healthcosts.net
Nasal/sinus endo w/ethmoidectomy part 31254 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$1,221.35
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.
$1,879.00
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 $11,685.63 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 | $148.99 | ↓ -88% |
| Summacare | Preferred | $148.99 | ↓ -88% |
| Summacare | Medicare Advantage Psych | $152.14 | ↓ -88% |
| Summacare | Medicare Advantage CNA | $194.84 | ↓ -84% |
| Humana | Medicare Advantage HMO | $202.85 | ↓ -83% |
| United | Medicare Advantage | $202.85 | ↓ -83% |
| Aetna | Medicare Advantage | $202.85 | ↓ -83% |
| The Health Plan | Medicare Advantage | $202.85 | ↓ -83% |
| Anthem | Medicare Advantage | $202.85 | ↓ -83% |
| Cigna | Medicare Advantage | $202.85 | ↓ -83% |
| MMO | Medicare HMO & PPO | $208.94 | ↓ -83% |
| CommuniCare | Medicare Advantage | $212.99 | ↓ -83% |
| Summacare | Premier | $212.99 | ↓ -83% |
| Summacare | Medicare Advantage MD | $217.76 | ↓ -82% |
| Perennial Health | Medicare Advantage | $219.08 | ↓ -82% |
| The Health Plan | All Products PCP | $223.14 | ↓ -82% |
| The Health Plan | All Products Specialty Physicians | $233.28 | ↓ -81% |
| United | Managed Medicaid | $236.31 | ↓ -81% |
| Caresource | Managed Medicaid | $243.40 | ↓ -80% |
| Buckeye | Managed Medicaid | $248.13 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $259.94 | ↓ -79% |
| Molina | Managed Medicaid | $259.94 | ↓ -79% |
| The Health Plan | All Products Radiation Oncology Physicians | $263.71 | ↓ -78% |
| Oscar | All Products | $477.45 | ↓ -61% |
| Cigna | All Products Mid-Level | $539.73 | ↓ -56% |
| Aetna | Acop | $565.61 | ↓ -54% |
| Anthem | All Products Mid-Level Non-Facility | $577.25 | ↓ -53% |
| Cigna | All Products Physician | $637.75 | ↓ -48% |
| Aultcare | PPO/HMO | $672.68 | ↓ -45% |
| OHCP | All Products | $730.93 | ↓ -40% |
| OMAS | All Products | $939.50 | ↓ -23% |
| United | All Products - Mid-Level | $948.50 | ↓ -22% |
| United | All Products | $1,053.89 | ↓ -14% |
| United | HMO & PPO | $1,053.89 | ↓ -14% |
| PHPHI | All Products | $1,127.40 | ↓ -8% |
| UNITED | Managed Medicaid | $1,270.68 | ↑ +4% |
| CARESOURCE | Managed Medicaid | $1,308.80 | ↑ +7% |
| GMS | All Products | $1,315.30 | ↑ +8% |
| MMO | Traditional | $1,315.30 | ↑ +8% |
| ANTHEM | Managed Medicaid | $1,334.21 | ↑ +9% |
| MOLINA | Managed Medicaid | $1,334.21 | ↑ +9% |
| AMERIHEALTH | Managed Medicaid | $1,397.75 | ↑ +14% |
| Immergrun | All Products | $1,409.25 | ↑ +15% |
| Aetna | All Products First Health | $1,409.25 | ↑ +15% |
| Aetna | Asa | $1,503.20 | ↑ +23% |
| Multiplan | All Products | $1,691.10 | ↑ +38% |
| Aetna | Qhp/Ifp | $1,879.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $5,756.60 | ↑ +371% |
| HUMANA | Medicare Advantage HMO | $6,396.22 | ↑ +424% |
| UNITED | MEDICARE ADVANTAGE | $6,396.22 | ↑ +424% |
| ANTHEM | MEDICARE ADVANTAGE | $6,676.90 | ↑ +447% |
| Summacare | MEDICARE ADVANTAGE | $6,676.90 | ↑ +447% |
| AETNA | MEDICARE ADVANTAGE | $6,676.90 | ↑ +447% |
| CIGNA | MEDICARE ADVANTAGE | $6,877.21 | ↑ +463% |
| Perennial Health | MEDICARE ADVANTAGE | $6,907.92 | ↑ +466% |
| CommuniCare | MEDICARE ADVANTAGE | $7,010.75 | ↑ +474% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $7,211.05 | ↑ +490% |
| MMO | ALL PRODUCTS | $10,357.61 | ↑ +748% |
| MMO | SuperMed | $11,685.63 | ↑ +857% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus endo w/ethmoidectomy part 31254 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $20,697.95 | $0.01 – $28,658.70 |
| akron general | Akron | $1,221.35 | $1.10 – $6,907.92 |
| avon hospital | Avon | not published | $1,326.68 – $7,344.59 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $2,165.99 – $2,507.99 |
| euclid hospital | Euclid | not published | $1,359.21 – $7,344.59 |
| fairview hospital | Cleveland | not published | $1,276.91 – $7,344.59 |
| lutheran hospital | Cleveland | not published | $1,215.67 – $7,344.59 |
| hillcrest hospital | Mayfield Heights | not published | $1,330.34 – $7,344.59 |