healthcosts.net
Excision breast lesion at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,913.60
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.
$2,944.00
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 $6,508.54 with MMO — 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% |
| Oscar | All Products | $225.13 | ↓ -88% |
| United | Managed Medicaid | $238.61 | ↓ -88% |
| Caresource | Managed Medicaid | $245.77 | ↓ -87% |
| Buckeye | Managed Medicaid | $250.54 | ↓ -87% |
| Molina | Managed Medicaid | $262.47 | ↓ -86% |
| AmeriHealth | Managed Medicaid | $262.47 | ↓ -86% |
| Summacare | Medicare Advantage Lower Level | $287.12 | ↓ -85% |
| Summacare | Preferred | $287.12 | ↓ -85% |
| Aultcare | PPO/HMO | $317.19 | ↓ -83% |
| Summacare | Medicare Advantage Psych | $329.75 | ↓ -83% |
| OHCP | All Products | $344.65 | ↓ -82% |
| Summacare | Medicare Advantage CNA | $375.46 | ↓ -80% |
| Summacare | Medicare Advantage MD | $419.63 | ↓ -78% |
| Aetna | Medicare Advantage | $439.67 | ↓ -77% |
| United | Medicare Advantage | $439.67 | ↓ -77% |
| Anthem | Medicare Advantage | $439.67 | ↓ -77% |
| Cigna | Medicare Advantage | $439.67 | ↓ -77% |
| The Health Plan | Medicare Advantage | $439.67 | ↓ -77% |
| Humana | Medicare Advantage HMO | $439.67 | ↓ -77% |
| OMAS | All Products | $443.00 | ↓ -77% |
| MMO | Medicare HMO & PPO | $452.86 | ↓ -76% |
| CommuniCare | Medicare Advantage | $461.65 | ↓ -76% |
| Summacare | Premier | $461.65 | ↓ -76% |
| Perennial Health | Medicare Advantage | $474.84 | ↓ -75% |
| The Health Plan | All Products PCP | $483.64 | ↓ -75% |
| The Health Plan | All Products Specialty Physicians | $505.62 | ↓ -74% |
| PHPHI | All Products | $531.60 | ↓ -72% |
| The Health Plan | All Products Radiation Oncology Physicians | $571.57 | ↓ -70% |
| MMO | Traditional | $620.20 | ↓ -68% |
| GMS | All Products | $620.20 | ↓ -68% |
| Aetna | All Products First Health | $664.50 | ↓ -65% |
| Immergrun | All Products | $664.50 | ↓ -65% |
| Aetna | Asa | $708.80 | ↓ -63% |
| Cigna | All Products Mid-Level | $712.34 | ↓ -63% |
| Anthem | All Products Mid-Level Non-Facility | $761.84 | ↓ -60% |
| Aetna | Acop | $767.98 | ↓ -60% |
| Multiplan | All Products | $797.40 | ↓ -58% |
| UNITED | Managed Medicaid | $841.30 | ↓ -56% |
| Cigna | All Products Physician | $841.70 | ↓ -56% |
| CARESOURCE | Managed Medicaid | $866.54 | ↓ -55% |
| MOLINA | Managed Medicaid | $883.37 | ↓ -54% |
| ANTHEM | Managed Medicaid | $883.37 | ↓ -54% |
| Aetna | Qhp/Ifp | $886.00 | ↓ -54% |
| AMERIHEALTH | Managed Medicaid | $925.43 | ↓ -52% |
| United | All Products - Mid-Level | $1,267.32 | ↓ -34% |
| United | All Products | $1,408.14 | ↓ -26% |
| United | HMO & PPO | $1,408.14 | ↓ -26% |
| The Health Plan | MEDICARE ADVANTAGE | $3,184.36 | ↑ +66% |
| ANTHEM | PPO/HMO | $3,402.00 | ↑ +78% |
| UNITED | MEDICARE ADVANTAGE | $3,538.18 | ↑ +85% |
| HUMANA | Medicare Advantage HMO | $3,538.18 | ↑ +85% |
| Summacare | MEDICARE ADVANTAGE | $3,704.30 | ↑ +94% |
| AETNA | MEDICARE ADVANTAGE | $3,704.30 | ↑ +94% |
| ANTHEM | MEDICARE ADVANTAGE | $3,704.30 | ↑ +94% |
| CIGNA | MEDICARE ADVANTAGE | $3,815.43 | ↑ +99% |
| Perennial Health | MEDICARE ADVANTAGE | $3,821.23 | ↑ +100% |
| CommuniCare | MEDICARE ADVANTAGE | $3,889.52 | ↑ +103% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $4,000.65 | ↑ +109% |
| CIGNA | ALL PRODUCTS | $5,520.00 | ↑ +188% |
| MMO | ALL PRODUCTS | $5,768.37 | ↑ +201% |
| MMO | SuperMed | $6,508.54 | ↑ +240% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Excision breast lesion at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,913.60 | $1.10 – $3,704.30 |
| akron general | Akron | $1,913.60 | $1.10 – $3,821.23 |
| avon hospital | Avon | not published | $878.38 – $4,074.73 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,434.07 – $1,660.51 |
| euclid hospital | Euclid | not published | $899.92 – $4,074.73 |
| fairview hospital | Cleveland | not published | $845.42 – $4,074.73 |
| lutheran hospital | Cleveland | not published | $804.88 – $4,074.73 |
| hillcrest hospital | Mayfield Heights | not published | $880.80 – $4,074.73 |