healthcosts.net
Excision radial head at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,669.20
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.
$2,568.00
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 $5,526.53 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% |
| Summacare | Preferred | $319.41 | ↓ -81% |
| Summacare | Medicare Advantage Lower Level | $319.41 | ↓ -81% |
| Summacare | Medicare Advantage Psych | $350.63 | ↓ -79% |
| United | Managed Medicaid | $371.83 | ↓ -78% |
| Caresource | Managed Medicaid | $382.98 | ↓ -77% |
| Buckeye | Managed Medicaid | $390.42 | ↓ -77% |
| AmeriHealth | Managed Medicaid | $409.01 | ↓ -75% |
| Molina | Managed Medicaid | $409.01 | ↓ -75% |
| Summacare | Medicare Advantage CNA | $417.69 | ↓ -75% |
| Summacare | Medicare Advantage MD | $466.83 | ↓ -72% |
| United | Medicare Advantage | $467.51 | ↓ -72% |
| Humana | Medicare Advantage HMO | $467.51 | ↓ -72% |
| The Health Plan | Medicare Advantage | $467.51 | ↓ -72% |
| Aetna | Medicare Advantage | $467.51 | ↓ -72% |
| Cigna | Medicare Advantage | $467.51 | ↓ -72% |
| Anthem | Medicare Advantage | $467.51 | ↓ -72% |
| MMO | Medicare HMO & PPO | $481.54 | ↓ -71% |
| Summacare | Premier | $490.89 | ↓ -71% |
| CommuniCare | Medicare Advantage | $490.89 | ↓ -71% |
| Perennial Health | Medicare Advantage | $504.91 | ↓ -70% |
| The Health Plan | All Products PCP | $514.26 | ↓ -69% |
| The Health Plan | All Products Specialty Physicians | $537.64 | ↓ -68% |
| The Health Plan | All Products Radiation Oncology Physicians | $607.76 | ↓ -64% |
| Oscar | All Products | $652.53 | ↓ -61% |
| Anthem | All Products Mid-Level Non-Facility | $688.87 | ↓ -59% |
| Aultcare | PPO/HMO | $919.34 | ↓ -45% |
| OHCP | All Products | $998.95 | ↓ -40% |
| United | All Products - Mid-Level | $1,144.29 | ↓ -31% |
| United | All Products | $1,271.43 | ↓ -24% |
| United | HMO & PPO | $1,271.43 | ↓ -24% |
| OMAS | All Products | $1,284.00 | ↓ -23% |
| PHPHI | All Products | $1,540.80 | ↓ -8% |
| GMS | All Products | $1,797.60 | ↑ +8% |
| MMO | Traditional | $1,797.60 | ↑ +8% |
| Immergrun | All Products | $1,926.00 | ↑ +15% |
| Aetna | All Products First Health | $1,926.00 | ↑ +15% |
| Aetna | Asa | $2,054.40 | ↑ +23% |
| Multiplan | All Products | $2,311.20 | ↑ +38% |
| Aetna | Qhp/Ifp | $2,568.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $2,698.16 | ↑ +62% |
| HUMANA | Medicare Advantage HMO | $2,997.95 | ↑ +80% |
| UNITED | MEDICARE ADVANTAGE | $2,997.95 | ↑ +80% |
| Summacare | MEDICARE ADVANTAGE | $3,095.56 | ↑ +85% |
| ANTHEM | MEDICARE ADVANTAGE | $3,095.56 | ↑ +85% |
| AETNA | MEDICARE ADVANTAGE | $3,095.56 | ↑ +85% |
| CIGNA | MEDICARE ADVANTAGE | $3,188.43 | ↑ +91% |
| Perennial Health | MEDICARE ADVANTAGE | $3,237.79 | ↑ +94% |
| CommuniCare | MEDICARE ADVANTAGE | $3,250.34 | ↑ +95% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,343.21 | ↑ +100% |
| UNITED | Managed Medicaid | $3,394.13 | ↑ +103% |
| CARESOURCE | Managed Medicaid | $3,495.95 | ↑ +109% |
| MOLINA | Managed Medicaid | $3,563.84 | ↑ +114% |
| ANTHEM | Managed Medicaid | $3,563.84 | ↑ +114% |
| AMERIHEALTH | Managed Medicaid | $3,733.54 | ↑ +124% |
| MMO | ALL PRODUCTS | $4,898.36 | ↑ +193% |
| MMO | SuperMed | $5,526.53 | ↑ +231% |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Excision radial head at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,669.20 | $1.10 – $4,819.94 |
| akron general | Akron | $1,669.20 | $1.10 – $3,825.93 |
| avon hospital | Avon | not published | $3,007.88 – $3,611.21 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $5,785.60 – $6,699.11 |
| euclid hospital | Euclid | not published | $2,808.13 – $4,203.88 |
| fairview hospital | Cleveland | not published | $2,808.13 – $3,949.33 |
| lutheran hospital | Cleveland | not published | $3,007.88 – $3,759.90 |
| hillcrest hospital | Mayfield Heights | not published | $2,808.13 – $4,114.58 |