healthcosts.net
Biopsy of nail unit 11755 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$325.00
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.
$500.00
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 Lower Level | $37.26 | ↓ -89% |
| Summacare | Preferred | $37.26 | ↓ -89% |
| Summacare | Medicare Advantage Psych | $40.40 | ↓ -88% |
| Summacare | Medicare Advantage CNA | $48.73 | ↓ -85% |
| United | Managed Medicaid | $50.44 | ↓ -84% |
| Caresource | Managed Medicaid | $51.95 | ↓ -84% |
| Buckeye | Managed Medicaid | $52.96 | ↓ -84% |
| Oscar | All Products | $53.36 | ↓ -84% |
| Aetna | Medicare Advantage | $53.87 | ↓ -83% |
| The Health Plan | Medicare Advantage | $53.87 | ↓ -83% |
| Anthem | Medicare Advantage | $53.87 | ↓ -83% |
| Humana | Medicare Advantage HMO | $53.87 | ↓ -83% |
| Cigna | Medicare Advantage | $53.87 | ↓ -83% |
| United | Medicare Advantage | $53.87 | ↓ -83% |
| Summacare | Medicare Advantage MD | $54.46 | ↓ -83% |
| AmeriHealth | Managed Medicaid | $55.48 | ↓ -83% |
| Molina | Managed Medicaid | $55.48 | ↓ -83% |
| MMO | Medicare HMO & PPO | $55.49 | ↓ -83% |
| CommuniCare | Medicare Advantage | $56.56 | ↓ -83% |
| Summacare | Premier | $56.56 | ↓ -83% |
| The Health Plan | PPO | $57.64 | ↓ -82% |
| Perennial Health | Medicare Advantage | $58.18 | ↓ -82% |
| The Health Plan | All Products PCP | $59.26 | ↓ -82% |
| The Health Plan | All Products Specialty Physicians | $61.95 | ↓ -81% |
| The Health Plan | All Products Radiation Oncology Physicians | $70.03 | ↓ -78% |
| Aultcare | PPO/HMO | $75.18 | ↓ -77% |
| OHCP | All Products | $81.69 | ↓ -75% |
| OMAS | All Products | $105.00 | ↓ -68% |
| PHPHI | All Products | $126.00 | ↓ -61% |
| MMO | Traditional | $147.00 | ↓ -55% |
| GMS | All Products | $147.00 | ↓ -55% |
| Cigna | All Products Mid-Level | $149.66 | ↓ -54% |
| Aetna | All Products First Health | $157.50 | ↓ -52% |
| Immergrun | All Products | $157.50 | ↓ -52% |
| Anthem | All Products Mid-Level Non-Facility | $160.06 | ↓ -51% |
| Aetna | Acop | $166.18 | ↓ -49% |
| Aetna | Asa | $168.00 | ↓ -48% |
| Cigna | All Products Physician | $176.84 | ↓ -46% |
| Multiplan | All Products | $189.00 | ↓ -42% |
| Aetna | Qhp/Ifp | $210.00 | ↓ -35% |
| United | All Products - Mid-Level | $264.84 | ↓ -19% |
| United | HMO & PPO | $294.27 | ↓ -9% |
| United | All Products | $294.27 | ↓ -9% |
| UNITED | Managed Medicaid | $317.47 | ↓ -2% |
| CARESOURCE | Managed Medicaid | $326.99 | ↑ +1% |
| ANTHEM | Managed Medicaid | $333.34 | ↑ +3% |
| MOLINA | Managed Medicaid | $333.34 | ↑ +3% |
| AMERIHEALTH | Managed Medicaid | $349.22 | ↑ +7% |
| The Health Plan | MEDICARE ADVANTAGE | $585.09 | ↑ +80% |
| UNITED | MEDICARE ADVANTAGE | $650.10 | ↑ +100% |
| HUMANA | Medicare Advantage HMO | $650.10 | ↑ +100% |
| AETNA | MEDICARE ADVANTAGE | $669.95 | ↑ +106% |
| Summacare | MEDICARE ADVANTAGE | $669.95 | ↑ +106% |
| ANTHEM | MEDICARE ADVANTAGE | $669.95 | ↑ +106% |
| CIGNA | MEDICARE ADVANTAGE | $690.05 | ↑ +112% |
| Perennial Health | MEDICARE ADVANTAGE | $702.11 | ↑ +116% |
| CommuniCare | MEDICARE ADVANTAGE | $703.45 | ↑ +116% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $723.54 | ↑ +123% |
| MMO | ALL PRODUCTS | $1,064.73 | ↑ +228% |
| MMO | SuperMed | $1,200.64 | ↑ +269% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +392653% |
| The Health Plan | POS | $4,036,081.00 | ↑ +1241771% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of nail unit 11755 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,372.15 | $0.01 – $1,899.90 |
| akron general | Akron | $1,372.15 | $0.01 – $1,899.90 |
| avon hospital | Avon | not published | $331.46 – $736.94 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $541.16 – $626.60 |
| euclid hospital | Euclid | not published | $339.59 – $736.94 |
| fairview hospital | Cleveland | not published | $319.03 – $736.94 |
| lutheran hospital | Cleveland | not published | $303.72 – $736.94 |
| hillcrest hospital | Mayfield Heights | not published | $332.38 – $736.94 |