healthcosts.net
Biopsy of urethra at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$673.40
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.
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What you pay up front if you don't use insurance.
$1,036.00
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 $3,478.27 with MMO — 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 | $87.34 | ↓ -87% |
| Summacare | Medicare Advantage Lower Level | $87.34 | ↓ -87% |
| Summacare | Medicare Advantage Psych | $94.49 | ↓ -86% |
| United | Managed Medicaid | $97.73 | ↓ -85% |
| Caresource | Managed Medicaid | $100.66 | ↓ -85% |
| Buckeye | Managed Medicaid | $102.62 | ↓ -85% |
| AmeriHealth | Managed Medicaid | $107.50 | ↓ -84% |
| Molina | Managed Medicaid | $107.50 | ↓ -84% |
| Summacare | Medicare Advantage CNA | $114.21 | ↓ -83% |
| Anthem | Medicare Advantage | $125.98 | ↓ -81% |
| United | Medicare Advantage | $125.98 | ↓ -81% |
| The Health Plan | Medicare Advantage | $125.98 | ↓ -81% |
| Aetna | Medicare Advantage | $125.98 | ↓ -81% |
| Cigna | Medicare Advantage | $125.98 | ↓ -81% |
| Humana | Medicare Advantage HMO | $125.98 | ↓ -81% |
| Summacare | Medicare Advantage MD | $127.65 | ↓ -81% |
| MMO | Medicare HMO & PPO | $129.76 | ↓ -81% |
| CommuniCare | Medicare Advantage | $132.28 | ↓ -80% |
| Summacare | Premier | $132.28 | ↓ -80% |
| Perennial Health | Medicare Advantage | $136.06 | ↓ -80% |
| The Health Plan | All Products PCP | $138.58 | ↓ -79% |
| The Health Plan | All Products Specialty Physicians | $144.88 | ↓ -78% |
| The Health Plan | All Products Radiation Oncology Physicians | $163.77 | ↓ -76% |
| Cigna | All Products Mid-Level | $197.19 | ↓ -71% |
| Anthem | All Products Mid-Level Non-Facility | $210.90 | ↓ -69% |
| Aetna | Acop | $222.78 | ↓ -67% |
| Cigna | All Products Physician | $233.00 | ↓ -65% |
| Oscar | All Products | $263.25 | ↓ -61% |
| United | All Products - Mid-Level | $353.54 | ↓ -47% |
| Aultcare | PPO/HMO | $370.89 | ↓ -45% |
| United | HMO & PPO | $392.83 | ↓ -42% |
| United | All Products | $392.83 | ↓ -42% |
| OHCP | All Products | $403.00 | ↓ -40% |
| OMAS | All Products | $518.00 | ↓ -23% |
| PHPHI | All Products | $621.60 | ↓ -8% |
| MMO | Traditional | $725.20 | ↑ +8% |
| GMS | All Products | $725.20 | ↑ +8% |
| Immergrun | All Products | $777.00 | ↑ +15% |
| Aetna | All Products First Health | $777.00 | ↑ +15% |
| Aetna | Asa | $828.80 | ↑ +23% |
| Multiplan | All Products | $932.40 | ↑ +38% |
| Aetna | Qhp/Ifp | $1,036.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $1,703.50 | ↑ +153% |
| UNITED | Managed Medicaid | $1,721.98 | ↑ +156% |
| CARESOURCE | Managed Medicaid | $1,773.64 | ↑ +163% |
| ANTHEM | Managed Medicaid | $1,808.08 | ↑ +169% |
| MOLINA | Managed Medicaid | $1,808.08 | ↑ +169% |
| HUMANA | Medicare Advantage HMO | $1,892.78 | ↑ +181% |
| UNITED | MEDICARE ADVANTAGE | $1,892.78 | ↑ +181% |
| AMERIHEALTH | Managed Medicaid | $1,894.18 | ↑ +181% |
| ANTHEM | MEDICARE ADVANTAGE | $1,977.66 | ↑ +194% |
| AETNA | MEDICARE ADVANTAGE | $1,977.66 | ↑ +194% |
| Summacare | MEDICARE ADVANTAGE | $1,977.66 | ↑ +194% |
| CIGNA | MEDICARE ADVANTAGE | $2,036.99 | ↑ +202% |
| Perennial Health | MEDICARE ADVANTAGE | $2,044.20 | ↑ +204% |
| CommuniCare | MEDICARE ADVANTAGE | $2,076.55 | ↑ +208% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $2,135.88 | ↑ +217% |
| MMO | ALL PRODUCTS | $3,082.35 | ↑ +358% |
| MMO | SuperMed | $3,478.27 | ↑ +417% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of urethra at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $6,124.95 | $0.01 – $8,480.70 |
| akron general | Akron | $673.40 | $1.10 – $2,044.20 |
| avon hospital | Avon | not published | $1,797.86 – $2,175.43 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $2,935.26 – $3,398.73 |
| euclid hospital | Euclid | not published | $1,767.05 – $2,175.43 |
| fairview hospital | Cleveland | not published | $1,730.43 – $2,175.43 |
| lutheran hospital | Cleveland | not published | $1,647.42 – $2,175.43 |
| hillcrest hospital | Mayfield Heights | not published | $1,767.05 – $2,175.43 |