healthcosts.net
Exploration of knee joint at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$2,600.00
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.
$4,000.00
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 $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 | Medicare Advantage Lower Level | $454.47 | ↓ -83% |
| Summacare | Preferred | $454.47 | ↓ -83% |
| Summacare | Medicare Advantage Psych | $500.45 | ↓ -81% |
| United | Managed Medicaid | $544.88 | ↓ -79% |
| Caresource | Managed Medicaid | $561.23 | ↓ -78% |
| Buckeye | Managed Medicaid | $572.12 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $594.31 | ↓ -77% |
| AmeriHealth | Managed Medicaid | $599.37 | ↓ -77% |
| Molina | Managed Medicaid | $599.37 | ↓ -77% |
| Summacare | Medicare Advantage MD | $664.23 | ↓ -74% |
| Humana | Medicare Advantage HMO | $667.26 | ↓ -74% |
| The Health Plan | Medicare Advantage | $667.26 | ↓ -74% |
| Cigna | Medicare Advantage | $667.26 | ↓ -74% |
| United | Medicare Advantage | $667.26 | ↓ -74% |
| Aetna | Medicare Advantage | $667.26 | ↓ -74% |
| Anthem | Medicare Advantage | $667.26 | ↓ -74% |
| MMO | Medicare HMO & PPO | $687.28 | ↓ -74% |
| CommuniCare | Medicare Advantage | $700.62 | ↓ -73% |
| Summacare | Premier | $700.62 | ↓ -73% |
| Perennial Health | Medicare Advantage | $720.64 | ↓ -72% |
| The Health Plan | All Products PCP | $733.99 | ↓ -72% |
| The Health Plan | All Products Specialty Physicians | $767.35 | ↓ -70% |
| The Health Plan | All Products Radiation Oncology Physicians | $867.44 | ↓ -67% |
| Anthem | All Products Mid-Level Non-Facility | $983.17 | ↓ -62% |
| Oscar | All Products | $1,016.40 | ↓ -61% |
| Aultcare | PPO/HMO | $1,432.00 | ↓ -45% |
| OHCP | All Products | $1,556.00 | ↓ -40% |
| United | All Products - Mid-Level | $1,638.29 | ↓ -37% |
| United | All Products | $1,820.32 | ↓ -30% |
| United | HMO & PPO | $1,820.32 | ↓ -30% |
| OMAS | All Products | $2,000.00 | ↓ -23% |
| UNITED | Managed Medicaid | $2,024.64 | ↓ -22% |
| CARESOURCE | Managed Medicaid | $2,085.38 | ↓ -20% |
| ANTHEM | Managed Medicaid | $2,125.87 | ↓ -18% |
| MOLINA | Managed Medicaid | $2,125.87 | ↓ -18% |
| AMERIHEALTH | Managed Medicaid | $2,227.10 | ↓ -14% |
| PHPHI | All Products | $2,400.00 | ↓ -8% |
| The Health Plan | MEDICARE ADVANTAGE | $2,698.16 | ↑ +4% |
| GMS | All Products | $2,800.00 | ↑ +8% |
| MMO | Traditional | $2,800.00 | ↑ +8% |
| UNITED | MEDICARE ADVANTAGE | $2,997.95 | ↑ +15% |
| HUMANA | Medicare Advantage HMO | $2,997.95 | ↑ +15% |
| Immergrun | All Products | $3,000.00 | ↑ +15% |
| Aetna | All Products First Health | $3,000.00 | ↑ +15% |
| ANTHEM | MEDICARE ADVANTAGE | $3,095.56 | ↑ +19% |
| Summacare | MEDICARE ADVANTAGE | $3,095.56 | ↑ +19% |
| AETNA | MEDICARE ADVANTAGE | $3,095.56 | ↑ +19% |
| CIGNA | MEDICARE ADVANTAGE | $3,188.43 | ↑ +23% |
| Aetna | Asa | $3,200.00 | ↑ +23% |
| Perennial Health | MEDICARE ADVANTAGE | $3,237.79 | ↑ +25% |
| CommuniCare | MEDICARE ADVANTAGE | $3,250.34 | ↑ +25% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,343.21 | ↑ +29% |
| Multiplan | All Products | $3,600.00 | ↑ +38% |
| Aetna | Qhp/Ifp | $4,000.00 | ↑ +54% |
| MMO | ALL PRODUCTS | $4,898.36 | ↑ +88% |
| MMO | SuperMed | $5,526.53 | ↑ +113% |
| 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
Exploration of knee joint at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $2,600.00 | $1.10 – $3,600.00 |
| akron general | Akron | $2,600.00 | $1.10 – $3,600.00 |
| avon hospital | Avon | not published | $2,113.87 – $3,405.12 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $3,451.18 – $3,996.10 |
| euclid hospital | Euclid | not published | $2,165.72 – $3,405.12 |
| fairview hospital | Cleveland | not published | $2,034.58 – $3,405.12 |
| lutheran hospital | Cleveland | not published | $1,936.98 – $3,405.12 |
| hillcrest hospital | Mayfield Heights | not published | $2,119.71 – $3,405.12 |