healthcosts.net
Nasal/sinus sphenoid endoscopy dx 31235 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$5,156.45
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.
$7,933.00
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.
$0.01 with UNITED vs $7,933.00 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 |
|---|---|---|---|
| UNITED | ALL PRODUCTS | $0.01 | ↓ -100% |
| The Health Plan | PPO | $525.00 | ↓ -90% |
| UNITED | Managed Medicaid | $1,154.64 | ↓ -78% |
| Buckeye | Managed Medicaid | $1,189.28 | ↓ -77% |
| CARESOURCE | Managed Medicaid | $1,189.28 | ↓ -77% |
| ANTHEM | Managed Medicaid | $1,212.37 | ↓ -76% |
| MOLINA | Managed Medicaid | $1,212.37 | ↓ -76% |
| AMERIHEALTH | Managed Medicaid | $1,270.10 | ↓ -75% |
| The Health Plan | MEDICARE ADVANTAGE | $1,434.04 | ↓ -72% |
| UNITED | MEDICARE ADVANTAGE | $1,593.38 | ↓ -69% |
| HUMANA | Medicare Advantage HMO | $1,593.38 | ↓ -69% |
| MMO | Medicare HMO & PPO | $1,673.04 | ↓ -68% |
| ANTHEM | MEDICARE ADVANTAGE | $1,683.92 | ↓ -67% |
| Summacare | MEDICARE ADVANTAGE | $1,683.92 | ↓ -67% |
| AETNA | MEDICARE ADVANTAGE | $1,683.92 | ↓ -67% |
| Perennial Health | MEDICARE ADVANTAGE | $1,720.85 | ↓ -67% |
| CIGNA | MEDICARE ADVANTAGE | $1,734.44 | ↓ -66% |
| CommuniCare | MEDICARE ADVANTAGE | $1,768.12 | ↓ -66% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,818.63 | ↓ -65% |
| Zing Health | Medicare Advantage | $1,852.31 | ↓ -64% |
| CIGNA | ALL PRODUCTS | $2,123.00 | ↓ -59% |
| OSCAR | ALL PRODUCTS | $2,243.45 | ↓ -56% |
| PHPHI | ALL PRODUCTS | $2,538.56 | ↓ -51% |
| PHP | ALL PRODUCTS | $2,538.56 | ↓ -51% |
| CC EHP | ALL PRODUCTS | $2,681.35 | ↓ -48% |
| Summacare | Preferred | $2,784.48 | ↓ -46% |
| Aultcare | PPO/HMO | $2,840.01 | ↓ -45% |
| Summacare | PREMIER | $3,030.41 | ↓ -41% |
| MMO | ALL PRODUCTS | $3,388.66 | ↓ -34% |
| Amish Community Aid Plan | ALL PRODUCTS | $3,569.85 | ↓ -31% |
| AETNA | Asa_Whirlpool_Peia | $3,810.00 | ↓ -26% |
| ANTHEM | HPN | $3,821.33 | ↓ -26% |
| OHCP | ALL PRODUCTS | $3,855.44 | ↓ -25% |
| Immergrun | ALL PRODUCTS | $3,966.50 | ↓ -23% |
| OMAS | ALL PRODUCTS | $3,966.50 | ↓ -23% |
| AETNA | International | $4,001.00 | ↓ -22% |
| ANTHEM | Exchange | $4,045.83 | ↓ -22% |
| Ohio Healthy | TRANSPLANT | $4,283.82 | ↓ -17% |
| ANTHEM | TRADITIONAL | $4,386.95 | ↓ -15% |
| ANTHEM | PPO/HMO | $4,495.63 | ↓ -13% |
| Medical Benefit Corp | Transplant SMCP | $5,553.10 | ↑ +8% |
| GMS | ALL PRODUCTS | $5,553.10 | ↑ +8% |
| AETNA | ALL PRODUCTS | $5,949.75 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $5,949.75 | ↑ +15% |
| The Health Plan | Self-Funded ASO | $6,663.72 | ↑ +29% |
| Tertiary Care Network | TRANSPLANT | $7,139.70 | ↑ +38% |
| FrontPath | TRANSPLANT | $7,139.70 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $7,139.70 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $7,139.70 | ↑ +38% |
| The Health Plan | HMO | $7,933.00 | ↑ +54% |
| AETNA | Qhp/Ipf | $7,933.00 | ↑ +54% |
| The Health Plan | POS | $7,933.00 | ↑ +54% |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Nasal/sinus sphenoid endoscopy dx 31235 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $5,156.45 | $0.01 – $7,139.70 |
| akron general | Akron | $5,156.45 | $0.01 – $7,139.70 |
| avon hospital | Avon | $5,156.45 | $0.01 – $7,139.70 |
| euclid hospital | Euclid | $5,156.45 | $0.01 – $7,139.70 |
| fairview hospital | Cleveland | $5,156.45 | $0.01 – $7,139.70 |
| lutheran hospital | Cleveland | $5,156.45 | $0.01 – $7,139.70 |
| hillcrest hospital | Mayfield Heights | $5,156.45 | $0.01 – $7,139.70 |
| marymount hospital | Garfield Heights | $5,156.45 | $0.01 – $7,139.70 |