healthcosts.net
Lap resect s/intestine addl 44203 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,154.40
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.
$1,776.00
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 | $147.90 | ↓ -87% |
| Summacare | Medicare Advantage Lower Level | $147.90 | ↓ -87% |
| Summacare | Medicare Advantage Psych | $160.76 | ↓ -86% |
| United | Managed Medicaid | $180.74 | ↓ -84% |
| Caresource | Managed Medicaid | $186.16 | ↓ -84% |
| Buckeye | Managed Medicaid | $189.78 | ↓ -84% |
| Summacare | Medicare Advantage CNA | $193.41 | ↓ -83% |
| Molina | Managed Medicaid | $198.81 | ↓ -83% |
| AmeriHealth | Managed Medicaid | $198.81 | ↓ -83% |
| United | Medicare Advantage | $214.34 | ↓ -81% |
| Anthem | Medicare Advantage | $214.34 | ↓ -81% |
| The Health Plan | Medicare Advantage | $214.34 | ↓ -81% |
| Cigna | Medicare Advantage | $214.34 | ↓ -81% |
| Aetna | Medicare Advantage | $214.34 | ↓ -81% |
| Humana | Medicare Advantage HMO | $214.34 | ↓ -81% |
| Summacare | Medicare Advantage MD | $216.16 | ↓ -81% |
| MMO | Medicare HMO & PPO | $220.77 | ↓ -81% |
| Summacare | Premier | $225.06 | ↓ -81% |
| CommuniCare | Medicare Advantage | $225.06 | ↓ -81% |
| The Health Plan | PPO | $229.34 | ↓ -80% |
| Perennial Health | Medicare Advantage | $231.49 | ↓ -80% |
| The Health Plan | All Products PCP | $235.77 | ↓ -80% |
| The Health Plan | All Products Specialty Physicians | $246.49 | ↓ -79% |
| The Health Plan | All Products Radiation Oncology Physicians | $278.64 | ↓ -76% |
| Anthem | All Products Mid-Level Non-Facility | $326.43 | ↓ -72% |
| MMO | SuperMed | $412.16 | ↓ -64% |
| Oscar | All Products | $451.28 | ↓ -61% |
| United | All Products - Mid-Level | $535.49 | ↓ -54% |
| United | All Products | $594.99 | ↓ -48% |
| United | HMO & PPO | $594.99 | ↓ -48% |
| Aultcare | PPO/HMO | $635.81 | ↓ -45% |
| OHCP | All Products | $690.86 | ↓ -40% |
| OMAS | All Products | $888.00 | ↓ -23% |
| PHPHI | All Products | $1,065.60 | ↓ -8% |
| MMO | Traditional | $1,243.20 | ↑ +8% |
| GMS | All Products | $1,243.20 | ↑ +8% |
| Aetna | All Products First Health | $1,332.00 | ↑ +15% |
| Immergrun | All Products | $1,332.00 | ↑ +15% |
| Aetna | Asa | $1,420.80 | ↑ +23% |
| Multiplan | All Products | $1,598.40 | ↑ +38% |
| Aetna | Qhp/Ifp | $1,776.00 | ↑ +54% |
| UNITED | Managed Medicaid | $2,826.19 | ↑ +145% |
| CARESOURCE | Managed Medicaid | $2,910.98 | ↑ +152% |
| ANTHEM | Managed Medicaid | $2,967.50 | ↑ +157% |
| MOLINA | Managed Medicaid | $2,967.50 | ↑ +157% |
| AMERIHEALTH | Managed Medicaid | $3,108.81 | ↑ +169% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +110472% |
| The Health Plan | POS | $4,036,081.00 | ↑ +349526% |
| 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
Lap resect s/intestine addl 44203 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,154.40 | $1.10 – $4,013.42 |
| akron general | Akron | $1,154.40 | $1.10 – $3,185.74 |
| avon hospital | Avon | not published | $2,950.74 – $3,006.95 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $4,817.50 – $5,578.16 |
| euclid hospital | Euclid | not published | $3,023.11 – $3,500.44 |
| fairview hospital | Cleveland | not published | $2,840.06 – $3,288.49 |
| lutheran hospital | Cleveland | not published | $2,703.83 – $3,130.75 |
| hillcrest hospital | Mayfield Heights | not published | $2,958.90 – $3,426.09 |