healthcosts.net
Partial proctectomy; perineal 45123 at akron general
1 Akron General Avenue, Akron, OH · Cleveland Clinic · · NPI 1821035940
$4,903.60
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.
$7,544.00
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 $7,544.00 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 | $682.57 | ↓ -86% |
| Optum | Managed Medicaid Transplant | $700.64 | ↓ -86% |
| Buckeye | Managed Medicaid | $737.52 | ↓ -85% |
| Summacare | Medicare Advantage Psych | $758.83 | ↓ -85% |
| Caresource | Managed Medicaid | $774.40 | ↓ -84% |
| United | Managed Medicaid | $774.40 | ↓ -84% |
| Molina | Managed Medicaid | $811.27 | ↓ -83% |
| AmeriHealth | Managed Medicaid | $811.27 | ↓ -83% |
| Summacare | Medicare Advantage CNA | $892.59 | ↓ -82% |
| Summacare | Medicare Advantage MD | $997.60 | ↓ -80% |
| Optum | Medicare Advantage Transplant | $1,011.77 | ↓ -79% |
| Aetna | Medicare Advantage | $1,011.77 | ↓ -79% |
| Anthem | Medicare Advantage | $1,011.77 | ↓ -79% |
| Humana | Medicare Advantage HMO | $1,011.77 | ↓ -79% |
| The Health Plan | All Products | $1,011.77 | ↓ -79% |
| The Health Plan | Medicare Advantage | $1,011.77 | ↓ -79% |
| United | Medicare Advantage | $1,011.77 | ↓ -79% |
| Valor | All Products | $1,011.77 | ↓ -79% |
| CommuniCare | Medicare Advantage | $1,062.36 | ↓ -78% |
| PPHP | All Products | $1,112.95 | ↓ -77% |
| OPTUM | Managed Medicaid Transplant | $1,457.88 | ↓ -70% |
| Anthem | All Products Mid-Level Non-Facility | $1,495.12 | ↓ -70% |
| Anthem | All Products Mid-Level Facility | $1,495.12 | ↓ -70% |
| CARESOURCE | Managed Medicaid | $1,534.61 | ↓ -69% |
| UNITED | Managed Medicaid | $1,611.34 | ↓ -67% |
| ANTHEM | Managed Medicaid | $1,611.34 | ↓ -67% |
| MOLINA | Managed Medicaid | $1,611.34 | ↓ -67% |
| United BH | Managed Medicaid | $1,626.69 | ↓ -67% |
| AMERIHEALTH | Managed Medicaid | $1,688.07 | ↓ -66% |
| MMO | SuperMed | $1,897.73 | ↓ -61% |
| MMO | NASCO | $1,897.73 | ↓ -61% |
| MMO | Medicare HMO & PPO | $1,902.77 | ↓ -61% |
| Oscar | All Products | $1,916.93 | ↓ -61% |
| Summacare | Preferred | $2,064.01 | ↓ -58% |
| Summacare | Premier | $2,142.20 | ↓ -56% |
| United | HMO & PPO | $2,744.46 | ↓ -44% |
| OHCP | All Products | $2,934.62 | ↓ -40% |
| United | All Products - Mid-Level | $3,015.68 | ↓ -39% |
| United | All Products | $3,250.31 | ↓ -34% |
| Aultcare | PPO/HMO | $3,726.74 | ↓ -24% |
| OMAS | All Products | $3,772.00 | ↓ -23% |
| Anthem | All Products Physician | $3,797.31 | ↓ -23% |
| Anthem | All Products Physician Non-Facility | $3,797.31 | ↓ -23% |
| Anthem | All Products Physician Facility | $3,797.31 | ↓ -23% |
| Optum | All Products Transplant | $4,398.15 | ↓ -10% |
| PHPHI | All Products | $4,526.40 | ↓ -8% |
| GMS | All Products | $5,280.80 | ↑ +8% |
| MMO | Traditional | $5,280.80 | ↑ +8% |
| Aetna | All Products First Health | $5,658.00 | ↑ +15% |
| Consociate Health | All Products | $5,658.00 | ↑ +15% |
| Aetna | Asa | $6,035.20 | ↑ +23% |
| Multiplan | All Products | $6,789.60 | ↑ +38% |
| Aetna | Qhp/Ifp | $7,544.00 | ↑ +54% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
Visitor-reported prices
Comments
Partial proctectomy; perineal 45123 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,903.60 | $1.10 – $6,789.60 |
| mercy hospital | Canton | $4,903.60 | $1.10 – $6,789.60 |
| avon hospital | Avon | not published | $1,563.54 – $1,593.33 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $2,552.71 – $2,955.77 |
| euclid hospital | Euclid | not published | $1,601.90 – $1,854.83 |
| fairview hospital | Cleveland | not published | $1,504.90 – $1,742.52 |
| lutheran hospital | Cleveland | not published | $1,432.71 – $1,658.93 |
| hillcrest hospital | Mayfield Heights | not published | $1,567.87 – $1,815.43 |