healthcosts.net
Exploration of toe joint at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,175.20
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.
$1,808.00
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 $2,743.55 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% |
| United | Managed Medicaid | $154.52 | ↓ -87% |
| Caresource | Managed Medicaid | $159.16 | ↓ -86% |
| Buckeye | Managed Medicaid | $162.25 | ↓ -86% |
| AmeriHealth | Managed Medicaid | $169.97 | ↓ -86% |
| Molina | Managed Medicaid | $169.97 | ↓ -86% |
| Summacare | Preferred | $191.87 | ↓ -84% |
| Summacare | Medicare Advantage Lower Level | $191.87 | ↓ -84% |
| Summacare | Medicare Advantage Psych | $215.86 | ↓ -82% |
| Summacare | Medicare Advantage CNA | $250.90 | ↓ -79% |
| Summacare | Medicare Advantage MD | $280.42 | ↓ -76% |
| The Health Plan | Medicare Advantage | $287.81 | ↓ -76% |
| Aetna | Medicare Advantage | $287.81 | ↓ -76% |
| Cigna | Medicare Advantage | $287.81 | ↓ -76% |
| Anthem | Medicare Advantage | $287.81 | ↓ -76% |
| United | Medicare Advantage | $287.81 | ↓ -76% |
| Humana | Medicare Advantage HMO | $287.81 | ↓ -76% |
| MMO | Medicare HMO & PPO | $296.44 | ↓ -75% |
| CommuniCare | Medicare Advantage | $302.20 | ↓ -74% |
| Summacare | Premier | $302.20 | ↓ -74% |
| Perennial Health | Medicare Advantage | $310.83 | ↓ -74% |
| The Health Plan | All Products PCP | $316.59 | ↓ -73% |
| The Health Plan | All Products Specialty Physicians | $330.98 | ↓ -72% |
| The Health Plan | All Products Radiation Oncology Physicians | $374.15 | ↓ -68% |
| Oscar | All Products | $459.41 | ↓ -61% |
| Cigna | All Products Mid-Level | $557.00 | ↓ -53% |
| Anthem | All Products Mid-Level Non-Facility | $595.71 | ↓ -49% |
| Aetna | Acop | $628.70 | ↓ -47% |
| Aultcare | PPO/HMO | $647.26 | ↓ -45% |
| Cigna | All Products Physician | $658.16 | ↓ -44% |
| OHCP | All Products | $703.31 | ↓ -40% |
| OMAS | All Products | $904.00 | ↓ -23% |
| United | All Products - Mid-Level | $1,001.01 | ↓ -15% |
| PHPHI | All Products | $1,084.80 | ↓ -8% |
| United | HMO & PPO | $1,112.23 | ↓ -5% |
| United | All Products | $1,112.23 | ↓ -5% |
| GMS | All Products | $1,265.60 | ↑ +8% |
| MMO | Traditional | $1,265.60 | ↑ +8% |
| The Health Plan | MEDICARE ADVANTAGE | $1,330.87 | ↑ +13% |
| Aetna | All Products First Health | $1,356.00 | ↑ +15% |
| Immergrun | All Products | $1,356.00 | ↑ +15% |
| UNITED | Managed Medicaid | $1,430.89 | ↑ +22% |
| Aetna | Asa | $1,446.40 | ↑ +23% |
| CARESOURCE | Managed Medicaid | $1,473.82 | ↑ +25% |
| UNITED | MEDICARE ADVANTAGE | $1,478.75 | ↑ +26% |
| HUMANA | Medicare Advantage HMO | $1,478.75 | ↑ +26% |
| ANTHEM | Managed Medicaid | $1,502.43 | ↑ +28% |
| MOLINA | Managed Medicaid | $1,502.43 | ↑ +28% |
| Summacare | MEDICARE ADVANTAGE | $1,521.28 | ↑ +29% |
| ANTHEM | MEDICARE ADVANTAGE | $1,521.28 | ↑ +29% |
| AETNA | MEDICARE ADVANTAGE | $1,521.28 | ↑ +29% |
| CIGNA | MEDICARE ADVANTAGE | $1,566.92 | ↑ +33% |
| AMERIHEALTH | Managed Medicaid | $1,573.98 | ↑ +34% |
| Perennial Health | MEDICARE ADVANTAGE | $1,597.05 | ↑ +36% |
| CommuniCare | MEDICARE ADVANTAGE | $1,597.35 | ↑ +36% |
| Multiplan | All Products | $1,627.20 | ↑ +38% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,642.99 | ↑ +40% |
| Aetna | Qhp/Ifp | $1,808.00 | ↑ +54% |
| MMO | ALL PRODUCTS | $2,432.21 | ↑ +107% |
| MMO | SuperMed | $2,743.55 | ↑ +133% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Exploration of toe joint at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,175.20 | $1.10 – $2,031.98 |
| akron general | Akron | $1,175.20 | $1.10 – $1,627.20 |
| avon hospital | Avon | not published | $1,483.64 – $1,673.41 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $2,439.08 – $2,824.20 |
| euclid hospital | Euclid | not published | $1,394.34 – $1,772.25 |
| fairview hospital | Cleveland | not published | $1,394.34 – $1,673.41 |
| lutheran hospital | Cleveland | not published | $1,368.94 – $1,673.41 |
| hillcrest hospital | Mayfield Heights | not published | $1,394.34 – $1,734.61 |