healthcosts.net
Biopsy of heart lining at akron general
1 Akron General Avenue, Akron, OH · Cleveland Clinic · · NPI 1821035940
$12,942.15
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.
?
What you pay up front if you don't use insurance.
$19,911.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1.10 with Zing Health vs $18,098.00 with AETNA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| Summacare | Medicare Advantage Lower Level | $137.06 | ↓ -99% |
| Summacare | Medicare Advantage Psych | $160.43 | ↓ -99% |
| Summacare | Medicare Advantage CNA | $179.23 | ↓ -99% |
| Summacare | Medicare Advantage MD | $200.32 | ↓ -98% |
| Valor | All Products | $213.91 | ↓ -98% |
| Optum | Medicare Advantage Transplant | $213.91 | ↓ -98% |
| Humana | Medicare Advantage HMO | $213.91 | ↓ -98% |
| Aetna | Medicare Advantage | $213.91 | ↓ -98% |
| The Health Plan | Medicare Advantage | $213.91 | ↓ -98% |
| The Health Plan | All Products | $213.91 | ↓ -98% |
| United | Medicare Advantage | $213.91 | ↓ -98% |
| Anthem | Medicare Advantage | $213.91 | ↓ -98% |
| CommuniCare | Medicare Advantage | $224.61 | ↓ -98% |
| PPHP | All Products | $227.73 | ↓ -98% |
| Anthem | All Products Mid-Level Facility | $299.43 | ↓ -98% |
| Anthem | All Products Mid-Level Non-Facility | $299.43 | ↓ -98% |
| Optum | Managed Medicaid Transplant | $327.28 | ↓ -97% |
| Buckeye | Managed Medicaid | $344.51 | ↓ -97% |
| United | Managed Medicaid | $361.74 | ↓ -97% |
| Caresource | Managed Medicaid | $361.74 | ↓ -97% |
| AmeriHealth | Managed Medicaid | $378.96 | ↓ -97% |
| Molina | Managed Medicaid | $378.96 | ↓ -97% |
| Summacare | Premier | $430.15 | ↓ -97% |
| Summacare | Preferred | $436.38 | ↓ -97% |
| MMO | Medicare HMO & PPO | $437.36 | ↓ -97% |
| Oscar | All Products | $460.68 | ↓ -96% |
| United | HMO & PPO | $493.37 | ↓ -96% |
| United | All Products - Mid-Level | $672.32 | ↓ -95% |
| OHCP | All Products | $705.26 | ↓ -95% |
| United | All Products | $714.09 | ↓ -94% |
| Anthem | All Products Physician Facility | $760.49 | ↓ -94% |
| Anthem | All Products Physician Non-Facility | $760.49 | ↓ -94% |
| Anthem | All Products Physician | $760.49 | ↓ -94% |
| Aultcare | PPO/HMO | $895.62 | ↓ -93% |
| OMAS | All Products | $906.50 | ↓ -93% |
| MMO | SuperMed | $979.02 | ↓ -92% |
| MMO | NASCO | $979.02 | ↓ -92% |
| Optum | All Products Transplant | $1,056.98 | ↓ -92% |
| ANTHEM | HPN | $1,071.48 | ↓ -92% |
| PHPHI | All Products | $1,087.80 | ↓ -92% |
| GMS | All Products | $1,269.10 | ↓ -90% |
| MMO | Traditional | $1,269.10 | ↓ -90% |
| Aetna | All Products First Health | $1,359.75 | ↓ -89% |
| Consociate Health | All Products | $1,359.75 | ↓ -89% |
| Aetna | Asa | $1,450.40 | ↓ -89% |
| OPTUM | Managed Medicaid Transplant | $1,546.13 | ↓ -88% |
| CARESOURCE | Managed Medicaid | $1,627.51 | ↓ -87% |
| Multiplan | All Products | $1,631.70 | ↓ -87% |
| MOLINA | Managed Medicaid | $1,708.89 | ↓ -87% |
| UNITED | Managed Medicaid | $1,708.89 | ↓ -87% |
| ANTHEM | Managed Medicaid | $1,708.89 | ↓ -87% |
| United BH | Managed Medicaid | $1,725.16 | ↓ -87% |
| AMERIHEALTH | Managed Medicaid | $1,790.26 | ↓ -86% |
| Aetna | Qhp/Ifp | $1,813.00 | ↓ -86% |
| HUMANA | Medicare Advantage HMO | $2,908.23 | ↓ -78% |
| MMO | Medicare Advantage HMO & PPO | $2,908.23 | ↓ -78% |
| OPTUM | All Products VA | $2,908.23 | ↓ -78% |
| UNITED | MEDICARE ADVANTAGE | $2,908.23 | ↓ -78% |
| Summacare | MEDICARE ADVANTAGE | $2,987.22 | ↓ -77% |
| UPMC | MEDICARE ADVANTAGE | $2,987.22 | ↓ -77% |
| ANTHEM | MEDICARE ADVANTAGE | $2,987.22 | ↓ -77% |
| AETNA | MEDICARE ADVANTAGE | $2,987.22 | ↓ -77% |
| Valor | HMO & PPO | $2,987.22 | ↓ -77% |
| AETNA | International | $3,004.00 | ↓ -77% |
| The Health Plan | MEDICARE ADVANTAGE | $3,010.02 | ↓ -77% |
| CIGNA | MEDICARE ADVANTAGE | $3,076.84 | ↓ -76% |
| Perennial Health | MEDICARE ADVANTAGE | $3,140.89 | ↓ -76% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,226.20 | ↓ -75% |
| PPHP | ALL PRODUCTS | $3,285.94 | ↓ -75% |
| OSCAR | ALL PRODUCTS | $5,118.11 | ↓ -60% |
| PHPHI | ALL PRODUCTS | $5,791.36 | ↓ -55% |
| PHP | ALL PRODUCTS | $5,791.36 | ↓ -55% |
| Summacare | PREMIER | $6,497.18 | ↓ -50% |
| CC EHP | ALL PRODUCTS | $7,329.69 | ↓ -43% |
| MMO | ALL PRODUCTS | $7,689.10 | ↓ -41% |
| UNITED | ALL PRODUCTS | $7,821.00 | ↓ -40% |
| Amish Community Aid Plan | ALL PRODUCTS | $8,144.10 | ↓ -37% |
| AETNA | Acop | $8,566.00 | ↓ -34% |
| OHCP | ALL PRODUCTS | $8,795.63 | ↓ -32% |
| ANTHEM | PPO/HMO | $8,849.94 | ↓ -32% |
| OMAS | ALL PRODUCTS | $9,049.00 | ↓ -30% |
| MMO | TRADITIONAL | $9,429.06 | ↓ -27% |
| Ohio Healthy | TRANSPLANT | $9,772.92 | ↓ -24% |
| AETNA | Asa_Whirlpool_Peia | $9,996.00 | ↓ -23% |
| ANTHEM | TRADITIONAL | $10,008.19 | ↓ -23% |
| OPTUM | All Products Transplant | $10,243.47 | ↓ -21% |
| UPMC | ALL PRODUCTS | $10,858.80 | ↓ -16% |
| The Health Plan | HMO | $10,858.80 | ↓ -16% |
| The Health Plan | ASO Self-Funded | $12,487.62 | ↓ -4% |
| GMS | ALL PRODUCTS | $12,668.60 | ↓ -2% |
| Medical Benefit Corp | Transplant SMCP | $12,668.60 | ↓ -2% |
| AETNA | ALL PRODUCTS | $13,573.50 | ↑ +5% |
| Consociate Health | ALL PRODUCTS | $13,573.50 | ↑ +5% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $14,478.40 | ↑ +12% |
| Tertiary Care Network | TRANSPLANT | $16,288.20 | ↑ +26% |
| MULTIPLAN | ALL PRODUCTS | $16,288.20 | ↑ +26% |
| Managed Care Services | TRANSPLANT | $16,288.20 | ↑ +26% |
| FrontPath | TRANSPLANT | $16,288.20 | ↑ +26% |
| AETNA | Qhp/Ipf | $18,098.00 | ↑ +40% |
| United BH | ALL PRODUCTS | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| United BH | MEDICARE ADVANTAGE | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of heart lining at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $12,942.15 | $1.10 – $16,288.20 |
| avon hospital | Avon | $11,763.70 | $1,398.18 – $16,288.20 |
| euclid hospital | Euclid | $11,763.70 | $831.05 – $16,288.20 |
| fairview hospital | Cleveland | $11,763.70 | $794.04 – $16,288.20 |
| lutheran hospital | Cleveland | $11,763.70 | $794.04 – $16,288.20 |
| hillcrest hospital | Mayfield Heights | $11,763.70 | $794.04 – $16,288.20 |
| marymount hospital | Garfield Heights | $11,763.70 | $794.04 – $16,288.20 |
| medina hospital | Medina | $11,763.70 | $948.78 – $16,288.20 |