healthcosts.net
Breast reconstruction tram flap 19367 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$6,968.00
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.
$10,720.00
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 | $1,087.10 | ↓ -84% |
| Summacare | Medicare Advantage Lower Level | $1,087.10 | ↓ -84% |
| Summacare | Medicare Advantage Psych | $1,141.79 | ↓ -84% |
| United | Managed Medicaid | $1,298.89 | ↓ -81% |
| Caresource | Managed Medicaid | $1,337.86 | ↓ -81% |
| Buckeye | Managed Medicaid | $1,363.83 | ↓ -80% |
| Summacare | Medicare Advantage CNA | $1,421.59 | ↓ -80% |
| Molina | Managed Medicaid | $1,428.78 | ↓ -79% |
| AmeriHealth | Managed Medicaid | $1,428.78 | ↓ -79% |
| United | Medicare Advantage | $1,522.38 | ↓ -78% |
| Anthem | Medicare Advantage | $1,522.38 | ↓ -78% |
| The Health Plan | Medicare Advantage | $1,522.38 | ↓ -78% |
| Cigna | Medicare Advantage | $1,522.38 | ↓ -78% |
| Aetna | Medicare Advantage | $1,522.38 | ↓ -78% |
| Humana | Medicare Advantage HMO | $1,522.38 | ↓ -78% |
| MMO | Medicare HMO & PPO | $1,568.05 | ↓ -77% |
| Summacare | Medicare Advantage MD | $1,588.84 | ↓ -77% |
| Summacare | Premier | $1,598.50 | ↓ -77% |
| CommuniCare | Medicare Advantage | $1,598.50 | ↓ -77% |
| The Health Plan | PPO | $1,628.95 | ↓ -77% |
| Perennial Health | Medicare Advantage | $1,644.17 | ↓ -76% |
| The Health Plan | All Products PCP | $1,674.62 | ↓ -76% |
| The Health Plan | All Products Specialty Physicians | $1,750.74 | ↓ -75% |
| The Health Plan | All Products Radiation Oncology Physicians | $1,979.09 | ↓ -72% |
| Anthem | All Products Mid-Level Non-Facility | $2,364.72 | ↓ -66% |
| Oscar | All Products | $2,723.95 | ↓ -61% |
| MMO | SuperMed | $3,008.77 | ↓ -57% |
| Aultcare | PPO/HMO | $3,837.76 | ↓ -45% |
| United | All Products - Mid-Level | $3,916.23 | ↓ -44% |
| UNITED | Managed Medicaid | $3,981.38 | ↓ -43% |
| CARESOURCE | Managed Medicaid | $4,100.82 | ↓ -41% |
| OHCP | All Products | $4,170.08 | ↓ -40% |
| ANTHEM | Managed Medicaid | $4,180.45 | ↓ -40% |
| MOLINA | Managed Medicaid | $4,180.45 | ↓ -40% |
| United | HMO & PPO | $4,351.37 | ↓ -38% |
| United | All Products | $4,351.37 | ↓ -38% |
| AMERIHEALTH | Managed Medicaid | $4,379.52 | ↓ -37% |
| OMAS | All Products | $5,360.00 | ↓ -23% |
| PHPHI | All Products | $6,432.00 | ↓ -8% |
| MMO | Traditional | $7,504.00 | ↑ +8% |
| GMS | All Products | $7,504.00 | ↑ +8% |
| Aetna | All Products First Health | $8,040.00 | ↑ +15% |
| Immergrun | All Products | $8,040.00 | ↑ +15% |
| Aetna | Asa | $8,576.00 | ↑ +23% |
| Multiplan | All Products | $9,648.00 | ↑ +38% |
| Aetna | Qhp/Ifp | $10,720.00 | ↑ +54% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +18219% |
| The Health Plan | POS | $4,036,081.00 | ↑ +57823% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Aetna | Acop | 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 tram flap 19367 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $6,968.00 | $1.10 – $9,648.00 |
| akron general | Akron | $6,968.00 | $1.10 – $9,648.00 |
| avon hospital | Avon | not published | $4,156.85 – $4,236.02 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $6,786.62 – $7,858.19 |
| euclid hospital | Euclid | not published | $4,258.79 – $4,931.23 |
| fairview hospital | Cleveland | not published | $4,000.93 – $4,632.65 |
| lutheran hospital | Cleveland | not published | $3,809.01 – $4,410.43 |
| hillcrest hospital | Mayfield Heights | not published | $4,168.33 – $4,826.49 |