healthcosts.net
Explor not followed by surg repair artery; low extrem 35703 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,950.00
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.
$3,000.00
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 | $255.35 | ↓ -87% |
| Summacare | Medicare Advantage Lower Level | $255.35 | ↓ -87% |
| Summacare | Medicare Advantage Psych | $281.57 | ↓ -86% |
| Summacare | Medicare Advantage CNA | $333.91 | ↓ -83% |
| United | Managed Medicaid | $342.32 | ↓ -82% |
| Caresource | Managed Medicaid | $352.59 | ↓ -82% |
| Buckeye | Managed Medicaid | $359.44 | ↓ -82% |
| Summacare | Medicare Advantage MD | $373.20 | ↓ -81% |
| Cigna | Medicare Advantage | $375.42 | ↓ -81% |
| Anthem | Medicare Advantage | $375.42 | ↓ -81% |
| The Health Plan | Medicare Advantage | $375.42 | ↓ -81% |
| Humana | Medicare Advantage HMO | $375.42 | ↓ -81% |
| Aetna | Medicare Advantage | $375.42 | ↓ -81% |
| United | Medicare Advantage | $375.42 | ↓ -81% |
| Molina | Managed Medicaid | $376.55 | ↓ -81% |
| AmeriHealth | Managed Medicaid | $376.55 | ↓ -81% |
| MMO | Medicare HMO & PPO | $386.68 | ↓ -80% |
| CommuniCare | Medicare Advantage | $394.19 | ↓ -80% |
| Summacare | Premier | $394.19 | ↓ -80% |
| The Health Plan | PPO | $401.70 | ↓ -79% |
| Perennial Health | Medicare Advantage | $405.45 | ↓ -79% |
| The Health Plan | All Products PCP | $412.96 | ↓ -79% |
| The Health Plan | All Products Specialty Physicians | $431.73 | ↓ -78% |
| The Health Plan | All Products Radiation Oncology Physicians | $488.05 | ↓ -75% |
| Anthem | All Products Mid-Level Non-Facility | $557.16 | ↓ -71% |
| MMO | SuperMed | $706.05 | ↓ -64% |
| Oscar | All Products | $762.30 | ↓ -61% |
| United | All Products - Mid-Level | $919.54 | ↓ -53% |
| United | HMO & PPO | $1,021.71 | ↓ -48% |
| United | All Products | $1,021.71 | ↓ -48% |
| Aultcare | PPO/HMO | $1,074.00 | ↓ -45% |
| OHCP | All Products | $1,167.00 | ↓ -40% |
| OMAS | All Products | $1,500.00 | ↓ -23% |
| PHPHI | All Products | $1,800.00 | ↓ -8% |
| GMS | All Products | $2,100.00 | ↑ +8% |
| MMO | Traditional | $2,100.00 | ↑ +8% |
| Aetna | All Products First Health | $2,250.00 | ↑ +15% |
| Immergrun | All Products | $2,250.00 | ↑ +15% |
| UNITED | Managed Medicaid | $2,282.27 | ↑ +17% |
| CARESOURCE | Managed Medicaid | $2,350.74 | ↑ +21% |
| ANTHEM | Managed Medicaid | $2,396.38 | ↑ +23% |
| MOLINA | Managed Medicaid | $2,396.38 | ↑ +23% |
| Aetna | Asa | $2,400.00 | ↑ +23% |
| AMERIHEALTH | Managed Medicaid | $2,510.50 | ↑ +29% |
| Multiplan | All Products | $2,700.00 | ↑ +38% |
| Aetna | Qhp/Ifp | $3,000.00 | ↑ +54% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +65359% |
| The Health Plan | POS | $4,036,081.00 | ↑ +206879% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
Visitor-reported prices
Comments
Explor not followed by surg repair artery; low extrem 35703 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,950.00 | $1.10 – $3,241.01 |
| akron general | Akron | $1,950.00 | $1.10 – $2,700.00 |
| avon hospital | Avon | not published | $2,382.85 – $2,428.24 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $3,890.33 – $4,504.59 |
| euclid hospital | Euclid | not published | $2,441.29 – $2,826.76 |
| fairview hospital | Cleveland | not published | $2,293.47 – $2,655.60 |
| lutheran hospital | Cleveland | not published | $2,183.46 – $2,528.22 |
| hillcrest hospital | Mayfield Heights | not published | $2,389.43 – $2,766.71 |