healthcosts.net
Biopsy thigh soft tissues at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,310.40
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.
$2,016.00
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 $4,850.94 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% |
| United | Managed Medicaid | $231.82 | ↓ -82% |
| Caresource | Managed Medicaid | $238.77 | ↓ -82% |
| Buckeye | Managed Medicaid | $243.41 | ↓ -81% |
| Summacare | Preferred | $254.98 | ↓ -81% |
| Summacare | Medicare Advantage Lower Level | $254.98 | ↓ -81% |
| AmeriHealth | Managed Medicaid | $255.00 | ↓ -81% |
| Molina | Managed Medicaid | $255.00 | ↓ -81% |
| Summacare | Medicare Advantage Psych | $290.43 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $333.44 | ↓ -75% |
| Summacare | Medicare Advantage MD | $372.67 | ↓ -72% |
| United | Medicare Advantage | $387.24 | ↓ -70% |
| The Health Plan | Medicare Advantage | $387.24 | ↓ -70% |
| Aetna | Medicare Advantage | $387.24 | ↓ -70% |
| Cigna | Medicare Advantage | $387.24 | ↓ -70% |
| Humana | Medicare Advantage HMO | $387.24 | ↓ -70% |
| Anthem | Medicare Advantage | $387.24 | ↓ -70% |
| MMO | Medicare HMO & PPO | $398.86 | ↓ -70% |
| Summacare | Premier | $406.60 | ↓ -69% |
| CommuniCare | Medicare Advantage | $406.60 | ↓ -69% |
| Perennial Health | Medicare Advantage | $418.22 | ↓ -68% |
| The Health Plan | All Products PCP | $425.96 | ↓ -67% |
| The Health Plan | All Products Specialty Physicians | $445.33 | ↓ -66% |
| The Health Plan | All Products Radiation Oncology Physicians | $503.41 | ↓ -62% |
| Oscar | All Products | $512.27 | ↓ -61% |
| Anthem | All Products Mid-Level Non-Facility | $550.08 | ↓ -58% |
| Aultcare | PPO/HMO | $721.73 | ↓ -45% |
| OHCP | All Products | $784.22 | ↓ -40% |
| United | All Products - Mid-Level | $918.50 | ↓ -30% |
| OMAS | All Products | $1,008.00 | ↓ -23% |
| United | HMO & PPO | $1,020.56 | ↓ -22% |
| United | All Products | $1,020.56 | ↓ -22% |
| UNITED | Managed Medicaid | $1,101.77 | ↓ -16% |
| CARESOURCE | Managed Medicaid | $1,134.82 | ↓ -13% |
| MOLINA | Managed Medicaid | $1,156.86 | ↓ -12% |
| ANTHEM | Managed Medicaid | $1,156.86 | ↓ -12% |
| PHPHI | All Products | $1,209.60 | ↓ -8% |
| AMERIHEALTH | Managed Medicaid | $1,211.95 | ↓ -8% |
| GMS | All Products | $1,411.20 | ↑ +8% |
| MMO | Traditional | $1,411.20 | ↑ +8% |
| Aetna | All Products First Health | $1,512.00 | ↑ +15% |
| Immergrun | All Products | $1,512.00 | ↑ +15% |
| Aetna | Asa | $1,612.80 | ↑ +23% |
| Multiplan | All Products | $1,814.40 | ↑ +38% |
| Aetna | Qhp/Ifp | $2,016.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $2,380.03 | ↑ +82% |
| UNITED | MEDICARE ADVANTAGE | $2,644.48 | ↑ +102% |
| HUMANA | Medicare Advantage HMO | $2,644.48 | ↑ +102% |
| ANTHEM | MEDICARE ADVANTAGE | $2,748.08 | ↑ +110% |
| Summacare | MEDICARE ADVANTAGE | $2,748.08 | ↑ +110% |
| AETNA | MEDICARE ADVANTAGE | $2,748.08 | ↑ +110% |
| CIGNA | MEDICARE ADVANTAGE | $2,830.53 | ↑ +116% |
| Perennial Health | MEDICARE ADVANTAGE | $2,856.04 | ↑ +118% |
| CommuniCare | MEDICARE ADVANTAGE | $2,885.49 | ↑ +120% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $2,967.93 | ↑ +126% |
| MMO | ALL PRODUCTS | $4,300.08 | ↑ +228% |
| MMO | SuperMed | $4,850.94 | ↑ +270% |
| Aetna | Acop | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy thigh soft tissues at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $8,557.25 | $0.01 – $11,848.50 |
| akron general | Akron | $1,310.40 | $1.10 – $2,856.04 |
| avon hospital | Avon | not published | $1,150.32 – $3,022.89 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,878.06 – $2,174.60 |
| euclid hospital | Euclid | not published | $1,178.53 – $3,022.89 |
| fairview hospital | Cleveland | not published | $1,107.18 – $3,022.89 |
| lutheran hospital | Cleveland | not published | $1,054.06 – $3,022.89 |
| hillcrest hospital | Mayfield Heights | not published | $1,153.50 – $3,022.89 |