healthcosts.net
Ercp lesion ablate w/dilate 43278 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$2,059.20
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.
$3,168.00
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 | $261.44 | ↓ -87% |
| Summacare | Medicare Advantage Lower Level | $261.44 | ↓ -87% |
| Summacare | Medicare Advantage Psych | $278.03 | ↓ -86% |
| Summacare | Medicare Advantage CNA | $341.89 | ↓ -83% |
| United | Managed Medicaid | $352.09 | ↓ -83% |
| Caresource | Managed Medicaid | $362.65 | ↓ -82% |
| Buckeye | Managed Medicaid | $369.69 | ↓ -82% |
| The Health Plan | Medicare Advantage | $370.71 | ↓ -82% |
| United | Medicare Advantage | $370.71 | ↓ -82% |
| Aetna | Medicare Advantage | $370.71 | ↓ -82% |
| Cigna | Medicare Advantage | $370.71 | ↓ -82% |
| Anthem | Medicare Advantage | $370.71 | ↓ -82% |
| Humana | Medicare Advantage HMO | $370.71 | ↓ -82% |
| MMO | Medicare HMO & PPO | $381.83 | ↓ -81% |
| Summacare | Medicare Advantage MD | $382.11 | ↓ -81% |
| Molina | Managed Medicaid | $387.30 | ↓ -81% |
| AmeriHealth | Managed Medicaid | $387.30 | ↓ -81% |
| Summacare | Premier | $389.25 | ↓ -81% |
| CommuniCare | Medicare Advantage | $389.25 | ↓ -81% |
| The Health Plan | PPO | $396.66 | ↓ -81% |
| Perennial Health | Medicare Advantage | $400.37 | ↓ -81% |
| The Health Plan | All Products PCP | $407.78 | ↓ -80% |
| The Health Plan | All Products Specialty Physicians | $426.32 | ↓ -79% |
| The Health Plan | All Products Radiation Oncology Physicians | $481.92 | ↓ -77% |
| Anthem | All Products Mid-Level Non-Facility | $570.32 | ↓ -72% |
| Oscar | All Products | $804.99 | ↓ -61% |
| United | All Products - Mid-Level | $949.35 | ↓ -54% |
| United | HMO & PPO | $1,054.83 | ↓ -49% |
| United | All Products | $1,054.83 | ↓ -49% |
| Aultcare | PPO/HMO | $1,134.14 | ↓ -45% |
| OHCP | All Products | $1,232.35 | ↓ -40% |
| OMAS | All Products | $1,584.00 | ↓ -23% |
| PHPHI | All Products | $1,900.80 | ↓ -8% |
| GMS | All Products | $2,217.60 | ↑ +8% |
| MMO | Traditional | $2,217.60 | ↑ +8% |
| UNITED | Managed Medicaid | $2,334.47 | ↑ +13% |
| Immergrun | All Products | $2,376.00 | ↑ +15% |
| Aetna | All Products First Health | $2,376.00 | ↑ +15% |
| CARESOURCE | Managed Medicaid | $2,404.50 | ↑ +17% |
| MOLINA | Managed Medicaid | $2,451.19 | ↑ +19% |
| ANTHEM | Managed Medicaid | $2,451.19 | ↑ +19% |
| Aetna | Asa | $2,534.40 | ↑ +23% |
| AMERIHEALTH | Managed Medicaid | $2,567.92 | ↑ +25% |
| Multiplan | All Products | $2,851.20 | ↑ +38% |
| The Health Plan | MEDICARE ADVANTAGE | $3,163.78 | ↑ +54% |
| Aetna | Qhp/Ifp | $3,168.00 | ↑ +54% |
| HUMANA | Medicare Advantage HMO | $3,515.31 | ↑ +71% |
| UNITED | MEDICARE ADVANTAGE | $3,515.31 | ↑ +71% |
| ANTHEM | MEDICARE ADVANTAGE | $3,647.57 | ↑ +77% |
| Summacare | MEDICARE ADVANTAGE | $3,647.57 | ↑ +77% |
| AETNA | MEDICARE ADVANTAGE | $3,647.57 | ↑ +77% |
| CIGNA | MEDICARE ADVANTAGE | $3,757.00 | ↑ +82% |
| Perennial Health | MEDICARE ADVANTAGE | $3,796.53 | ↑ +84% |
| CommuniCare | MEDICARE ADVANTAGE | $3,829.95 | ↑ +86% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,939.38 | ↑ +91% |
| MMO | ALL PRODUCTS | $5,795.64 | ↑ +181% |
| MMO | SuperMed | $6,539.01 | ↑ +218% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +61888% |
| The Health Plan | POS | $4,036,081.00 | ↑ +195902% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
Visitor-reported prices
Comments
Ercp lesion ablate w/dilate 43278 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $11,375.65 | $1.10 – $15,750.90 |
| akron general | Akron | $2,059.20 | $1.10 – $3,796.53 |
| University Hospitals Ahuja Medical Center | Beachwood | $5,948.25 | $900.00 – $7,137.90 |
| University Hospitals Beachwood Medical Center | Beachwood | $5,948.25 | $900.00 – $9,238.28 |
| University Hospitals Elyria Medical Center | Elyria | $5,948.25 | $3,647.57 – $6,565.63 |
| University Hospitals Regional Hospitals - Geauga Medical Center | Chardon | $5,948.25 | $3,647.57 – $6,565.63 |
| University Hospitals Lake West Medical Center | Willoughby OH 44094|7590 Auburn Road | $5,948.25 | $3,647.57 – $6,565.63 |
| University Hospitals Parma Medical Center | Parma OH 44129|7007 Powers Boulevard | $5,948.25 | $3,647.57 – $6,565.63 |