healthcosts.net
Fixation of knee joint at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$465.40
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.
$716.00
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% |
| Summacare | Preferred | $95.69 | ↓ -79% |
| Summacare | Medicare Advantage Lower Level | $95.69 | ↓ -79% |
| United | Managed Medicaid | $106.87 | ↓ -77% |
| Summacare | Medicare Advantage Psych | $107.93 | ↓ -77% |
| Caresource | Managed Medicaid | $110.08 | ↓ -76% |
| Buckeye | Managed Medicaid | $112.21 | ↓ -76% |
| AmeriHealth | Managed Medicaid | $117.56 | ↓ -75% |
| Molina | Managed Medicaid | $117.56 | ↓ -75% |
| Summacare | Medicare Advantage CNA | $125.13 | ↓ -73% |
| Summacare | Medicare Advantage MD | $139.85 | ↓ -70% |
| United | Medicare Advantage | $143.90 | ↓ -69% |
| Humana | Medicare Advantage HMO | $143.90 | ↓ -69% |
| The Health Plan | Medicare Advantage | $143.90 | ↓ -69% |
| Aetna | Medicare Advantage | $143.90 | ↓ -69% |
| Cigna | Medicare Advantage | $143.90 | ↓ -69% |
| Anthem | Medicare Advantage | $143.90 | ↓ -69% |
| MMO | Medicare HMO & PPO | $148.22 | ↓ -68% |
| Summacare | Premier | $151.10 | ↓ -68% |
| CommuniCare | Medicare Advantage | $151.10 | ↓ -68% |
| Perennial Health | Medicare Advantage | $155.41 | ↓ -67% |
| The Health Plan | All Products PCP | $158.29 | ↓ -66% |
| The Health Plan | All Products Specialty Physicians | $165.49 | ↓ -64% |
| Oscar | All Products | $181.94 | ↓ -61% |
| The Health Plan | All Products Radiation Oncology Physicians | $187.07 | ↓ -60% |
| Anthem | All Products Mid-Level Non-Facility | $204.43 | ↓ -56% |
| Aultcare | PPO/HMO | $256.33 | ↓ -45% |
| OHCP | All Products | $278.52 | ↓ -40% |
| United | All Products - Mid-Level | $342.71 | ↓ -26% |
| OMAS | All Products | $358.00 | ↓ -23% |
| United | HMO & PPO | $380.79 | ↓ -18% |
| United | All Products | $380.79 | ↓ -18% |
| PHPHI | All Products | $429.60 | ↓ -8% |
| MMO | Traditional | $501.20 | ↑ +8% |
| GMS | All Products | $501.20 | ↑ +8% |
| Aetna | All Products First Health | $537.00 | ↑ +15% |
| Immergrun | All Products | $537.00 | ↑ +15% |
| Aetna | Asa | $572.80 | ↑ +23% |
| Multiplan | All Products | $644.40 | ↑ +38% |
| UNITED | Managed Medicaid | $672.41 | ↑ +44% |
| CARESOURCE | Managed Medicaid | $692.58 | ↑ +49% |
| ANTHEM | Managed Medicaid | $706.03 | ↑ +52% |
| MOLINA | Managed Medicaid | $706.03 | ↑ +52% |
| Aetna | Qhp/Ifp | $716.00 | ↑ +54% |
| AMERIHEALTH | Managed Medicaid | $739.65 | ↑ +59% |
| The Health Plan | MEDICARE ADVANTAGE | $1,330.87 | ↑ +186% |
| HUMANA | Medicare Advantage HMO | $1,478.75 | ↑ +218% |
| UNITED | MEDICARE ADVANTAGE | $1,478.75 | ↑ +218% |
| Summacare | MEDICARE ADVANTAGE | $1,521.28 | ↑ +227% |
| ANTHEM | MEDICARE ADVANTAGE | $1,521.28 | ↑ +227% |
| AETNA | MEDICARE ADVANTAGE | $1,521.28 | ↑ +227% |
| CIGNA | MEDICARE ADVANTAGE | $1,566.92 | ↑ +237% |
| Perennial Health | MEDICARE ADVANTAGE | $1,597.05 | ↑ +243% |
| CommuniCare | MEDICARE ADVANTAGE | $1,597.35 | ↑ +243% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,642.99 | ↑ +253% |
| MMO | ALL PRODUCTS | $2,432.21 | ↑ +423% |
| MMO | SuperMed | $2,743.55 | ↑ +490% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
Visitor-reported prices
Comments
Fixation of knee joint at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $465.40 | $1.10 – $1,521.28 |
| akron general | Akron | $465.40 | $1.10 – $1,597.05 |
| University Hospitals Ahuja Medical Center | Beachwood | $1,863.75 | $549.19 – $2,738.31 |
| University Hospitals Beachwood Medical Center | Beachwood | $1,863.75 | $900.00 – $3,852.98 |
| University Hospitals Elyria Medical Center | Elyria | $1,863.75 | $1,521.28 – $2,738.31 |
| University Hospitals Regional Hospitals - Geauga Medical Center | Chardon | $1,863.75 | $1,521.28 – $2,738.31 |
| University Hospitals Lake West Medical Center | Willoughby OH 44094|7590 Auburn Road | $1,863.75 | $1,521.28 – $2,738.31 |
| University Hospitals Parma Medical Center | Parma OH 44129|7007 Powers Boulevard | $1,863.75 | $1,521.28 – $2,738.31 |