Bx of breast open 19101 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$7,467.20
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.
$11,488.00
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 $11,488.00 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 |
|---|---|---|---|
| UNITED | ALL PRODUCTS | $0.01 | ↓ -100% |
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| United | Managed Medicaid | $115.59 | ↓ -98% |
| Caresource | Managed Medicaid | $119.06 | ↓ -98% |
| Buckeye | Managed Medicaid | $121.37 | ↓ -98% |
| Oscar | All Products | $121.97 | ↓ -98% |
| Molina | Managed Medicaid | $127.15 | ↓ -98% |
| AmeriHealth | Managed Medicaid | $127.15 | ↓ -98% |
| Summacare | Medicare Advantage Lower Level | $138.15 | ↓ -98% |
| Summacare | Preferred | $138.15 | ↓ -98% |
| Summacare | Medicare Advantage Psych | $157.73 | ↓ -98% |
| Aultcare | PPO/HMO | $171.84 | ↓ -98% |
| Summacare | Medicare Advantage CNA | $180.66 | ↓ -98% |
| OHCP | All Products | $186.72 | ↓ -97% |
| Summacare | Medicare Advantage MD | $201.91 | ↓ -97% |
| Humana | Medicare Advantage HMO | $210.31 | ↓ -97% |
| Aetna | Medicare Advantage | $210.31 | ↓ -97% |
| Anthem | Medicare Advantage | $210.31 | ↓ -97% |
| United | Medicare Advantage | $210.31 | ↓ -97% |
| Cigna | Medicare Advantage | $210.31 | ↓ -97% |
| The Health Plan | Medicare Advantage | $210.31 | ↓ -97% |
| MMO | Medicare HMO & PPO | $216.62 | ↓ -97% |
| Summacare | Premier | $220.83 | ↓ -97% |
| CommuniCare | Medicare Advantage | $220.83 | ↓ -97% |
| Perennial Health | Medicare Advantage | $227.13 | ↓ -97% |
| The Health Plan | All Products PCP | $231.34 | ↓ -97% |
| OMAS | All Products | $240.00 | ↓ -97% |
| The Health Plan | All Products Specialty Physicians | $241.86 | ↓ -97% |
| The Health Plan | All Products Radiation Oncology Physicians | $273.40 | ↓ -96% |
| PHPHI | All Products | $288.00 | ↓ -96% |
| MMO | Traditional | $336.00 | ↓ -96% |
| GMS | All Products | $336.00 | ↓ -96% |
| Immergrun | All Products | $360.00 | ↓ -95% |
| Aetna | All Products First Health | $360.00 | ↓ -95% |
| Aetna | Asa | $384.00 | ↓ -95% |
| Cigna | All Products Mid-Level | $407.63 | ↓ -95% |
| Multiplan | All Products | $432.00 | ↓ -94% |
| Anthem | All Products Mid-Level Non-Facility | $435.96 | ↓ -94% |
| Aetna | Acop | $462.78 | ↓ -94% |
| Aetna | Qhp/Ifp | $480.00 | ↓ -94% |
| Cigna | All Products Physician | $481.65 | ↓ -94% |
| The Health Plan | PPO | $702.45 | ↓ -91% |
| United | All Products - Mid-Level | $716.94 | ↓ -90% |
| United | HMO & PPO | $796.59 | ↓ -89% |
| United | All Products | $796.59 | ↓ -89% |
| UNITED | Managed Medicaid | $841.30 | ↓ -89% |
| CARESOURCE | Managed Medicaid | $866.54 | ↓ -88% |
| MOLINA | Managed Medicaid | $883.37 | ↓ -88% |
| ANTHEM | Managed Medicaid | $883.37 | ↓ -88% |
| AMERIHEALTH | Managed Medicaid | $925.43 | ↓ -88% |
| ANTHEM | HPN | $2,892.00 | ↓ -61% |
| ANTHEM | Exchange | $3,062.00 | ↓ -59% |
| The Health Plan | MEDICARE ADVANTAGE | $3,184.36 | ↓ -57% |
| OSCAR | ALL PRODUCTS | $3,248.81 | ↓ -56% |
| ANTHEM | PPO/HMO | $3,402.00 | ↓ -54% |
| CIGNA | ALL PRODUCTS | $3,465.00 | ↓ -54% |
| UNITED | MEDICARE ADVANTAGE | $3,538.18 | ↓ -53% |
| HUMANA | Medicare Advantage HMO | $3,538.18 | ↓ -53% |
| PHP | ALL PRODUCTS | $3,676.16 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $3,676.16 | ↓ -51% |
| ANTHEM | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| Summacare | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| AETNA | MEDICARE ADVANTAGE | $3,704.30 | ↓ -50% |
| AETNA | Asa_Whirlpool_Peia | $3,810.00 | ↓ -49% |
| CIGNA | MEDICARE ADVANTAGE | $3,815.43 | ↓ -49% |
| Perennial Health | MEDICARE ADVANTAGE | $3,821.23 | ↓ -49% |
| CC EHP | ALL PRODUCTS | $3,882.94 | ↓ -48% |
| CommuniCare | MEDICARE ADVANTAGE | $3,889.52 | ↓ -48% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $4,000.65 | ↓ -46% |
| AETNA | International | $4,001.00 | ↓ -46% |
| Summacare | PREMIER | $4,388.42 | ↓ -41% |
| Amish Community Aid Plan | ALL PRODUCTS | $5,169.60 | ↓ -31% |
| OHCP | ALL PRODUCTS | $5,583.17 | ↓ -25% |
| OMAS | ALL PRODUCTS | $5,744.00 | ↓ -23% |
| Immergrun | ALL PRODUCTS | $5,744.00 | ↓ -23% |
| Ohio Healthy | TRANSPLANT | $6,203.52 | ↓ -17% |
| ANTHEM | TRADITIONAL | $6,352.86 | ↓ -15% |
| MMO | SuperMed | $6,508.54 | ↓ -13% |
| MMO | ALL PRODUCTS | $7,610.30 | ↑ +2% |
| GMS | ALL PRODUCTS | $8,041.60 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $8,041.60 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $8,616.00 | ↑ +15% |
| AETNA | ALL PRODUCTS | $8,616.00 | ↑ +15% |
| The Health Plan | Self-Funded ASO | $9,649.92 | ↑ +29% |
| Tertiary Care Network | TRANSPLANT | $10,339.20 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $10,339.20 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $10,339.20 | ↑ +38% |
| FrontPath | TRANSPLANT | $10,339.20 | ↑ +38% |
| The Health Plan | POS | $11,488.00 | ↑ +54% |
| AETNA | Qhp/Ipf | $11,488.00 | ↑ +54% |
| The Health Plan | HMO | $11,488.00 | ↑ +54% |
| AETNA | NAP | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Bx of breast open 19101 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jewish Hospital | Cincinnati | $15,303.28 | $3,815.67 – $3,815.67 |
| cleveland clinic main campus | Cleveland | $7,467.20 | $0.01 – $10,339.20 |
| akron general | Akron | $839.80 | $1.10 – $3,821.23 |
| avon hospital | Avon | $7,467.20 | $0.01 – $10,339.20 |
| euclid hospital | Euclid | $7,467.20 | $0.01 – $10,339.20 |
| fairview hospital | Cleveland | $7,467.20 | $0.01 – $10,339.20 |
| lutheran hospital | Cleveland | $7,467.20 | $0.01 – $10,339.20 |
| hillcrest hospital | Mayfield Heights | $7,467.20 | $0.01 – $10,339.20 |