Prolng off/op e/m ea 15 min 99417 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$174.20
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.
$268.00
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 $1,276,448.04 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 | ↓ -99% |
| Summacare | Medicare Advantage Lower Level | $18.29 | ↓ -90% |
| Summacare | Preferred | $18.29 | ↓ -90% |
| United | Managed Medicaid | $22.87 | ↓ -87% |
| Caresource | Managed Medicaid | $23.56 | ↓ -86% |
| Summacare | Medicare Advantage CNA | $23.92 | ↓ -86% |
| Buckeye | Managed Medicaid | $24.01 | ↓ -86% |
| AmeriHealth | Managed Medicaid | $25.16 | ↓ -86% |
| Molina | Managed Medicaid | $25.16 | ↓ -86% |
| Summacare | Medicare Advantage MD | $26.73 | ↓ -85% |
| Summacare | Premier | $33.77 | ↓ -81% |
| Anthem | All Products Mid-Level Non-Facility | $35.52 | ↓ -80% |
| Cigna | All Products Mid-Level | $38.74 | ↓ -78% |
| MMO | SuperMed | $44.05 | ↓ -75% |
| United | All Products - Mid-Level | $45.16 | ↓ -74% |
| Cigna | All Products Physician | $45.78 | ↓ -74% |
| United | HMO & PPO | $50.18 | ↓ -71% |
| United | All Products | $50.18 | ↓ -71% |
| UNITED | Managed Medicaid | $51.99 | ↓ -70% |
| CARESOURCE | Managed Medicaid | $53.55 | ↓ -69% |
| ANTHEM | Managed Medicaid | $54.59 | ↓ -69% |
| MOLINA | Managed Medicaid | $54.59 | ↓ -69% |
| AMERIHEALTH | Managed Medicaid | $57.19 | ↓ -67% |
| Oscar | All Products | $68.10 | ↓ -61% |
| Aultcare | PPO/HMO | $95.94 | ↓ -45% |
| OHCP | All Products | $104.25 | ↓ -40% |
| OMAS | All Products | $134.00 | ↓ -23% |
| PHPHI | All Products | $160.80 | ↓ -8% |
| Summacare | Medicare Advantage Psych | $187.60 | ↑ +8% |
| GMS | All Products | $187.60 | ↑ +8% |
| MMO | Traditional | $187.60 | ↑ +8% |
| Aetna | All Products First Health | $201.00 | ↑ +15% |
| Immergrun | All Products | $201.00 | ↑ +15% |
| Aetna | Asa | $214.40 | ↑ +23% |
| Multiplan | All Products | $241.20 | ↑ +38% |
| Aetna | Qhp/Ifp | $268.00 | ↑ +54% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +732649% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Anthem | Medicare Advantage | not published by hospital | — |
| Cigna | Medicare Advantage | not published by hospital | — |
| CommuniCare | Medicare Advantage | not published by hospital | — |
| Humana | Medicare Advantage HMO | not published by hospital | — |
| MMO | Medicare HMO & PPO | not published by hospital | — |
| Perennial Health | Medicare Advantage | not published by hospital | — |
| Aetna | Medicare Advantage | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| The Health Plan | All Products PCP | not published by hospital | — |
| The Health Plan | All Products Radiation Oncology Physicians | not published by hospital | — |
| The Health Plan | All Products Specialty Physicians | not published by hospital | — |
| The Health Plan | Medicare Advantage | not published by hospital | — |
| United | Medicare Advantage | not published by hospital | — |
Visitor-reported prices
Comments
Prolng off/op e/m ea 15 min 99417 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $174.20 | $1.10 – $241.20 |
| akron general | Akron | $174.20 | $1.10 – $241.20 |
| University Hospitals Ahuja Medical Center | Beachwood | $42.00 | $12.38 – $56.11 |
| University Hospitals Beachwood Medical Center | Beachwood | $42.00 | $14.71 – $56.11 |
| University Hospitals Conneaut Medical Center | Conneaut | $39.00 | not published |
| University Hospitals Elyria Medical Center | Elyria | $42.00 | $31.17 – $56.11 |
| University Hospitals Regional Hospitals - Geauga Medical Center | Chardon | $42.00 | $31.17 – $56.11 |
| University Hospitals Geneva Medical Center | Geneva | $39.00 | not published |