healthcosts.net
Established Patient Office Visit (level 5) at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$728.00
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.
$1,120.00
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 CIGNA vs $261.00 with Cigna — 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 |
|---|---|---|---|
| CIGNA | ALL PRODUCTS | $0.01 | ↓ -100% |
| UNITED | ALL PRODUCTS | $0.01 | ↓ -100% |
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| Oscar | All Products | $6.35 | ↓ -99% |
| Aultcare | PPO/HMO | $8.95 | ↓ -99% |
| OHCP | All Products | $9.73 | ↓ -99% |
| OMAS | All Products | $12.50 | ↓ -98% |
| PHPHI | All Products | $15.00 | ↓ -98% |
| MMO | Traditional | $17.50 | ↓ -98% |
| Summacare | Medicare Advantage Lower Level | $17.50 | ↓ -98% |
| Summacare | Preferred | $17.50 | ↓ -98% |
| GMS | All Products | $17.50 | ↓ -98% |
| Aetna | All Products First Health | $18.75 | ↓ -97% |
| Immergrun | All Products | $18.75 | ↓ -97% |
| Aetna | Asa | $20.00 | ↓ -97% |
| Multiplan | All Products | $22.50 | ↓ -97% |
| Aetna | Qhp/Ifp | $25.00 | ↓ -97% |
| AETNA | MEDICARE ADVANTAGE | $52.32 | ↓ -93% |
| UNITED | Managed Medicaid | $56.04 | ↓ -92% |
| AETNA | Asa_Whirlpool_Peia | $56.71 | ↓ -92% |
| CARESOURCE | Managed Medicaid | $57.72 | ↓ -92% |
| Buckeye | Managed Medicaid | $57.72 | ↓ -92% |
| ANTHEM | Managed Medicaid | $58.84 | ↓ -92% |
| MOLINA | Managed Medicaid | $58.84 | ↓ -92% |
| AETNA | International | $60.00 | ↓ -92% |
| AMERIHEALTH | Managed Medicaid | $61.64 | ↓ -92% |
| OSCAR | ALL PRODUCTS | $67.87 | ↓ -91% |
| United | Managed Medicaid | $73.54 | ↓ -90% |
| Caresource | Managed Medicaid | $75.75 | ↓ -90% |
| PHP | ALL PRODUCTS | $76.80 | ↓ -89% |
| PHPHI | ALL PRODUCTS | $76.80 | ↓ -89% |
| Molina | Managed Medicaid | $80.89 | ↓ -89% |
| AmeriHealth | Managed Medicaid | $80.89 | ↓ -89% |
| CC EHP | ALL PRODUCTS | $81.12 | ↓ -89% |
| Summacare | PREMIER | $91.68 | ↓ -87% |
| Summacare | Medicare Advantage Psych | $93.06 | ↓ -87% |
| MMO | ALL PRODUCTS | $107.52 | ↓ -85% |
| Amish Community Aid Plan | ALL PRODUCTS | $108.00 | ↓ -85% |
| ANTHEM | HPN | $109.99 | ↓ -85% |
| Summacare | Medicare Advantage CNA | $115.01 | ↓ -84% |
| ANTHEM | Exchange | $116.47 | ↓ -84% |
| OHCP | ALL PRODUCTS | $116.64 | ↓ -84% |
| Immergrun | ALL PRODUCTS | $120.00 | ↓ -84% |
| OMAS | ALL PRODUCTS | $120.00 | ↓ -84% |
| United | Medicare Advantage | $124.08 | ↓ -83% |
| Anthem | Medicare Advantage | $124.08 | ↓ -83% |
| Cigna | Medicare Advantage | $124.08 | ↓ -83% |
| Humana | Medicare Advantage HMO | $124.08 | ↓ -83% |
| Aetna | Medicare Advantage | $124.08 | ↓ -83% |
| The Health Plan | Medicare Advantage | $124.08 | ↓ -83% |
| MMO | Medicare HMO & PPO | $127.80 | ↓ -82% |
| ANTHEM | PPO/HMO | $129.41 | ↓ -82% |
| Ohio Healthy | TRANSPLANT | $129.60 | ↓ -82% |
| Summacare | Premier | $130.28 | ↓ -82% |
| CommuniCare | Medicare Advantage | $130.28 | ↓ -82% |
| ANTHEM | TRADITIONAL | $132.72 | ↓ -82% |
| The Health Plan | PPO | $132.77 | ↓ -82% |
| Perennial Health | Medicare Advantage | $134.01 | ↓ -82% |
| The Health Plan | All Products PCP | $136.49 | ↓ -81% |
| Summacare | Medicare Advantage MD | $142.08 | ↓ -80% |
| The Health Plan | All Products Specialty Physicians | $142.69 | ↓ -80% |
| The Health Plan | All Products Radiation Oncology Physicians | $161.30 | ↓ -78% |
| Medical Benefit Corp | Transplant SMCP | $168.00 | ↓ -77% |
| GMS | ALL PRODUCTS | $168.00 | ↓ -77% |
| Managed Care Services | TRANSPLANT | $180.00 | ↓ -75% |
| AETNA | ALL PRODUCTS | $180.00 | ↓ -75% |
| Consociate Health | ALL PRODUCTS | $180.00 | ↓ -75% |
| Aetna | Acop | $199.19 | ↓ -73% |
| The Health Plan | Self-Funded ASO | $201.60 | ↓ -72% |
| Anthem | All Products Mid-Level Non-Facility | $202.29 | ↓ -72% |
| MMO | SuperMed | $211.82 | ↓ -71% |
| United | All Products - Mid-Level | $215.55 | ↓ -70% |
| MULTIPLAN | ALL PRODUCTS | $216.00 | ↓ -70% |
| Tertiary Care Network | TRANSPLANT | $216.00 | ↓ -70% |
| FrontPath | TRANSPLANT | $216.00 | ↓ -70% |
| Cigna | All Products Mid-Level | $220.67 | ↓ -70% |
| United | All Products | $239.50 | ↓ -67% |
| United | HMO & PPO | $239.50 | ↓ -67% |
| The Health Plan | POS | $240.00 | ↓ -67% |
| The Health Plan | HMO | $240.00 | ↓ -67% |
| AETNA | Qhp/Ipf | $240.00 | ↓ -67% |
| Cigna | All Products Physician | $261.00 | ↓ -64% |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| Perennial Health | MEDICARE ADVANTAGE | not published by hospital | — |
| Perennial Health | HMO I-SNP and HMO C-SNP | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| ANTHEM | MEDICARE ADVANTAGE | not published by hospital | — |
| Summacare | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| The Health Plan | MEDICARE ADVANTAGE | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic childrens hospital for rehabilitation | Cleveland | $156.00 | $0.01 – $227.63 |
| cleveland clinic main campus | Cleveland | $728.00 | $0.01 – $216.00 |
| akron general | Akron | $728.00 | $0.01 – $227.63 |
| avon hospital | Avon | $156.00 | $0.01 – $216.00 |
| euclid hospital | Euclid | $156.00 | $0.01 – $216.00 |
| fairview hospital | Cleveland | $156.00 | $0.01 – $227.63 |
| lutheran hospital | Cleveland | $156.00 | $0.01 – $227.63 |
| hillcrest hospital | Mayfield Heights | $156.00 | $0.01 – $216.00 |