healthcosts.net
Biopsy forearm soft tissues at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,110.20
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.
$1,708.00
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% |
| Summacare | Preferred | $230.75 | ↓ -79% |
| Summacare | Medicare Advantage Lower Level | $230.75 | ↓ -79% |
| United | Managed Medicaid | $252.96 | ↓ -77% |
| Oscar | All Products | $253.85 | ↓ -77% |
| Summacare | Medicare Advantage Psych | $257.71 | ↓ -77% |
| Caresource | Managed Medicaid | $260.55 | ↓ -77% |
| Buckeye | Managed Medicaid | $265.61 | ↓ -76% |
| AmeriHealth | Managed Medicaid | $278.26 | ↓ -75% |
| Molina | Managed Medicaid | $278.26 | ↓ -75% |
| Summacare | Medicare Advantage CNA | $301.75 | ↓ -73% |
| Summacare | Medicare Advantage MD | $337.25 | ↓ -70% |
| Humana | Medicare Advantage HMO | $343.61 | ↓ -69% |
| United | Medicare Advantage | $343.61 | ↓ -69% |
| Aetna | Medicare Advantage | $343.61 | ↓ -69% |
| Anthem | Medicare Advantage | $343.61 | ↓ -69% |
| Cigna | Medicare Advantage | $343.61 | ↓ -69% |
| The Health Plan | Medicare Advantage | $343.61 | ↓ -69% |
| MMO | Medicare HMO & PPO | $353.92 | ↓ -68% |
| Aultcare | PPO/HMO | $357.64 | ↓ -68% |
| Summacare | Premier | $360.79 | ↓ -68% |
| CommuniCare | Medicare Advantage | $360.79 | ↓ -68% |
| Perennial Health | Medicare Advantage | $371.10 | ↓ -67% |
| The Health Plan | All Products PCP | $377.97 | ↓ -66% |
| OHCP | All Products | $388.61 | ↓ -65% |
| The Health Plan | All Products Specialty Physicians | $395.15 | ↓ -64% |
| The Health Plan | All Products Radiation Oncology Physicians | $446.69 | ↓ -60% |
| Anthem | All Products Mid-Level Non-Facility | $491.82 | ↓ -56% |
| OMAS | All Products | $499.50 | ↓ -55% |
| PHPHI | All Products | $599.40 | ↓ -46% |
| GMS | All Products | $699.30 | ↓ -37% |
| MMO | Traditional | $699.30 | ↓ -37% |
| Immergrun | All Products | $749.25 | ↓ -33% |
| Aetna | All Products First Health | $749.25 | ↓ -33% |
| Aetna | Asa | $799.20 | ↓ -28% |
| United | All Products - Mid-Level | $821.72 | ↓ -26% |
| Multiplan | All Products | $899.10 | ↓ -19% |
| United | All Products | $913.03 | ↓ -18% |
| United | HMO & PPO | $913.03 | ↓ -18% |
| Aetna | Qhp/Ifp | $999.00 | ↓ -10% |
| UNITED | Managed Medicaid | $1,007.73 | ↓ -9% |
| CARESOURCE | Managed Medicaid | $1,037.96 | ↓ -7% |
| ANTHEM | Managed Medicaid | $1,058.12 | ↓ -5% |
| MOLINA | Managed Medicaid | $1,058.12 | ↓ -5% |
| AMERIHEALTH | Managed Medicaid | $1,108.50 | ↓ -0% |
| The Health Plan | MEDICARE ADVANTAGE | $2,380.03 | ↑ +114% |
| HUMANA | Medicare Advantage HMO | $2,644.48 | ↑ +138% |
| UNITED | MEDICARE ADVANTAGE | $2,644.48 | ↑ +138% |
| Summacare | MEDICARE ADVANTAGE | $2,748.08 | ↑ +148% |
| AETNA | MEDICARE ADVANTAGE | $2,748.08 | ↑ +148% |
| ANTHEM | MEDICARE ADVANTAGE | $2,748.08 | ↑ +148% |
| CIGNA | MEDICARE ADVANTAGE | $2,830.53 | ↑ +155% |
| Perennial Health | MEDICARE ADVANTAGE | $2,856.04 | ↑ +157% |
| CommuniCare | MEDICARE ADVANTAGE | $2,885.49 | ↑ +160% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $2,967.93 | ↑ +167% |
| MMO | ALL PRODUCTS | $4,300.08 | ↑ +287% |
| MMO | SuperMed | $4,850.94 | ↑ +337% |
| Aetna | Acop | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy forearm soft tissues at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,110.20 | $1.10 – $2,748.08 |
| akron general | Akron | $1,110.20 | $1.10 – $2,856.04 |
| avon hospital | Avon | not published | $1,052.14 – $3,022.89 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,717.77 – $1,989.00 |
| euclid hospital | Euclid | not published | $1,077.95 – $3,022.89 |
| fairview hospital | Cleveland | not published | $1,012.67 – $3,022.89 |
| lutheran hospital | Cleveland | not published | $964.10 – $3,022.89 |
| hillcrest hospital | Mayfield Heights | not published | $1,055.05 – $3,022.89 |