healthcosts.net
Repair/graft of thigh muscle at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$2,893.80
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.
$4,452.00
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 $12,214.27 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 | $527.37 | ↓ -82% |
| Summacare | Preferred | $527.37 | ↓ -82% |
| Summacare | Medicare Advantage Psych | $584.63 | ↓ -80% |
| United | Managed Medicaid | $638.17 | ↓ -78% |
| Caresource | Managed Medicaid | $657.32 | ↓ -77% |
| Buckeye | Managed Medicaid | $670.08 | ↓ -77% |
| Summacare | Medicare Advantage CNA | $689.64 | ↓ -76% |
| AmeriHealth | Managed Medicaid | $701.99 | ↓ -76% |
| Molina | Managed Medicaid | $701.99 | ↓ -76% |
| Summacare | Medicare Advantage MD | $770.77 | ↓ -73% |
| Humana | Medicare Advantage HMO | $779.51 | ↓ -73% |
| The Health Plan | Medicare Advantage | $779.51 | ↓ -73% |
| Cigna | Medicare Advantage | $779.51 | ↓ -73% |
| United | Medicare Advantage | $779.51 | ↓ -73% |
| Aetna | Medicare Advantage | $779.51 | ↓ -73% |
| Anthem | Medicare Advantage | $779.51 | ↓ -73% |
| MMO | Medicare HMO & PPO | $802.90 | ↓ -72% |
| CommuniCare | Medicare Advantage | $818.49 | ↓ -72% |
| Summacare | Premier | $818.49 | ↓ -72% |
| Perennial Health | Medicare Advantage | $841.87 | ↓ -71% |
| The Health Plan | All Products PCP | $857.46 | ↓ -70% |
| The Health Plan | All Products Specialty Physicians | $896.44 | ↓ -69% |
| The Health Plan | All Products Radiation Oncology Physicians | $1,013.36 | ↓ -65% |
| Oscar | All Products | $1,131.25 | ↓ -61% |
| Anthem | All Products Mid-Level Non-Facility | $1,145.33 | ↓ -60% |
| Aultcare | PPO/HMO | $1,593.82 | ↓ -45% |
| OHCP | All Products | $1,731.83 | ↓ -40% |
| United | All Products - Mid-Level | $1,905.95 | ↓ -34% |
| United | All Products | $2,117.72 | ↓ -27% |
| United | HMO & PPO | $2,117.72 | ↓ -27% |
| OMAS | All Products | $2,226.00 | ↓ -23% |
| UNITED | Managed Medicaid | $2,501.35 | ↓ -14% |
| CARESOURCE | Managed Medicaid | $2,576.39 | ↓ -11% |
| MOLINA | Managed Medicaid | $2,626.42 | ↓ -9% |
| ANTHEM | Managed Medicaid | $2,626.42 | ↓ -9% |
| PHPHI | All Products | $2,671.20 | ↓ -8% |
| AMERIHEALTH | Managed Medicaid | $2,751.49 | ↓ -5% |
| MMO | Traditional | $3,116.40 | ↑ +8% |
| GMS | All Products | $3,116.40 | ↑ +8% |
| Immergrun | All Products | $3,339.00 | ↑ +15% |
| Aetna | All Products First Health | $3,339.00 | ↑ +15% |
| Aetna | Asa | $3,561.60 | ↑ +23% |
| Multiplan | All Products | $4,006.80 | ↑ +38% |
| Aetna | Qhp/Ifp | $4,452.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $5,940.60 | ↑ +105% |
| HUMANA | Medicare Advantage HMO | $6,600.66 | ↑ +128% |
| UNITED | MEDICARE ADVANTAGE | $6,600.66 | ↑ +128% |
| AETNA | MEDICARE ADVANTAGE | $6,864.94 | ↑ +137% |
| ANTHEM | MEDICARE ADVANTAGE | $6,864.94 | ↑ +137% |
| Summacare | MEDICARE ADVANTAGE | $6,864.94 | ↑ +137% |
| CIGNA | MEDICARE ADVANTAGE | $7,070.89 | ↑ +144% |
| Perennial Health | MEDICARE ADVANTAGE | $7,128.72 | ↑ +146% |
| CommuniCare | MEDICARE ADVANTAGE | $7,208.19 | ↑ +149% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $7,414.13 | ↑ +156% |
| MMO | ALL PRODUCTS | $10,826.38 | ↑ +274% |
| MMO | SuperMed | $12,214.27 | ↑ +322% |
| Aetna | Acop | not published by hospital | — |
| Aetna | ALL PRODUCTS | 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
Repair/graft of thigh muscle at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $2,893.80 | $1.10 – $6,864.94 |
| akron general | Akron | $2,893.80 | $1.10 – $7,128.72 |
| avon hospital | Avon | not published | $2,611.58 – $7,551.43 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $4,263.77 – $4,937.00 |
| euclid hospital | Euclid | not published | $2,675.64 – $7,551.43 |
| fairview hospital | Cleveland | not published | $2,513.62 – $7,551.43 |
| lutheran hospital | Cleveland | not published | $2,393.05 – $7,551.43 |
| hillcrest hospital | Mayfield Heights | not published | $2,618.80 – $7,551.43 |