healthcosts.net
Insert self-contd prosthesis at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$2,714.40
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.
$4,176.00
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 $34,442.24 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 | $408.92 | ↓ -85% |
| Summacare | Medicare Advantage Lower Level | $408.92 | ↓ -85% |
| Summacare | Medicare Advantage Psych | $450.43 | ↓ -83% |
| United | Managed Medicaid | $458.75 | ↓ -83% |
| Caresource | Managed Medicaid | $472.51 | ↓ -83% |
| Buckeye | Managed Medicaid | $481.69 | ↓ -82% |
| AmeriHealth | Managed Medicaid | $504.63 | ↓ -81% |
| Molina | Managed Medicaid | $504.63 | ↓ -81% |
| Summacare | Medicare Advantage CNA | $534.74 | ↓ -80% |
| Summacare | Medicare Advantage MD | $597.65 | ↓ -78% |
| United | Medicare Advantage | $600.57 | ↓ -78% |
| Humana | Medicare Advantage HMO | $600.57 | ↓ -78% |
| The Health Plan | Medicare Advantage | $600.57 | ↓ -78% |
| Cigna | Medicare Advantage | $600.57 | ↓ -78% |
| Aetna | Medicare Advantage | $600.57 | ↓ -78% |
| Anthem | Medicare Advantage | $600.57 | ↓ -78% |
| MMO | Medicare HMO & PPO | $618.59 | ↓ -77% |
| Summacare | Premier | $630.60 | ↓ -77% |
| CommuniCare | Medicare Advantage | $630.60 | ↓ -77% |
| Perennial Health | Medicare Advantage | $648.62 | ↓ -76% |
| The Health Plan | All Products PCP | $660.63 | ↓ -76% |
| The Health Plan | All Products Specialty Physicians | $690.66 | ↓ -75% |
| The Health Plan | All Products Radiation Oncology Physicians | $780.74 | ↓ -71% |
| Anthem | All Products Mid-Level Non-Facility | $878.48 | ↓ -68% |
| Oscar | All Products | $1,061.12 | ↓ -61% |
| United | All Products - Mid-Level | $1,475.43 | ↓ -46% |
| Aultcare | PPO/HMO | $1,495.01 | ↓ -45% |
| OHCP | All Products | $1,624.46 | ↓ -40% |
| United | HMO & PPO | $1,639.37 | ↓ -40% |
| United | All Products | $1,639.37 | ↓ -40% |
| OMAS | All Products | $2,088.00 | ↓ -23% |
| PHPHI | All Products | $2,505.60 | ↓ -8% |
| MMO | Traditional | $2,923.20 | ↑ +8% |
| GMS | All Products | $2,923.20 | ↑ +8% |
| Aetna | All Products First Health | $3,132.00 | ↑ +15% |
| Immergrun | All Products | $3,132.00 | ↑ +15% |
| Aetna | Asa | $3,340.80 | ↑ +23% |
| Multiplan | All Products | $3,758.40 | ↑ +38% |
| Aetna | Qhp/Ifp | $4,176.00 | ↑ +54% |
| UNITED | Managed Medicaid | $10,237.62 | ↑ +277% |
| CARESOURCE | Managed Medicaid | $10,544.75 | ↑ +288% |
| MOLINA | Managed Medicaid | $10,749.50 | ↑ +296% |
| ANTHEM | Managed Medicaid | $10,749.50 | ↑ +296% |
| AMERIHEALTH | Managed Medicaid | $11,261.38 | ↑ +315% |
| The Health Plan | MEDICARE ADVANTAGE | $16,738.55 | ↑ +517% |
| HUMANA | Medicare Advantage HMO | $18,598.39 | ↑ +585% |
| UNITED | MEDICARE ADVANTAGE | $18,598.39 | ↑ +585% |
| Summacare | MEDICARE ADVANTAGE | $19,608.51 | ↑ +622% |
| ANTHEM | MEDICARE ADVANTAGE | $19,608.51 | ↑ +622% |
| AETNA | MEDICARE ADVANTAGE | $19,608.51 | ↑ +622% |
| Perennial Health | MEDICARE ADVANTAGE | $20,086.26 | ↑ +640% |
| CIGNA | MEDICARE ADVANTAGE | $20,196.77 | ↑ +644% |
| CommuniCare | MEDICARE ADVANTAGE | $20,588.94 | ↑ +659% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $21,177.19 | ↑ +680% |
| MMO | ALL PRODUCTS | $30,526.33 | ↑ +1025% |
| MMO | SuperMed | $34,442.24 | ↑ +1169% |
| Cigna | All Products Physician | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
Visitor-reported prices
Comments
Insert self-contd prosthesis at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $2,714.40 | $1.10 – $19,608.51 |
| akron general | Akron | $2,714.40 | $1.10 – $20,196.77 |
| avon hospital | Avon | not published | $10,688.80 – $21,569.36 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $17,450.93 – $20,206.34 |
| euclid hospital | Euclid | not published | $10,950.94 – $21,569.36 |
| fairview hospital | Cleveland | not published | $10,287.86 – $21,569.36 |
| lutheran hospital | Cleveland | not published | $9,794.40 – $21,569.36 |
| hillcrest hospital | Mayfield Heights | not published | $10,718.35 – $21,569.36 |