healthcosts.net
Repair shoulder capsule at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$3,562.00
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.
$5,480.00
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 | Preferred | $585.20 | ↓ -84% |
| Summacare | Medicare Advantage Lower Level | $585.20 | ↓ -84% |
| Summacare | Medicare Advantage Psych | $635.99 | ↓ -82% |
| United | Managed Medicaid | $748.34 | ↓ -79% |
| Summacare | Medicare Advantage CNA | $765.26 | ↓ -79% |
| Caresource | Managed Medicaid | $770.79 | ↓ -78% |
| Buckeye | Managed Medicaid | $785.76 | ↓ -78% |
| AmeriHealth | Managed Medicaid | $823.17 | ↓ -77% |
| Molina | Managed Medicaid | $823.17 | ↓ -77% |
| Aetna | Medicare Advantage | $847.99 | ↓ -76% |
| United | Medicare Advantage | $847.99 | ↓ -76% |
| Anthem | Medicare Advantage | $847.99 | ↓ -76% |
| Cigna | Medicare Advantage | $847.99 | ↓ -76% |
| The Health Plan | Medicare Advantage | $847.99 | ↓ -76% |
| Humana | Medicare Advantage HMO | $847.99 | ↓ -76% |
| Summacare | Medicare Advantage MD | $855.29 | ↓ -76% |
| MMO | Medicare HMO & PPO | $873.43 | ↓ -75% |
| Summacare | Premier | $890.39 | ↓ -75% |
| CommuniCare | Medicare Advantage | $890.39 | ↓ -75% |
| Perennial Health | Medicare Advantage | $915.83 | ↓ -74% |
| The Health Plan | All Products PCP | $932.79 | ↓ -74% |
| The Health Plan | All Products Specialty Physicians | $975.19 | ↓ -73% |
| The Health Plan | All Products Radiation Oncology Physicians | $1,102.39 | ↓ -69% |
| Anthem | All Products Mid-Level Non-Facility | $1,269.26 | ↓ -64% |
| Oscar | All Products | $1,392.47 | ↓ -61% |
| Aultcare | PPO/HMO | $1,961.84 | ↓ -45% |
| United | All Products - Mid-Level | $2,110.46 | ↓ -41% |
| OHCP | All Products | $2,131.72 | ↓ -40% |
| United | All Products | $2,344.95 | ↓ -34% |
| United | HMO & PPO | $2,344.95 | ↓ -34% |
| UNITED | Managed Medicaid | $2,670.57 | ↓ -25% |
| OMAS | All Products | $2,740.00 | ↓ -23% |
| CARESOURCE | Managed Medicaid | $2,750.69 | ↓ -23% |
| MOLINA | Managed Medicaid | $2,804.10 | ↓ -21% |
| ANTHEM | Managed Medicaid | $2,804.10 | ↓ -21% |
| AMERIHEALTH | Managed Medicaid | $2,937.63 | ↓ -18% |
| PHPHI | All Products | $3,288.00 | ↓ -8% |
| MMO | Traditional | $3,836.00 | ↑ +8% |
| GMS | All Products | $3,836.00 | ↑ +8% |
| Immergrun | All Products | $4,110.00 | ↑ +15% |
| Aetna | All Products First Health | $4,110.00 | ↑ +15% |
| Aetna | Asa | $4,384.00 | ↑ +23% |
| Multiplan | All Products | $4,932.00 | ↑ +38% |
| Aetna | Qhp/Ifp | $5,480.00 | ↑ +54% |
| The Health Plan | MEDICARE ADVANTAGE | $5,940.60 | ↑ +67% |
| HUMANA | Medicare Advantage HMO | $6,600.66 | ↑ +85% |
| UNITED | MEDICARE ADVANTAGE | $6,600.66 | ↑ +85% |
| AETNA | MEDICARE ADVANTAGE | $6,864.94 | ↑ +93% |
| ANTHEM | MEDICARE ADVANTAGE | $6,864.94 | ↑ +93% |
| Summacare | MEDICARE ADVANTAGE | $6,864.94 | ↑ +93% |
| CIGNA | MEDICARE ADVANTAGE | $7,070.89 | ↑ +99% |
| Perennial Health | MEDICARE ADVANTAGE | $7,128.72 | ↑ +100% |
| CommuniCare | MEDICARE ADVANTAGE | $7,208.19 | ↑ +102% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $7,414.13 | ↑ +108% |
| MMO | ALL PRODUCTS | $10,826.38 | ↑ +204% |
| MMO | SuperMed | $12,214.27 | ↑ +243% |
| 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 shoulder capsule at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $3,562.00 | $1.10 – $6,864.94 |
| akron general | Akron | $3,562.00 | $1.10 – $7,128.72 |
| avon hospital | Avon | not published | $2,788.26 – $7,551.43 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $4,552.23 – $5,271.00 |
| euclid hospital | Euclid | not published | $2,856.65 – $7,551.43 |
| fairview hospital | Cleveland | not published | $2,683.68 – $7,551.43 |
| lutheran hospital | Cleveland | not published | $2,554.95 – $7,551.43 |
| hillcrest hospital | Mayfield Heights | not published | $2,795.97 – $7,551.43 |