healthcosts.net
Biopsy of salivary glnd;incisional 42405 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$868.40
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.
$1,336.00
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 $2,603.78 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% |
| Summacare | Preferred | $139.48 | ↓ -84% |
| Summacare | Medicare Advantage Lower Level | $139.48 | ↓ -84% |
| United | Managed Medicaid | $144.22 | ↓ -83% |
| Summacare | Medicare Advantage Psych | $147.30 | ↓ -83% |
| Caresource | Managed Medicaid | $148.55 | ↓ -83% |
| Buckeye | Managed Medicaid | $151.43 | ↓ -83% |
| AmeriHealth | Managed Medicaid | $158.64 | ↓ -82% |
| Molina | Managed Medicaid | $158.64 | ↓ -82% |
| Summacare | Medicare Advantage CNA | $182.39 | ↓ -79% |
| Anthem | Medicare Advantage | $196.40 | ↓ -77% |
| United | Medicare Advantage | $196.40 | ↓ -77% |
| Aetna | Medicare Advantage | $196.40 | ↓ -77% |
| Humana | Medicare Advantage HMO | $196.40 | ↓ -77% |
| Cigna | Medicare Advantage | $196.40 | ↓ -77% |
| The Health Plan | Medicare Advantage | $196.40 | ↓ -77% |
| MMO | Medicare HMO & PPO | $202.29 | ↓ -77% |
| Summacare | Medicare Advantage MD | $203.85 | ↓ -77% |
| Summacare | Premier | $206.22 | ↓ -76% |
| CommuniCare | Medicare Advantage | $206.22 | ↓ -76% |
| Perennial Health | Medicare Advantage | $212.11 | ↓ -76% |
| The Health Plan | All Products PCP | $216.04 | ↓ -75% |
| The Health Plan | All Products Specialty Physicians | $225.86 | ↓ -74% |
| The Health Plan | All Products Radiation Oncology Physicians | $255.32 | ↓ -71% |
| Oscar | All Products | $339.48 | ↓ -61% |
| Cigna | All Products Mid-Level | $376.54 | ↓ -57% |
| Anthem | All Products Mid-Level Non-Facility | $402.71 | ↓ -54% |
| Aetna | Acop | $413.55 | ↓ -52% |
| Cigna | All Products Physician | $444.92 | ↓ -49% |
| Aultcare | PPO/HMO | $478.29 | ↓ -45% |
| OHCP | All Products | $519.70 | ↓ -40% |
| OMAS | All Products | $668.00 | ↓ -23% |
| United | All Products - Mid-Level | $668.07 | ↓ -23% |
| United | HMO & PPO | $742.31 | ↓ -15% |
| United | All Products | $742.31 | ↓ -15% |
| PHPHI | All Products | $801.60 | ↓ -8% |
| MMO | Traditional | $935.20 | ↑ +8% |
| GMS | All Products | $935.20 | ↑ +8% |
| Aetna | All Products First Health | $1,002.00 | ↑ +15% |
| Immergrun | All Products | $1,002.00 | ↑ +15% |
| Aetna | Asa | $1,068.80 | ↑ +23% |
| Multiplan | All Products | $1,202.40 | ↑ +38% |
| The Health Plan | MEDICARE ADVANTAGE | $1,231.81 | ↑ +42% |
| Aetna | Qhp/Ifp | $1,336.00 | ↑ +54% |
| UNITED | MEDICARE ADVANTAGE | $1,368.67 | ↑ +58% |
| HUMANA | Medicare Advantage HMO | $1,368.67 | ↑ +58% |
| UNITED | Managed Medicaid | $1,430.00 | ↑ +65% |
| Summacare | MEDICARE ADVANTAGE | $1,467.92 | ↑ +69% |
| ANTHEM | MEDICARE ADVANTAGE | $1,467.92 | ↑ +69% |
| AETNA | MEDICARE ADVANTAGE | $1,467.92 | ↑ +69% |
| CARESOURCE | Managed Medicaid | $1,472.90 | ↑ +70% |
| Perennial Health | MEDICARE ADVANTAGE | $1,478.17 | ↑ +70% |
| MOLINA | Managed Medicaid | $1,501.50 | ↑ +73% |
| ANTHEM | Managed Medicaid | $1,501.50 | ↑ +73% |
| CIGNA | MEDICARE ADVANTAGE | $1,511.96 | ↑ +74% |
| CommuniCare | MEDICARE ADVANTAGE | $1,541.31 | ↑ +77% |
| AMERIHEALTH | Managed Medicaid | $1,573.00 | ↑ +81% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,585.35 | ↑ +83% |
| MMO | ALL PRODUCTS | $2,307.88 | ↑ +166% |
| MMO | SuperMed | $2,603.78 | ↑ +200% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,429.10 | $0.01 – $6,132.60 |
| akron general | Akron | $868.40 | $1.10 – $1,573.00 |
| University Hospitals Ahuja Medical Center | Beachwood | $1,768.50 | $521.12 – $2,642.25 |
| University Hospitals Beachwood Medical Center | Beachwood | $1,768.50 | $900.00 – $3,717.82 |
| University Hospitals Elyria Medical Center | Elyria | $1,768.50 | $1,467.92 – $2,642.25 |
| University Hospitals Regional Hospitals - Geauga Medical Center | Chardon | $1,768.50 | $1,467.92 – $2,642.25 |
| University Hospitals Lake West Medical Center | Willoughby OH 44094|7590 Auburn Road | $1,768.50 | $1,467.92 – $2,642.25 |
| University Hospitals Parma Medical Center | Parma OH 44129|7007 Powers Boulevard | $1,768.50 | $1,467.92 – $2,642.25 |