healthcosts.net
Biopsy vestibule of mouth 40808 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$273.00
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.
$420.00
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 | Preferred | $54.59 | ↓ -80% |
| Summacare | Medicare Advantage Lower Level | $54.59 | ↓ -80% |
| Summacare | Medicare Advantage Psych | $59.34 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $71.38 | ↓ -74% |
| Humana | Medicare Advantage HMO | $79.12 | ↓ -71% |
| The Health Plan | Medicare Advantage | $79.12 | ↓ -71% |
| United | Medicare Advantage | $79.12 | ↓ -71% |
| Cigna | Medicare Advantage | $79.12 | ↓ -71% |
| Aetna | Medicare Advantage | $79.12 | ↓ -71% |
| Anthem | Medicare Advantage | $79.12 | ↓ -71% |
| Summacare | Medicare Advantage MD | $79.78 | ↓ -71% |
| MMO | Medicare HMO & PPO | $81.49 | ↓ -70% |
| CommuniCare | Medicare Advantage | $83.08 | ↓ -70% |
| Summacare | Premier | $83.08 | ↓ -70% |
| United | Managed Medicaid | $83.15 | ↓ -70% |
| The Health Plan | PPO | $84.66 | ↓ -69% |
| Perennial Health | Medicare Advantage | $85.45 | ↓ -69% |
| Caresource | Managed Medicaid | $85.64 | ↓ -69% |
| The Health Plan | All Products PCP | $87.03 | ↓ -68% |
| Buckeye | Managed Medicaid | $87.31 | ↓ -68% |
| The Health Plan | All Products Specialty Physicians | $90.99 | ↓ -67% |
| Molina | Managed Medicaid | $91.47 | ↓ -66% |
| AmeriHealth | Managed Medicaid | $91.47 | ↓ -66% |
| The Health Plan | All Products Radiation Oncology Physicians | $102.86 | ↓ -62% |
| Oscar | All Products | $106.72 | ↓ -61% |
| Aultcare | PPO/HMO | $150.36 | ↓ -45% |
| OHCP | All Products | $163.38 | ↓ -40% |
| Cigna | All Products Mid-Level | $205.25 | ↓ -25% |
| OMAS | All Products | $210.00 | ↓ -23% |
| Anthem | All Products Mid-Level Non-Facility | $219.51 | ↓ -20% |
| Cigna | All Products Physician | $242.53 | ↓ -11% |
| PHPHI | All Products | $252.00 | ↓ -8% |
| Aetna | Acop | $253.40 | ↓ -7% |
| GMS | All Products | $294.00 | ↑ +8% |
| MMO | Traditional | $294.00 | ↑ +8% |
| Aetna | All Products First Health | $315.00 | ↑ +15% |
| Immergrun | All Products | $315.00 | ↑ +15% |
| Aetna | Asa | $336.00 | ↑ +23% |
| United | All Products - Mid-Level | $363.30 | ↑ +33% |
| Multiplan | All Products | $378.00 | ↑ +38% |
| United | HMO & PPO | $403.67 | ↑ +48% |
| United | All Products | $403.67 | ↑ +48% |
| Aetna | Qhp/Ifp | $420.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $423.48 | ↑ +55% |
| HUMANA | Medicare Advantage HMO | $470.54 | ↑ +72% |
| UNITED | MEDICARE ADVANTAGE | $470.54 | ↑ +72% |
| Perennial Health | MEDICARE ADVANTAGE | $508.18 | ↑ +86% |
| ANTHEM | MEDICARE ADVANTAGE | $510.25 | ↑ +87% |
| Summacare | MEDICARE ADVANTAGE | $510.25 | ↑ +87% |
| AETNA | MEDICARE ADVANTAGE | $510.25 | ↑ +87% |
| CIGNA | MEDICARE ADVANTAGE | $525.55 | ↑ +93% |
| CommuniCare | MEDICARE ADVANTAGE | $535.76 | ↑ +96% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $551.07 | ↑ +102% |
| MMO | ALL PRODUCTS | $832.63 | ↑ +205% |
| MMO | SuperMed | $939.01 | ↑ +244% |
| UNITED | Managed Medicaid | $1,430.00 | ↑ +424% |
| CARESOURCE | Managed Medicaid | $1,472.90 | ↑ +440% |
| ANTHEM | Managed Medicaid | $1,501.50 | ↑ +450% |
| MOLINA | Managed Medicaid | $1,501.50 | ↑ +450% |
| AMERIHEALTH | Managed Medicaid | $1,573.00 | ↑ +476% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +467463% |
| The Health Plan | POS | $4,036,081.00 | ↑ +1478318% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy vestibule of mouth 40808 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,522.95 | $0.01 – $2,108.70 |
| akron general | Akron | $273.00 | $1.10 – $1,573.00 |
| University Hospitals Ahuja Medical Center | Beachwood | $1,356.75 | $399.79 – $1,628.10 |
| University Hospitals Beachwood Medical Center | Beachwood | $1,356.75 | $510.25 – $1,628.10 |
| University Hospitals Conneaut Medical Center | Conneaut | $1,332.00 | not published |
| University Hospitals Elyria Medical Center | Elyria | $1,356.75 | $510.25 – $918.44 |
| University Hospitals Regional Hospitals - Geauga Medical Center | Chardon | $1,356.75 | $510.25 – $918.44 |
| University Hospitals Geneva Medical Center | Geneva | $1,332.00 | not published |