healthcosts.net
Breast Biopsy (ultrasound-guided, percutaneous) at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$7,267.00
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.
$11,180.00
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.
$0.01 with UNITED vs $11,180.00 with AETNA — 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 |
|---|---|---|---|
| UNITED | ALL PRODUCTS | $0.01 | ↓ -100% |
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| Summacare | Medicare Advantage Lower Level | $93.34 | ↓ -99% |
| Summacare | Preferred | $93.34 | ↓ -99% |
| Summacare | Medicare Advantage Psych | $97.30 | ↓ -99% |
| Summacare | Medicare Advantage CNA | $122.06 | ↓ -98% |
| United | Medicare Advantage | $129.73 | ↓ -98% |
| Anthem | Medicare Advantage | $129.73 | ↓ -98% |
| Cigna | Medicare Advantage | $129.73 | ↓ -98% |
| Humana | Medicare Advantage HMO | $129.73 | ↓ -98% |
| Aetna | Medicare Advantage | $129.73 | ↓ -98% |
| The Health Plan | Medicare Advantage | $129.73 | ↓ -98% |
| United | Managed Medicaid | $133.00 | ↓ -98% |
| MMO | Medicare HMO & PPO | $133.62 | ↓ -98% |
| Summacare | Premier | $136.22 | ↓ -98% |
| CommuniCare | Medicare Advantage | $136.22 | ↓ -98% |
| Summacare | Medicare Advantage MD | $136.42 | ↓ -98% |
| Caresource | Managed Medicaid | $136.99 | ↓ -98% |
| Buckeye | Managed Medicaid | $139.65 | ↓ -98% |
| Perennial Health | Medicare Advantage | $140.11 | ↓ -98% |
| The Health Plan | All Products PCP | $142.70 | ↓ -98% |
| Molina | Managed Medicaid | $146.30 | ↓ -98% |
| AmeriHealth | Managed Medicaid | $146.30 | ↓ -98% |
| The Health Plan | All Products Specialty Physicians | $149.19 | ↓ -98% |
| The Health Plan | All Products Radiation Oncology Physicians | $168.65 | ↓ -98% |
| Oscar | All Products | $346.59 | ↓ -95% |
| Aultcare | PPO/HMO | $488.31 | ↓ -93% |
| OHCP | All Products | $530.60 | ↓ -93% |
| Cigna | All Products Mid-Level | $610.52 | ↓ -92% |
| Anthem | All Products Mid-Level Non-Facility | $652.96 | ↓ -91% |
| OMAS | All Products | $682.00 | ↓ -91% |
| Cigna | All Products Physician | $721.40 | ↓ -90% |
| PHPHI | All Products | $818.40 | ↓ -89% |
| UNITED | Managed Medicaid | $841.30 | ↓ -88% |
| Aetna | Acop | $849.14 | ↓ -88% |
| CARESOURCE | Managed Medicaid | $866.54 | ↓ -88% |
| ANTHEM | Managed Medicaid | $883.37 | ↓ -88% |
| MOLINA | Managed Medicaid | $883.37 | ↓ -88% |
| AMERIHEALTH | Managed Medicaid | $925.43 | ↓ -87% |
| MMO | Traditional | $954.80 | ↓ -87% |
| GMS | All Products | $954.80 | ↓ -87% |
| Aetna | All Products First Health | $1,023.00 | ↓ -86% |
| Immergrun | All Products | $1,023.00 | ↓ -86% |
| United | All Products - Mid-Level | $1,054.16 | ↓ -85% |
| Aetna | Asa | $1,091.20 | ↓ -85% |
| United | All Products | $1,171.29 | ↓ -84% |
| United | HMO & PPO | $1,171.29 | ↓ -84% |
| Multiplan | All Products | $1,227.60 | ↓ -83% |
| The Health Plan | MEDICARE ADVANTAGE | $1,347.36 | ↓ -81% |
| Aetna | Qhp/Ifp | $1,364.00 | ↓ -81% |
| UNITED | MEDICARE ADVANTAGE | $1,497.07 | ↓ -79% |
| HUMANA | Medicare Advantage HMO | $1,497.07 | ↓ -79% |
| Summacare | MEDICARE ADVANTAGE | $1,562.54 | ↓ -78% |
| ANTHEM | MEDICARE ADVANTAGE | $1,562.54 | ↓ -78% |
| AETNA | MEDICARE ADVANTAGE | $1,562.54 | ↓ -78% |
| CIGNA | MEDICARE ADVANTAGE | $1,609.41 | ↓ -78% |
| Perennial Health | MEDICARE ADVANTAGE | $1,616.83 | ↓ -78% |
| CommuniCare | MEDICARE ADVANTAGE | $1,640.67 | ↓ -77% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,687.54 | ↓ -77% |
| ANTHEM | HPN | $1,789.00 | ↓ -75% |
| ANTHEM | Exchange | $1,894.00 | ↓ -74% |
| ANTHEM | PPO/HMO | $2,104.00 | ↓ -71% |
| MMO | SuperMed | $2,768.64 | ↓ -62% |
| OSCAR | ALL PRODUCTS | $3,161.70 | ↓ -56% |
| MMO | ALL PRODUCTS | $3,236.97 | ↓ -55% |
| PHP | ALL PRODUCTS | $3,577.60 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $3,577.60 | ↓ -51% |
| CC EHP | ALL PRODUCTS | $3,778.84 | ↓ -48% |
| AETNA | Asa_Whirlpool_Peia | $3,810.00 | ↓ -48% |
| AETNA | International | $4,001.00 | ↓ -45% |
| Summacare | PREMIER | $4,270.76 | ↓ -41% |
| Amish Community Aid Plan | ALL PRODUCTS | $5,031.00 | ↓ -31% |
| OHCP | ALL PRODUCTS | $5,433.48 | ↓ -25% |
| CIGNA | ALL PRODUCTS | $5,520.00 | ↓ -24% |
| Immergrun | ALL PRODUCTS | $5,590.00 | ↓ -23% |
| OMAS | ALL PRODUCTS | $5,590.00 | ↓ -23% |
| Ohio Healthy | TRANSPLANT | $6,037.20 | ↓ -17% |
| ANTHEM | TRADITIONAL | $6,182.54 | ↓ -15% |
| The Health Plan | PPO | $7,137.31 | ↓ -2% |
| Medical Benefit Corp | Transplant SMCP | $7,826.00 | ↑ +8% |
| GMS | ALL PRODUCTS | $7,826.00 | ↑ +8% |
| AETNA | ALL PRODUCTS | $8,385.00 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $8,385.00 | ↑ +15% |
| The Health Plan | Self-Funded ASO | $9,391.20 | ↑ +29% |
| MULTIPLAN | ALL PRODUCTS | $10,062.00 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $10,062.00 | ↑ +38% |
| FrontPath | TRANSPLANT | $10,062.00 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $10,062.00 | ↑ +38% |
| The Health Plan | POS | $11,180.00 | ↑ +54% |
| The Health Plan | HMO | $11,180.00 | ↑ +54% |
| AETNA | Qhp/Ipf | $11,180.00 | ↑ +54% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Breast Biopsy (ultrasound-guided, percutaneous) at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $7,267.00 | $0.01 – $10,062.00 |
| akron general | Akron | $7,267.00 | $0.01 – $10,062.00 |
| avon hospital | Avon | $7,267.00 | $0.01 – $10,062.00 |
| euclid hospital | Euclid | $7,267.00 | $0.01 – $10,062.00 |
| fairview hospital | Cleveland | $7,267.00 | $0.01 – $10,062.00 |
| lutheran hospital | Cleveland | $7,267.00 | $0.01 – $10,062.00 |
| hillcrest hospital | Mayfield Heights | $7,267.00 | $0.01 – $10,062.00 |
| marymount hospital | Garfield Heights | $7,267.00 | $0.01 – $10,062.00 |