveland Clinic vs Other Hospitals
- Conclusion
How to Open the Cleveland Clinic Standard Charges File
You can open and view the Cleveland Clinic Standard Charges file here in a Row Zero spreadsheet and also explore our analysis tool. The file is too large to open in Excel or Google Sheets so Row Zero is your best option to open and analyze the file. Here's how we opened the Cleveland Clinic chargemaster file in Row Zero:
Access the latest file on the Comprehensive Hospital Charges page at ClevelandClinic.org. Scroll down to Charge Lists for Cleveland Clinic Hospitals and click on the link Cleveland Clinic Main Campus. The file will download as a CSV onto your computer.
Open up a Row Zero workbook: Login or sign up for free and open a workbook.
Import the CSV file: Click Data in the top navigation to import a file and then select the CSV you downloaded and click Import.
The first two rows of the file are descriptors of the file. After viewing them, you can delete them to clean up the file.
Take a moment to familiarize yourself with the chargemaster data. The two key columns are "description" which is the descriptive name of each item or procedure and "standard_charge|negotiated_dollar" which is the price negotiated by a specific payer and plan (see a definition of key fields below). A good first step to analyze Cleveland Clinic price data is to add filters and freeze the first row and column to make it easier to drill down. To add filters, select the data (or hit Ctrl + A) and go to Data, Filter.
Analyzing Cleveland Clinic Standard Charges
Now that we have the Cleveland Clinic standard charges data in our spreadsheet and ready to filter, we can start exploring the data. The Cleveland Clinic chargemaster data contains one row for every combination of 1) item/procedure 2) payer and 3) plan and lists the Negotiated Price that each payer/plan has negotiated along with some additional info. The Negotiated Price is highlighted in green.
Definition of key fields:
- description - The descriptive name for each item or procedure
- code|1 - While there are 3 code columns, the first is consistently filled and typically has a standard code for that item that is comparable across hospitals. Note, the same "description" can have multiple codes.
- code|1|type - Code type refers to the category the code represents. For example NDC is National Drug Code and is used for medications. Here's a breakdown of code types
- setting - This can be inpatient, outpatient, or both. Note that prices for anything can vary by setting, even something as simple as Acetaminophen (Tylenol).
- standard_charge|gross - The list price before any discounts
- standard_charge|discounted_cash - The discounted price for paying out-of-pocket without insurance
- payer_name - Typically the insurance company that has negotiated the price with the hospital (e.g. Aetna)
- plan_name - The insurance plan, which can be commercial insurance or government programs like Medicare and Medicaid
- Negotiated Price - The price negotiated by a specific payer and plan. Note, there are a number of variables that can impact this including the charge methodology, payment models, and prices negotiated for other services. In the original file, this field was named "standard_charge|negotiated_dollar"
- standard_charge|min - Lowest charge negotiated for the item
- standard_charge|max - Maximum charge for the item across plans
- count_of_compared_rates - Count of different negotiated rates for the item
- standard_charge|methodology - The pricing methodology for the item. View a breakdown of these methodologies. Note that the majority of the
Filtering to a specific item
Filter the "description" column to narrow down to a specific item. For example, filter to Acetaminophen 325 MG Tablet (Tylenol) to see the range of prices Cleveland Clinic charges by health plan. 
The prices charged range from $0.01 to $0.12 per pill with a median price of $0.03. There are 188 health plans that have negotiated their own price for this and there are 84 different prices charged depending on the plan. This simple example demonstrates the wide disparity in prices that hospitals charge for medications.
To dig deeper, we've created a pivot table in the Analysis of Cleveland Clinic tab that shows the Cleveland Clinic price ranges for each procedure, medication, and medical supply. This lets us quickly filter to one item and analyze its price disparity.
Prices for Common Medications at Cleveland Clinic
In our Analysis tab, filtering down to some common medications reveals a wide range of drug prices across plans and significant markup from what you'd pay from a discount pharmacy like Cost Plus Drug Company. 
However, as we'll see below, Cleveland Clinic generally has much lower costs than other hospitals, so while the upcharge is meaningful, its dramatically lower than the Mayo Clinic prices for these same medications for example.
Important note: The median price and price range for Ondansetron (Zofran) looks unusually high with a very wide range of prices charged. Keep in mind that this is a 3.5 million row file with pretty messy data that at one point was likely manually entered into a system. So when you see anomalies, they're worth digging into to try to better understand. To do so, we can add the associated code for each item into the pivot table to see if there is one particular entry for Ondansetron causing issues. 
Sure enough, there are 3 different codes for Ondansetron HCL 8 MG Tablet and the prices for one of them look much more appropriate with a median price of $1.52. Digging further into the specific codes with the National Drug Code Directory suggests that the much more expensive line items for Ondansetron are likely 30 tablet bottles and not one single dose. This is a good example of why you need to be careful comparing prices and question when you see anomalies. Fortunately, after reviewing the data analyzed in this post and other hospital standard charge analysis we've done, this appears to be the only instance of this, where the same description doesn't actually represent the same thing.
Prices for Common Procedures at Cleveland Clinic
Filtering down to a few common medical procedures reveals a wide range of prices charged across health plans. 
Note that this is just the price for the specific procedure. You may also be charged for supplies used, medication provided, and will incur significant costs for overnight stays so the prices will vary whether done in-patient or out-patient.
For example, the standard charges file lists a Vaginal Delivery (childbirth) as $3.6K to $7.6K across insurance plans and uninsured patients, but the estimate of the total cost of a vaginal delivery at Cleveland Clinic is more than $36K without insurance, according to the Cleveland Clinic's Cost Estimator Tool. 
As you can see, the standard charge range of $3.6k to $7.6k is likely just related to the "Physician Charges" line item after discounts, whereas the majority of the total cost is made up of "Hospital Charges" which may include things like the room, supplies, medication, etc. This is why it's important to contact the hospital directly to get an understanding of prices before a procedure.
Lookup and chart any item
Using our template analysis tool, you can look up the negotiated price distribution of any item at Cleveland Clinic. Here's an example for Amoxicillin 500 MG capsules, a common antibiotic. 
Just like the examples above, there is a wide variety of prices paid for Amoxicillin and a significant upcharge over what you would pay at a discount prescription drug company like Cost Plus Drug Company, which lists 500 MG Amoxicillin capsules at $13.10 for 90 pills or $0.15 per pill. Using our simple Upcharge Calculator shows a 280% upcharge for Amoxicillin at the median price charged of $0.57. 
While this represents a significant markup, it's actually a much smaller markup on drug prices than what we see at other hospitals analyzed.
Compare Cleveland Clinic vs Other Hospitals
Are these upcharges and big price ranges unique to Cleveland Clinic or typical across all hospitals? Since each hospital is required to publish a hospital standard charges file we can easily use Row Zero to open and compare standard charges files at any hospital. Let's compare Cleveland Clinic vs Mayo Clinic and UCLA Health across the same common medications and procedures analyzed above.
Compare Standard Charges for Common Medications
When we compare drug prices at hospitals we can see a wide disparity in the median prices charged for common medications and in most cases, a significant upcharge versus retail options like Cost Plus Drugs, Amazon Pharmacy, or Walmart. 
As you can see, Cleveland Clinic is significantly cheaper for most items compared to other hospitals and reflects the hospital's reputation for providing quality and affordable care.
Compare Standard Charges for Common Procedures
We see a similar dynamic when we compare prices at each hospital for common medical procedures. 
Again, Cleveland Clinic appears to be providing more affordable care than other hospitals. However, keep in mind that this may be just a fraction of the total cost of your visit. For something like a childbirth that requires multiple nights stay in a hospital, and significant supplies and medication, the total costs will be much higher and the least expensive option for the procedure could be a more expensive option for total cost.
Disclaimer: Discrepancies and Errors in Hospital Standard Charge Files
While hospital standard charges files give a powerful level of transparency into healthcare pricing, it's important to note some caveats. First of all, these files are complicated, have millions of rows, and the data was likely manually input into a system at some point, so it's susceptible to human error. In reviewing the files, several input errors were identified. There are also often several line items for very similar items with different price ranges and it's not clear which particular item is the one most frequently used at a given hospital. While the standard charge files use standard codes for items, there can be several potential codes for a given item so comparing items across hospitals isn't always easy or necessarily an exact, accurate comparison. As a result, these files should be used as a starting point for analysis and exploration and you should contact the hospital directly before making any definitive conclusions about the data or to inquire about noteworthy findings.
Conclusion
Hospital standard charges files provide detailed price transparency at hospitals across the U.S. It's typically not possible to open standard charges files in Excel or Google Sheets because of those spreadsheets' data limits. Row Zero is a powerful spreadsheet built for big data that lets you open and analyze hospital standard charge files and compare prices across hospitals (with the caveats mentioned above). To make it easy, we've already opened the Cleveland Clinic standard charges file in Row Zero and set up a template with pivot tables and charts to analyze Cleveland Clinic standard charges in a spreadsheet. The data reveals a wide range of prices charged across health plans and payers. While there appear to be significant upcharges at Cleveland Clinic for some medications and medical supplies, Cleveland Clinic appears to be much more affordable compared to other hospitals analyzed. You can try Row Zero for free to analyze Cleveland Clinic price data or open and analyze hospital standard charges for any hospital in the U.S.
Analyze Cleveland Clinic Standard Charges in Row Zero