healthcosts.net
Biopsy of lip 40490 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$317.20
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.
$488.00
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 $4,036,081.00 with The Health Plan — 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 Psych | $41.51 | ↓ -87% |
| Summacare | Medicare Advantage Lower Level | $42.46 | ↓ -87% |
| Summacare | Preferred | $42.46 | ↓ -87% |
| The Health Plan | Medicare Advantage | $55.35 | ↓ -83% |
| United | Medicare Advantage | $55.35 | ↓ -83% |
| Aetna | Medicare Advantage | $55.35 | ↓ -83% |
| Humana | Medicare Advantage HMO | $55.35 | ↓ -83% |
| Anthem | Medicare Advantage | $55.35 | ↓ -83% |
| Cigna | Medicare Advantage | $55.35 | ↓ -83% |
| Summacare | Medicare Advantage CNA | $55.52 | ↓ -82% |
| MMO | Medicare HMO & PPO | $57.01 | ↓ -82% |
| CommuniCare | Medicare Advantage | $58.12 | ↓ -82% |
| Summacare | Premier | $58.12 | ↓ -82% |
| The Health Plan | PPO | $59.22 | ↓ -81% |
| Perennial Health | Medicare Advantage | $59.78 | ↓ -81% |
| The Health Plan | All Products PCP | $60.89 | ↓ -81% |
| Summacare | Medicare Advantage MD | $62.05 | ↓ -80% |
| United | Managed Medicaid | $63.27 | ↓ -80% |
| The Health Plan | All Products Specialty Physicians | $63.65 | ↓ -80% |
| Caresource | Managed Medicaid | $65.17 | ↓ -79% |
| Buckeye | Managed Medicaid | $66.43 | ↓ -79% |
| AmeriHealth | Managed Medicaid | $69.60 | ↓ -78% |
| Molina | Managed Medicaid | $69.60 | ↓ -78% |
| The Health Plan | All Products Radiation Oncology Physicians | $71.96 | ↓ -77% |
| UNITED | Managed Medicaid | $87.77 | ↓ -72% |
| CARESOURCE | Managed Medicaid | $90.40 | ↓ -72% |
| MOLINA | Managed Medicaid | $92.16 | ↓ -71% |
| ANTHEM | Managed Medicaid | $92.16 | ↓ -71% |
| AMERIHEALTH | Managed Medicaid | $96.55 | ↓ -70% |
| Oscar | All Products | $124.00 | ↓ -61% |
| Cigna | All Products Mid-Level | $150.07 | ↓ -53% |
| Anthem | All Products Mid-Level Non-Facility | $160.51 | ↓ -49% |
| Aetna | Acop | $171.96 | ↓ -46% |
| Aultcare | PPO/HMO | $174.70 | ↓ -45% |
| Cigna | All Products Physician | $177.33 | ↓ -44% |
| OHCP | All Products | $189.83 | ↓ -40% |
| The Health Plan | MEDICARE ADVANTAGE | $193.11 | ↓ -39% |
| UNITED | MEDICARE ADVANTAGE | $214.57 | ↓ -32% |
| HUMANA | Medicare Advantage HMO | $214.57 | ↓ -32% |
| ANTHEM | MEDICARE ADVANTAGE | $224.08 | ↓ -29% |
| AETNA | MEDICARE ADVANTAGE | $224.08 | ↓ -29% |
| Summacare | MEDICARE ADVANTAGE | $224.08 | ↓ -29% |
| CIGNA | MEDICARE ADVANTAGE | $230.80 | ↓ -27% |
| Perennial Health | MEDICARE ADVANTAGE | $231.73 | ↓ -27% |
| CommuniCare | MEDICARE ADVANTAGE | $235.28 | ↓ -26% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $242.00 | ↓ -24% |
| OMAS | All Products | $244.00 | ↓ -23% |
| United | All Products - Mid-Level | $265.62 | ↓ -16% |
| PHPHI | All Products | $292.80 | ↓ -8% |
| United | HMO & PPO | $295.14 | ↓ -7% |
| United | All Products | $295.14 | ↓ -7% |
| GMS | All Products | $341.60 | ↑ +8% |
| MMO | Traditional | $341.60 | ↑ +8% |
| Immergrun | All Products | $366.00 | ↑ +15% |
| Aetna | All Products First Health | $366.00 | ↑ +15% |
| MMO | ALL PRODUCTS | $369.64 | ↑ +17% |
| Aetna | Asa | $390.40 | ↑ +23% |
| MMO | SuperMed | $417.54 | ↑ +32% |
| Multiplan | All Products | $439.20 | ↑ +38% |
| Aetna | Qhp/Ifp | $488.00 | ↑ +54% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +402311% |
| The Health Plan | POS | $4,036,081.00 | ↑ +1272309% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $694.20 | $0.01 – $961.20 |
| akron general | Akron | $317.20 | $1.10 – $439.20 |
| University Hospitals Cleveland Medical Center | Cleveland OH 44106|3999 Richmond Road | $479.25 | $224.08 – $403.34 |
| avon hospital | Avon | not published | $91.63 – $246.49 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $149.62 – $173.24 |
| euclid hospital | Euclid | not published | $93.89 – $246.49 |
| fairview hospital | Cleveland | not published | $88.20 – $246.49 |
| lutheran hospital | Cleveland | not published | $83.97 – $246.49 |