healthcosts.net
Excision addl breast lesion 19126 at akron general
1 Akron General Avenue, Akron, OH · Cleveland Clinic · · NPI 1821035940
$761.80
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.
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What you pay up front if you don't use insurance.
$1,172.00
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.
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The hospital's undiscounted list price — almost no one pays this.
$1.10 with Zing Health vs $1,172.00 with Aetna — same scan, same building. Share
Negotiated rates by payer
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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 →
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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 | $98.88 | ↓ -87% |
| Summacare | Medicare Advantage Psych | $107.08 | ↓ -86% |
| Optum | Managed Medicaid Transplant | $118.48 | ↓ -84% |
| Buckeye | Managed Medicaid | $124.72 | ↓ -84% |
| Summacare | Medicare Advantage CNA | $129.31 | ↓ -83% |
| Caresource | Managed Medicaid | $130.96 | ↓ -83% |
| United | Managed Medicaid | $130.96 | ↓ -83% |
| AmeriHealth | Managed Medicaid | $137.19 | ↓ -82% |
| Molina | Managed Medicaid | $137.19 | ↓ -82% |
| Aetna | Medicare Advantage | $142.77 | ↓ -81% |
| Optum | Medicare Advantage Transplant | $142.77 | ↓ -81% |
| Anthem | Medicare Advantage | $142.77 | ↓ -81% |
| United | Medicare Advantage | $142.77 | ↓ -81% |
| Valor | All Products | $142.77 | ↓ -81% |
| The Health Plan | All Products | $142.77 | ↓ -81% |
| Humana | Medicare Advantage HMO | $142.77 | ↓ -81% |
| The Health Plan | Medicare Advantage | $142.77 | ↓ -81% |
| Summacare | Medicare Advantage MD | $144.52 | ↓ -81% |
| CommuniCare | Medicare Advantage | $149.91 | ↓ -80% |
| PPHP | All Products | $157.05 | ↓ -79% |
| Anthem | All Products Mid-Level Non-Facility | $216.61 | ↓ -72% |
| Anthem | All Products Mid-Level Facility | $216.61 | ↓ -72% |
| MMO | Medicare HMO & PPO | $282.30 | ↓ -63% |
| Summacare | Preferred | $291.25 | ↓ -62% |
| Oscar | All Products | $297.81 | ↓ -61% |
| Summacare | Premier | $310.35 | ↓ -59% |
| United | HMO & PPO | $398.67 | ↓ -48% |
| United | All Products - Mid-Level | $438.06 | ↓ -42% |
| OHCP | All Products | $455.91 | ↓ -40% |
| United | All Products | $472.15 | ↓ -38% |
| Anthem | All Products Physician Non-Facility | $550.14 | ↓ -28% |
| Anthem | All Products Physician Facility | $550.14 | ↓ -28% |
| Anthem | All Products Physician | $550.14 | ↓ -28% |
| Aultcare | PPO/HMO | $578.97 | ↓ -24% |
| OMAS | All Products | $586.00 | ↓ -23% |
| MMO | NASCO | $632.88 | ↓ -17% |
| MMO | SuperMed | $632.88 | ↓ -17% |
| Optum | All Products Transplant | $683.28 | ↓ -10% |
| PHPHI | All Products | $703.20 | ↓ -8% |
| OPTUM | Managed Medicaid Transplant | $819.01 | ↑ +8% |
| MMO | Traditional | $820.40 | ↑ +8% |
| GMS | All Products | $820.40 | ↑ +8% |
| CARESOURCE | Managed Medicaid | $862.12 | ↑ +13% |
| Aetna | All Products First Health | $879.00 | ↑ +15% |
| Consociate Health | All Products | $879.00 | ↑ +15% |
| UNITED | Managed Medicaid | $905.23 | ↑ +19% |
| MOLINA | Managed Medicaid | $905.23 | ↑ +19% |
| ANTHEM | Managed Medicaid | $905.23 | ↑ +19% |
| United BH | Managed Medicaid | $913.85 | ↑ +20% |
| Aetna | Asa | $937.60 | ↑ +23% |
| AMERIHEALTH | Managed Medicaid | $948.33 | ↑ +24% |
| Multiplan | All Products | $1,054.80 | ↑ +38% |
| Aetna | Qhp/Ifp | $1,172.00 | ↑ +54% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
Visitor-reported prices
Comments
Excision addl breast lesion 19126 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $761.80 | $1.10 – $1,194.71 |
| mercy hospital | Canton | $761.80 | $1.10 – $1,054.80 |
| avon hospital | Avon | not published | $878.38 – $895.11 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,434.07 – $1,660.51 |
| euclid hospital | Euclid | not published | $899.92 – $1,042.01 |
| fairview hospital | Cleveland | not published | $845.42 – $978.91 |
| lutheran hospital | Cleveland | not published | $804.88 – $931.96 |
| hillcrest hospital | Mayfield Heights | not published | $880.80 – $1,019.88 |