healthcosts.net
Biopsy of hip joint at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,929.20
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.
$2,968.00
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 $2,968.00 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 | Preferred | $360.45 | ↓ -81% |
| Summacare | Medicare Advantage Lower Level | $360.45 | ↓ -81% |
| United | Managed Medicaid | $395.81 | ↓ -79% |
| Summacare | Medicare Advantage Psych | $402.43 | ↓ -79% |
| Caresource | Managed Medicaid | $407.68 | ↓ -79% |
| Buckeye | Managed Medicaid | $415.60 | ↓ -78% |
| AmeriHealth | Managed Medicaid | $435.39 | ↓ -77% |
| Molina | Managed Medicaid | $435.39 | ↓ -77% |
| Summacare | Medicare Advantage CNA | $471.36 | ↓ -76% |
| Summacare | Medicare Advantage MD | $526.81 | ↓ -73% |
| United | Medicare Advantage | $536.57 | ↓ -72% |
| Humana | Medicare Advantage HMO | $536.57 | ↓ -72% |
| The Health Plan | Medicare Advantage | $536.57 | ↓ -72% |
| Aetna | Medicare Advantage | $536.57 | ↓ -72% |
| Cigna | Medicare Advantage | $536.57 | ↓ -72% |
| Anthem | Medicare Advantage | $536.57 | ↓ -72% |
| MMO | Medicare HMO & PPO | $552.67 | ↓ -71% |
| Summacare | Premier | $563.40 | ↓ -71% |
| CommuniCare | Medicare Advantage | $563.40 | ↓ -71% |
| Perennial Health | Medicare Advantage | $579.50 | ↓ -70% |
| The Health Plan | All Products PCP | $590.23 | ↓ -69% |
| The Health Plan | All Products Specialty Physicians | $617.06 | ↓ -68% |
| The Health Plan | All Products Radiation Oncology Physicians | $697.54 | ↓ -64% |
| Oscar | All Products | $754.17 | ↓ -61% |
| Anthem | All Products Mid-Level Non-Facility | $776.31 | ↓ -60% |
| Aultcare | PPO/HMO | $1,062.54 | ↓ -45% |
| OHCP | All Products | $1,154.55 | ↓ -40% |
| United | All Products - Mid-Level | $1,297.25 | ↓ -33% |
| The Health Plan | MEDICARE ADVANTAGE | $1,330.87 | ↓ -31% |
| United | All Products | $1,441.39 | ↓ -25% |
| United | HMO & PPO | $1,441.39 | ↓ -25% |
| UNITED | MEDICARE ADVANTAGE | $1,478.75 | ↓ -23% |
| HUMANA | Medicare Advantage HMO | $1,478.75 | ↓ -23% |
| OMAS | All Products | $1,484.00 | ↓ -23% |
| Summacare | MEDICARE ADVANTAGE | $1,521.28 | ↓ -21% |
| ANTHEM | MEDICARE ADVANTAGE | $1,521.28 | ↓ -21% |
| AETNA | MEDICARE ADVANTAGE | $1,521.28 | ↓ -21% |
| CIGNA | MEDICARE ADVANTAGE | $1,566.92 | ↓ -19% |
| Perennial Health | MEDICARE ADVANTAGE | $1,597.05 | ↓ -17% |
| CommuniCare | MEDICARE ADVANTAGE | $1,597.35 | ↓ -17% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,642.99 | ↓ -15% |
| PHPHI | All Products | $1,780.80 | ↓ -8% |
| MMO | Traditional | $2,077.60 | ↑ +8% |
| GMS | All Products | $2,077.60 | ↑ +8% |
| Immergrun | All Products | $2,226.00 | ↑ +15% |
| Aetna | All Products First Health | $2,226.00 | ↑ +15% |
| Aetna | Asa | $2,374.40 | ↑ +23% |
| MMO | ALL PRODUCTS | $2,432.21 | ↑ +26% |
| UNITED | Managed Medicaid | $2,501.35 | ↑ +30% |
| CARESOURCE | Managed Medicaid | $2,576.39 | ↑ +34% |
| ANTHEM | Managed Medicaid | $2,626.42 | ↑ +36% |
| MOLINA | Managed Medicaid | $2,626.42 | ↑ +36% |
| Multiplan | All Products | $2,671.20 | ↑ +38% |
| MMO | SuperMed | $2,743.55 | ↑ +42% |
| AMERIHEALTH | Managed Medicaid | $2,751.49 | ↑ +43% |
| Aetna | Qhp/Ifp | $2,968.00 | ↑ +54% |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of hip joint at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,929.20 | $1.10 – $3,552.11 |
| akron general | Akron | $1,929.20 | $1.10 – $2,819.58 |
| avon hospital | Avon | not published | $1,483.64 – $2,661.33 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $4,263.77 – $4,937.00 |
| euclid hospital | Euclid | not published | $1,394.34 – $3,098.11 |
| fairview hospital | Cleveland | not published | $1,394.34 – $2,910.51 |
| lutheran hospital | Cleveland | not published | $1,483.64 – $2,770.90 |
| hillcrest hospital | Mayfield Heights | not published | $1,394.34 – $3,032.29 |