healthcosts.net
Removal of frontal sinus 31085 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$4,066.40
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.
$6,256.00
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 $9,999.36 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 | $750.44 | ↓ -82% |
| Summacare | Medicare Advantage Lower Level | $750.44 | ↓ -82% |
| Summacare | Medicare Advantage Psych | $805.25 | ↓ -80% |
| United | Managed Medicaid | $818.56 | ↓ -80% |
| Caresource | Managed Medicaid | $843.12 | ↓ -79% |
| Buckeye | Managed Medicaid | $859.49 | ↓ -79% |
| AmeriHealth | Managed Medicaid | $900.42 | ↓ -78% |
| Molina | Managed Medicaid | $900.42 | ↓ -78% |
| Summacare | Medicare Advantage CNA | $981.34 | ↓ -76% |
| Anthem | Medicare Advantage | $1,073.66 | ↓ -74% |
| United | Medicare Advantage | $1,073.66 | ↓ -74% |
| Humana | Medicare Advantage HMO | $1,073.66 | ↓ -74% |
| The Health Plan | Medicare Advantage | $1,073.66 | ↓ -74% |
| Cigna | Medicare Advantage | $1,073.66 | ↓ -74% |
| Aetna | Medicare Advantage | $1,073.66 | ↓ -74% |
| Summacare | Medicare Advantage MD | $1,096.79 | ↓ -73% |
| MMO | Medicare HMO & PPO | $1,105.87 | ↓ -73% |
| Summacare | Premier | $1,127.34 | ↓ -72% |
| CommuniCare | Medicare Advantage | $1,127.34 | ↓ -72% |
| Perennial Health | Medicare Advantage | $1,159.55 | ↓ -71% |
| The Health Plan | All Products PCP | $1,181.03 | ↓ -71% |
| The Health Plan | All Products Specialty Physicians | $1,234.71 | ↓ -70% |
| The Health Plan | All Products Radiation Oncology Physicians | $1,395.76 | ↓ -66% |
| Oscar | All Products | $1,589.65 | ↓ -61% |
| Anthem | All Products Mid-Level Non-Facility | $1,664.94 | ↓ -59% |
| Aultcare | PPO/HMO | $2,239.65 | ↓ -45% |
| OHCP | All Products | $2,433.58 | ↓ -40% |
| United | All Products - Mid-Level | $2,742.89 | ↓ -33% |
| UNITED | Managed Medicaid | $2,769.26 | ↓ -32% |
| CARESOURCE | Managed Medicaid | $2,852.34 | ↓ -30% |
| ANTHEM | Managed Medicaid | $2,907.72 | ↓ -28% |
| MOLINA | Managed Medicaid | $2,907.72 | ↓ -28% |
| AMERIHEALTH | Managed Medicaid | $3,046.19 | ↓ -25% |
| United | All Products | $3,047.66 | ↓ -25% |
| United | HMO & PPO | $3,047.66 | ↓ -25% |
| OMAS | All Products | $3,128.00 | ↓ -23% |
| PHPHI | All Products | $3,753.60 | ↓ -8% |
| GMS | All Products | $4,379.20 | ↑ +8% |
| MMO | Traditional | $4,379.20 | ↑ +8% |
| Aetna | All Products First Health | $4,692.00 | ↑ +15% |
| Immergrun | All Products | $4,692.00 | ↑ +15% |
| The Health Plan | MEDICARE ADVANTAGE | $4,919.36 | ↑ +21% |
| Aetna | Asa | $5,004.80 | ↑ +23% |
| UNITED | MEDICARE ADVANTAGE | $5,465.95 | ↑ +34% |
| HUMANA | Medicare Advantage HMO | $5,465.95 | ↑ +34% |
| Summacare | MEDICARE ADVANTAGE | $5,600.62 | ↑ +38% |
| AETNA | MEDICARE ADVANTAGE | $5,600.62 | ↑ +38% |
| ANTHEM | MEDICARE ADVANTAGE | $5,600.62 | ↑ +38% |
| Multiplan | All Products | $5,630.40 | ↑ +38% |
| CIGNA | MEDICARE ADVANTAGE | $5,768.63 | ↑ +42% |
| CommuniCare | MEDICARE ADVANTAGE | $5,880.65 | ↑ +45% |
| Perennial Health | MEDICARE ADVANTAGE | $5,903.23 | ↑ +45% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $6,048.66 | ↑ +49% |
| Aetna | Qhp/Ifp | $6,256.00 | ↑ +54% |
| MMO | ALL PRODUCTS | $8,862.25 | ↑ +118% |
| MMO | SuperMed | $9,999.36 | ↑ +146% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
Visitor-reported prices
Comments
Removal of frontal sinus 31085 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,066.40 | $1.10 – $5,630.40 |
| akron general | Akron | $4,066.40 | $1.10 – $5,903.23 |
| avon hospital | Avon | not published | $2,891.30 – $6,160.68 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $4,720.45 – $5,465.78 |
| euclid hospital | Euclid | not published | $2,962.21 – $6,160.68 |
| fairview hospital | Cleveland | not published | $2,782.84 – $6,160.68 |
| lutheran hospital | Cleveland | not published | $2,649.36 – $6,160.68 |
| hillcrest hospital | Mayfield Heights | not published | $2,899.30 – $6,160.68 |