healthcosts.net
Breast reconstruction 19357 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$4,244.50
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.
$6,530.00
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 $30,087.68 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 | Medicare Advantage Lower Level | $710.19 | ↓ -83% |
| Summacare | Preferred | $710.19 | ↓ -83% |
| Summacare | Medicare Advantage Psych | $776.49 | ↓ -82% |
| United | Managed Medicaid | $877.18 | ↓ -79% |
| Caresource | Managed Medicaid | $903.50 | ↓ -79% |
| Buckeye | Managed Medicaid | $921.04 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $928.71 | ↓ -78% |
| AmeriHealth | Managed Medicaid | $964.90 | ↓ -77% |
| Molina | Managed Medicaid | $964.90 | ↓ -77% |
| Cigna | Medicare Advantage | $1,035.32 | ↓ -76% |
| Humana | Medicare Advantage HMO | $1,035.32 | ↓ -76% |
| The Health Plan | Medicare Advantage | $1,035.32 | ↓ -76% |
| Anthem | Medicare Advantage | $1,035.32 | ↓ -76% |
| United | Medicare Advantage | $1,035.32 | ↓ -76% |
| Aetna | Medicare Advantage | $1,035.32 | ↓ -76% |
| Summacare | Medicare Advantage MD | $1,037.97 | ↓ -76% |
| MMO | Medicare HMO & PPO | $1,066.38 | ↓ -75% |
| CommuniCare | Medicare Advantage | $1,087.09 | ↓ -74% |
| Summacare | Premier | $1,087.09 | ↓ -74% |
| Perennial Health | Medicare Advantage | $1,118.15 | ↓ -74% |
| The Health Plan | All Products PCP | $1,138.85 | ↓ -73% |
| The Health Plan | All Products Specialty Physicians | $1,190.62 | ↓ -72% |
| The Health Plan | All Products Radiation Oncology Physicians | $1,345.92 | ↓ -68% |
| Anthem | All Products Mid-Level Non-Facility | $1,539.18 | ↓ -64% |
| Oscar | All Products | $1,659.27 | ↓ -61% |
| Aultcare | PPO/HMO | $2,337.74 | ↓ -45% |
| OHCP | All Products | $2,540.17 | ↓ -40% |
| United | All Products - Mid-Level | $2,556.49 | ↓ -40% |
| United | All Products | $2,840.55 | ↓ -33% |
| United | HMO & PPO | $2,840.55 | ↓ -33% |
| OMAS | All Products | $3,265.00 | ↓ -23% |
| PHPHI | All Products | $3,918.00 | ↓ -8% |
| UNITED | Managed Medicaid | $3,981.38 | ↓ -6% |
| CARESOURCE | Managed Medicaid | $4,100.82 | ↓ -3% |
| ANTHEM | Managed Medicaid | $4,180.45 | ↓ -2% |
| MOLINA | Managed Medicaid | $4,180.45 | ↓ -2% |
| AMERIHEALTH | Managed Medicaid | $4,379.52 | ↑ +3% |
| MMO | Traditional | $4,571.00 | ↑ +8% |
| GMS | All Products | $4,571.00 | ↑ +8% |
| Immergrun | All Products | $4,897.50 | ↑ +15% |
| Aetna | All Products First Health | $4,897.50 | ↑ +15% |
| Aetna | Asa | $5,224.00 | ↑ +23% |
| Multiplan | All Products | $5,877.00 | ↑ +38% |
| Aetna | Qhp/Ifp | $6,530.00 | ↑ +54% |
| AETNA | MEDICARE ADVANTAGE | $13,037.84 | ↑ +207% |
| ANTHEM | MEDICARE ADVANTAGE | $13,037.84 | ↑ +207% |
| Summacare | MEDICARE ADVANTAGE | $13,037.84 | ↑ +207% |
| CIGNA | MEDICARE ADVANTAGE | $13,428.98 | ↑ +216% |
| CommuniCare | MEDICARE ADVANTAGE | $13,689.74 | ↑ +223% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $14,080.87 | ↑ +232% |
| The Health Plan | MEDICARE ADVANTAGE | $14,468.15 | ↑ +241% |
| UNITED | MEDICARE ADVANTAGE | $16,075.73 | ↑ +279% |
| HUMANA | Medicare Advantage HMO | $16,075.73 | ↑ +279% |
| Perennial Health | MEDICARE ADVANTAGE | $17,361.79 | ↑ +309% |
| MMO | ALL PRODUCTS | $26,667.57 | ↑ +528% |
| MMO | SuperMed | $30,087.68 | ↑ +609% |
| Aetna | Acop | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
Visitor-reported prices
Comments
Breast reconstruction 19357 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,244.50 | $1.10 – $16,128.97 |
| akron general | Akron | $4,244.50 | $1.10 – $16,075.73 |
| avon hospital | Avon | not published | $4,156.85 – $16,128.97 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $6,786.62 – $7,858.19 |
| euclid hospital | Euclid | not published | $4,258.79 – $16,128.97 |
| fairview hospital | Cleveland | not published | $4,000.93 – $16,128.97 |
| lutheran hospital | Cleveland | not published | $3,809.01 – $16,128.97 |
| hillcrest hospital | Mayfield Heights | not published | $4,168.33 – $16,128.97 |