healthcosts.net
Biopsy of rectum wall anal approach 45100 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,050.40
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.
?
What you pay up front if you don't use insurance.
$1,616.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1.10 with Zing Health vs $4,793.60 with MMO — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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% |
| Oscar | All Products | $137.21 | ↓ -87% |
| United | Managed Medicaid | $172.23 | ↓ -84% |
| Caresource | Managed Medicaid | $177.40 | ↓ -83% |
| Buckeye | Managed Medicaid | $180.84 | ↓ -83% |
| Summacare | Preferred | $186.44 | ↓ -82% |
| Summacare | Medicare Advantage Lower Level | $186.44 | ↓ -82% |
| AmeriHealth | Managed Medicaid | $189.45 | ↓ -82% |
| Molina | Managed Medicaid | $189.45 | ↓ -82% |
| Aultcare | PPO/HMO | $193.32 | ↓ -82% |
| OHCP | All Products | $210.06 | ↓ -80% |
| Summacare | Medicare Advantage Psych | $218.51 | ↓ -79% |
| Summacare | Medicare Advantage CNA | $243.81 | ↓ -77% |
| OMAS | All Products | $270.00 | ↓ -74% |
| Summacare | Medicare Advantage MD | $272.49 | ↓ -74% |
| Humana | Medicare Advantage HMO | $291.35 | ↓ -72% |
| Anthem | Medicare Advantage | $291.35 | ↓ -72% |
| United | Medicare Advantage | $291.35 | ↓ -72% |
| The Health Plan | Medicare Advantage | $291.35 | ↓ -72% |
| Aetna | Medicare Advantage | $291.35 | ↓ -72% |
| Cigna | Medicare Advantage | $291.35 | ↓ -72% |
| MMO | Medicare HMO & PPO | $300.09 | ↓ -71% |
| CommuniCare | Medicare Advantage | $305.92 | ↓ -71% |
| Summacare | Premier | $305.92 | ↓ -71% |
| Perennial Health | Medicare Advantage | $314.66 | ↓ -70% |
| The Health Plan | All Products PCP | $320.49 | ↓ -69% |
| PHPHI | All Products | $324.00 | ↓ -69% |
| The Health Plan | All Products Specialty Physicians | $335.05 | ↓ -68% |
| GMS | All Products | $378.00 | ↓ -64% |
| MMO | Traditional | $378.00 | ↓ -64% |
| The Health Plan | All Products Radiation Oncology Physicians | $378.76 | ↓ -64% |
| Anthem | All Products Mid-Level Non-Facility | $403.30 | ↓ -62% |
| Aetna | All Products First Health | $405.00 | ↓ -61% |
| Immergrun | All Products | $405.00 | ↓ -61% |
| Aetna | Asa | $432.00 | ↓ -59% |
| Multiplan | All Products | $486.00 | ↓ -54% |
| Aetna | Qhp/Ifp | $540.00 | ↓ -49% |
| United | All Products - Mid-Level | $673.35 | ↓ -36% |
| United | HMO & PPO | $748.17 | ↓ -29% |
| United | All Products | $748.17 | ↓ -29% |
| UNITED | Managed Medicaid | $886.67 | ↓ -16% |
| CARESOURCE | Managed Medicaid | $913.27 | ↓ -13% |
| MOLINA | Managed Medicaid | $931.00 | ↓ -11% |
| ANTHEM | Managed Medicaid | $931.00 | ↓ -11% |
| AMERIHEALTH | Managed Medicaid | $975.34 | ↓ -7% |
| The Health Plan | MEDICARE ADVANTAGE | $2,280.52 | ↑ +117% |
| HUMANA | Medicare Advantage HMO | $2,533.91 | ↑ +141% |
| UNITED | MEDICARE ADVANTAGE | $2,533.91 | ↑ +141% |
| AETNA | MEDICARE ADVANTAGE | $2,625.99 | ↑ +150% |
| ANTHEM | MEDICARE ADVANTAGE | $2,625.99 | ↑ +150% |
| Summacare | MEDICARE ADVANTAGE | $2,625.99 | ↑ +150% |
| CIGNA | MEDICARE ADVANTAGE | $2,704.77 | ↑ +157% |
| Perennial Health | MEDICARE ADVANTAGE | $2,736.63 | ↑ +161% |
| CommuniCare | MEDICARE ADVANTAGE | $2,757.29 | ↑ +162% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $2,836.07 | ↑ +170% |
| MMO | ALL PRODUCTS | $4,249.08 | ↑ +305% |
| MMO | SuperMed | $4,793.60 | ↑ +356% |
| 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 rectum wall anal approach 45100 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $8,199.75 | $1.10 – $11,353.50 |
| akron general | Akron | $1,050.40 | $1.10 – $2,736.63 |
| avon hospital | Avon | not published | $925.74 – $2,888.59 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,511.41 – $1,750.06 |
| euclid hospital | Euclid | not published | $948.45 – $2,888.59 |
| fairview hospital | Cleveland | not published | $891.02 – $2,888.59 |
| lutheran hospital | Cleveland | not published | $848.28 – $2,888.59 |
| hillcrest hospital | Mayfield Heights | not published | $928.31 – $2,888.59 |