healthcosts.net
Biopsy arm/elbow soft tissue at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,391.00
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.
$2,140.00
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 $4,850.94 with MMO — 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% |
| United | Managed Medicaid | $216.12 | ↓ -84% |
| Caresource | Managed Medicaid | $222.60 | ↓ -84% |
| Buckeye | Managed Medicaid | $226.93 | ↓ -84% |
| AmeriHealth | Managed Medicaid | $237.73 | ↓ -83% |
| Molina | Managed Medicaid | $237.73 | ↓ -83% |
| Oscar | All Products | $255.12 | ↓ -82% |
| Summacare | Preferred | $263.91 | ↓ -81% |
| Summacare | Medicare Advantage Lower Level | $263.91 | ↓ -81% |
| Summacare | Medicare Advantage Psych | $300.47 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $345.11 | ↓ -75% |
| Aultcare | PPO/HMO | $359.43 | ↓ -74% |
| Summacare | Medicare Advantage MD | $385.71 | ↓ -72% |
| OHCP | All Products | $390.56 | ↓ -72% |
| Anthem | Medicare Advantage | $400.63 | ↓ -71% |
| United | Medicare Advantage | $400.63 | ↓ -71% |
| The Health Plan | Medicare Advantage | $400.63 | ↓ -71% |
| Humana | Medicare Advantage HMO | $400.63 | ↓ -71% |
| Cigna | Medicare Advantage | $400.63 | ↓ -71% |
| Aetna | Medicare Advantage | $400.63 | ↓ -71% |
| MMO | Medicare HMO & PPO | $412.65 | ↓ -70% |
| CommuniCare | Medicare Advantage | $420.66 | ↓ -70% |
| Summacare | Premier | $420.66 | ↓ -70% |
| Perennial Health | Medicare Advantage | $432.68 | ↓ -69% |
| The Health Plan | All Products PCP | $440.69 | ↓ -68% |
| The Health Plan | All Products Specialty Physicians | $460.72 | ↓ -67% |
| OMAS | All Products | $502.00 | ↓ -64% |
| The Health Plan | All Products Radiation Oncology Physicians | $520.82 | ↓ -63% |
| PHPHI | All Products | $602.40 | ↓ -57% |
| MMO | Traditional | $702.80 | ↓ -49% |
| GMS | All Products | $702.80 | ↓ -49% |
| Immergrun | All Products | $753.00 | ↓ -46% |
| Aetna | All Products First Health | $753.00 | ↓ -46% |
| Cigna | All Products Mid-Level | $768.21 | ↓ -45% |
| Aetna | Asa | $803.20 | ↓ -42% |
| Anthem | All Products Mid-Level Non-Facility | $821.61 | ↓ -41% |
| Aetna | Acop | $863.18 | ↓ -38% |
| Multiplan | All Products | $903.60 | ↓ -35% |
| Cigna | All Products Physician | $907.72 | ↓ -35% |
| Aetna | Qhp/Ifp | $1,004.00 | ↓ -28% |
| UNITED | Managed Medicaid | $1,101.77 | ↓ -21% |
| CARESOURCE | Managed Medicaid | $1,134.82 | ↓ -18% |
| MOLINA | Managed Medicaid | $1,156.86 | ↓ -17% |
| ANTHEM | Managed Medicaid | $1,156.86 | ↓ -17% |
| AMERIHEALTH | Managed Medicaid | $1,211.95 | ↓ -13% |
| United | All Products - Mid-Level | $1,368.03 | ↓ -2% |
| United | HMO & PPO | $1,520.03 | ↑ +9% |
| United | All Products | $1,520.03 | ↑ +9% |
| The Health Plan | MEDICARE ADVANTAGE | $2,380.03 | ↑ +71% |
| HUMANA | Medicare Advantage HMO | $2,644.48 | ↑ +90% |
| UNITED | MEDICARE ADVANTAGE | $2,644.48 | ↑ +90% |
| ANTHEM | MEDICARE ADVANTAGE | $2,748.08 | ↑ +98% |
| Summacare | MEDICARE ADVANTAGE | $2,748.08 | ↑ +98% |
| AETNA | MEDICARE ADVANTAGE | $2,748.08 | ↑ +98% |
| CIGNA | MEDICARE ADVANTAGE | $2,830.53 | ↑ +103% |
| Perennial Health | MEDICARE ADVANTAGE | $2,856.04 | ↑ +105% |
| CommuniCare | MEDICARE ADVANTAGE | $2,885.49 | ↑ +107% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $2,967.93 | ↑ +113% |
| MMO | ALL PRODUCTS | $4,300.08 | ↑ +209% |
| MMO | SuperMed | $4,850.94 | ↑ +249% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy arm/elbow soft tissue at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $8,557.25 | $0.01 – $11,848.50 |
| akron general | Akron | $1,391.00 | $1.10 – $2,856.04 |
| avon hospital | Avon | not published | $1,150.32 – $3,022.89 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,878.06 – $2,174.60 |
| euclid hospital | Euclid | not published | $1,178.53 – $3,022.89 |
| fairview hospital | Cleveland | not published | $1,107.18 – $3,022.89 |
| lutheran hospital | Cleveland | not published | $1,054.06 – $3,022.89 |
| hillcrest hospital | Mayfield Heights | not published | $1,153.50 – $3,022.89 |