healthcosts.net
Excision of gum lesion at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$816.40
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.
$1,256.00
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 | Medicare Advantage Lower Level | $137.03 | ↓ -83% |
| Summacare | Preferred | $137.03 | ↓ -83% |
| Summacare | Medicare Advantage Psych | $145.95 | ↓ -82% |
| Summacare | Medicare Advantage CNA | $179.20 | ↓ -78% |
| The Health Plan | Medicare Advantage | $194.60 | ↓ -76% |
| Cigna | Medicare Advantage | $194.60 | ↓ -76% |
| Humana | Medicare Advantage HMO | $194.60 | ↓ -76% |
| United | Medicare Advantage | $194.60 | ↓ -76% |
| Aetna | Medicare Advantage | $194.60 | ↓ -76% |
| Anthem | Medicare Advantage | $194.60 | ↓ -76% |
| Summacare | Medicare Advantage MD | $200.28 | ↓ -75% |
| MMO | Medicare HMO & PPO | $200.44 | ↓ -75% |
| Summacare | Premier | $204.33 | ↓ -75% |
| CommuniCare | Medicare Advantage | $204.33 | ↓ -75% |
| The Health Plan | PPO | $208.22 | ↓ -74% |
| Perennial Health | Medicare Advantage | $210.17 | ↓ -74% |
| The Health Plan | All Products PCP | $214.06 | ↓ -74% |
| The Health Plan | All Products Specialty Physicians | $223.79 | ↓ -73% |
| The Health Plan | All Products Radiation Oncology Physicians | $252.98 | ↓ -69% |
| Oscar | All Products | $319.15 | ↓ -61% |
| Aetna | Acop | $432.78 | ↓ -47% |
| Cigna | All Products Mid-Level | $433.04 | ↓ -47% |
| Aultcare | PPO/HMO | $449.65 | ↓ -45% |
| Anthem | All Products Mid-Level Non-Facility | $463.14 | ↓ -43% |
| OHCP | All Products | $488.58 | ↓ -40% |
| Cigna | All Products Physician | $511.68 | ↓ -37% |
| OMAS | All Products | $628.00 | ↓ -23% |
| PHPHI | All Products | $753.60 | ↓ -8% |
| United | All Products - Mid-Level | $765.77 | ↓ -6% |
| United | All Products | $850.86 | ↑ +4% |
| United | HMO & PPO | $850.86 | ↑ +4% |
| MMO | Traditional | $879.20 | ↑ +8% |
| GMS | All Products | $879.20 | ↑ +8% |
| Aetna | All Products First Health | $942.00 | ↑ +15% |
| Immergrun | All Products | $942.00 | ↑ +15% |
| Aetna | Asa | $1,004.80 | ↑ +23% |
| Multiplan | All Products | $1,130.40 | ↑ +38% |
| The Health Plan | MEDICARE ADVANTAGE | $1,231.81 | ↑ +51% |
| Aetna | Qhp/Ifp | $1,256.00 | ↑ +54% |
| UNITED | MEDICARE ADVANTAGE | $1,368.67 | ↑ +68% |
| HUMANA | Medicare Advantage HMO | $1,368.67 | ↑ +68% |
| UNITED | Managed Medicaid | $1,430.00 | ↑ +75% |
| ANTHEM | MEDICARE ADVANTAGE | $1,467.92 | ↑ +80% |
| Summacare | MEDICARE ADVANTAGE | $1,467.92 | ↑ +80% |
| AETNA | MEDICARE ADVANTAGE | $1,467.92 | ↑ +80% |
| Buckeye | Managed Medicaid | $1,472.90 | ↑ +80% |
| CARESOURCE | Managed Medicaid | $1,472.90 | ↑ +80% |
| Perennial Health | MEDICARE ADVANTAGE | $1,478.17 | ↑ +81% |
| MOLINA | Managed Medicaid | $1,501.50 | ↑ +84% |
| ANTHEM | Managed Medicaid | $1,501.50 | ↑ +84% |
| CIGNA | MEDICARE ADVANTAGE | $1,511.96 | ↑ +85% |
| CommuniCare | MEDICARE ADVANTAGE | $1,541.31 | ↑ +89% |
| AMERIHEALTH | Managed Medicaid | $1,573.00 | ↑ +93% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,585.35 | ↑ +94% |
| MMO | ALL PRODUCTS | $2,307.88 | ↑ +183% |
| MMO | SuperMed | $2,603.78 | ↑ +219% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +156251% |
| The Health Plan | POS | $4,036,081.00 | ↑ +494275% |
| Caresource | Managed Medicaid | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| AmeriHealth | Managed Medicaid | not published by hospital | — |
| United | Managed Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Excision of gum lesion at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,429.10 | $0.01 – $6,132.60 |
| akron general | Akron | $816.40 | $1.10 – $1,573.00 |
| avon hospital | Avon | not published | $1,373.21 – $1,614.71 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,358.50 – $1,573.00 |
| euclid hospital | Euclid | not published | $1,323.06 – $1,614.71 |
| fairview hospital | Cleveland | not published | $1,323.06 – $1,614.71 |
| lutheran hospital | Cleveland | not published | $1,358.50 – $1,614.71 |
| hillcrest hospital | Mayfield Heights | not published | $1,323.06 – $1,614.71 |