healthcosts.net
Ex palate/uvula lesion without closure 42104 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$439.40
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.
$676.00
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 | $82.26 | ↓ -81% |
| Summacare | Medicare Advantage Lower Level | $82.26 | ↓ -81% |
| Summacare | Medicare Advantage Psych | $88.50 | ↓ -80% |
| United | Managed Medicaid | $94.97 | ↓ -78% |
| Caresource | Managed Medicaid | $97.82 | ↓ -78% |
| Buckeye | Managed Medicaid | $99.72 | ↓ -77% |
| AmeriHealth | Managed Medicaid | $104.47 | ↓ -76% |
| Molina | Managed Medicaid | $104.47 | ↓ -76% |
| Summacare | Medicare Advantage CNA | $107.57 | ↓ -76% |
| United | Medicare Advantage | $118.00 | ↓ -73% |
| Aetna | Medicare Advantage | $118.00 | ↓ -73% |
| The Health Plan | Medicare Advantage | $118.00 | ↓ -73% |
| Cigna | Medicare Advantage | $118.00 | ↓ -73% |
| Anthem | Medicare Advantage | $118.00 | ↓ -73% |
| Humana | Medicare Advantage HMO | $118.00 | ↓ -73% |
| Summacare | Medicare Advantage MD | $120.22 | ↓ -73% |
| MMO | Medicare HMO & PPO | $121.54 | ↓ -72% |
| CommuniCare | Medicare Advantage | $123.90 | ↓ -72% |
| Summacare | Premier | $123.90 | ↓ -72% |
| The Health Plan | PPO | $126.26 | ↓ -71% |
| Perennial Health | Medicare Advantage | $127.44 | ↓ -71% |
| The Health Plan | All Products PCP | $129.80 | ↓ -70% |
| The Health Plan | All Products Specialty Physicians | $135.70 | ↓ -69% |
| The Health Plan | All Products Radiation Oncology Physicians | $153.40 | ↓ -65% |
| Oscar | All Products | $171.77 | ↓ -61% |
| Aultcare | PPO/HMO | $242.01 | ↓ -45% |
| OHCP | All Products | $262.96 | ↓ -40% |
| Cigna | All Products Mid-Level | $265.72 | ↓ -40% |
| Anthem | All Products Mid-Level Non-Facility | $284.20 | ↓ -35% |
| Aetna | Acop | $295.09 | ↓ -33% |
| Cigna | All Products Physician | $313.98 | ↓ -29% |
| OMAS | All Products | $338.00 | ↓ -23% |
| PHPHI | All Products | $405.60 | ↓ -8% |
| United | All Products - Mid-Level | $470.18 | ↑ +7% |
| GMS | All Products | $473.20 | ↑ +8% |
| MMO | Traditional | $473.20 | ↑ +8% |
| Aetna | All Products First Health | $507.00 | ↑ +15% |
| Immergrun | All Products | $507.00 | ↑ +15% |
| United | HMO & PPO | $522.42 | ↑ +19% |
| United | All Products | $522.42 | ↑ +19% |
| Aetna | Asa | $540.80 | ↑ +23% |
| Multiplan | All Products | $608.40 | ↑ +38% |
| Aetna | Qhp/Ifp | $676.00 | ↑ +54% |
| UNITED | Managed Medicaid | $1,270.68 | ↑ +189% |
| CARESOURCE | Managed Medicaid | $1,308.80 | ↑ +198% |
| ANTHEM | Managed Medicaid | $1,334.21 | ↑ +204% |
| MOLINA | Managed Medicaid | $1,334.21 | ↑ +204% |
| AMERIHEALTH | Managed Medicaid | $1,397.75 | ↑ +218% |
| The Health Plan | MEDICARE ADVANTAGE | $2,696.88 | ↑ +514% |
| UNITED | MEDICARE ADVANTAGE | $2,996.53 | ↑ +582% |
| HUMANA | Medicare Advantage HMO | $2,996.53 | ↑ +582% |
| ANTHEM | MEDICARE ADVANTAGE | $3,136.68 | ↑ +614% |
| AETNA | MEDICARE ADVANTAGE | $3,136.68 | ↑ +614% |
| Summacare | MEDICARE ADVANTAGE | $3,136.68 | ↑ +614% |
| CIGNA | MEDICARE ADVANTAGE | $3,230.78 | ↑ +635% |
| Perennial Health | MEDICARE ADVANTAGE | $3,236.25 | ↑ +637% |
| CommuniCare | MEDICARE ADVANTAGE | $3,293.51 | ↑ +650% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,387.61 | ↑ +671% |
| MMO | ALL PRODUCTS | $4,872.30 | ↑ +1009% |
| MMO | SuperMed | $5,497.86 | ↑ +1151% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +290398% |
| The Health Plan | POS | $4,036,081.00 | ↑ +918444% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Ex palate/uvula lesion without closure 42104 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $9,696.70 | $0.01 – $13,426.20 |
| akron general | Akron | $439.40 | $1.10 – $3,236.25 |
| University Hospitals Ahuja Medical Center | Beachwood | $3,629.25 | $900.00 – $5,646.02 |
| University Hospitals Beachwood Medical Center | Beachwood | $3,629.25 | $900.00 – $7,944.33 |
| University Hospitals Elyria Medical Center | Elyria | $3,629.25 | $3,136.68 – $5,646.02 |
| University Hospitals Regional Hospitals - Geauga Medical Center | Chardon | $3,629.25 | $3,136.68 – $5,646.02 |
| University Hospitals Lake West Medical Center | Willoughby OH 44094|7590 Auburn Road | $3,629.25 | $3,136.68 – $5,646.02 |
| University Hospitals Parma Medical Center | Parma OH 44129|7007 Powers Boulevard | $3,629.25 | $3,136.68 – $5,646.02 |