healthcosts.net
Revise/replace knee joint at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$7,048.60
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.
$10,844.00
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 $4,036,081.00 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 |
|---|---|---|---|
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| Summacare | Preferred | $1,080.05 | ↓ -85% |
| Summacare | Medicare Advantage Lower Level | $1,080.05 | ↓ -85% |
| Summacare | Medicare Advantage Psych | $1,154.81 | ↓ -84% |
| Summacare | Medicare Advantage CNA | $1,412.37 | ↓ -80% |
| United | Managed Medicaid | $1,441.87 | ↓ -80% |
| Caresource | Managed Medicaid | $1,485.13 | ↓ -79% |
| Buckeye | Managed Medicaid | $1,513.96 | ↓ -79% |
| Cigna | Medicare Advantage | $1,539.75 | ↓ -78% |
| United | Medicare Advantage | $1,539.75 | ↓ -78% |
| Aetna | Medicare Advantage | $1,539.75 | ↓ -78% |
| The Health Plan | Medicare Advantage | $1,539.75 | ↓ -78% |
| Anthem | Medicare Advantage | $1,539.75 | ↓ -78% |
| Humana | Medicare Advantage HMO | $1,539.75 | ↓ -78% |
| Summacare | Medicare Advantage MD | $1,578.53 | ↓ -78% |
| MMO | Medicare HMO & PPO | $1,585.94 | ↓ -77% |
| AmeriHealth | Managed Medicaid | $1,586.06 | ↓ -77% |
| Molina | Managed Medicaid | $1,586.06 | ↓ -77% |
| Summacare | Premier | $1,616.74 | ↓ -77% |
| CommuniCare | Medicare Advantage | $1,616.74 | ↓ -77% |
| The Health Plan | PPO | $1,647.53 | ↓ -77% |
| Perennial Health | Medicare Advantage | $1,662.93 | ↓ -76% |
| The Health Plan | All Products PCP | $1,693.73 | ↓ -76% |
| The Health Plan | All Products Specialty Physicians | $1,770.71 | ↓ -75% |
| The Health Plan | All Products Radiation Oncology Physicians | $2,001.68 | ↓ -72% |
| Anthem | All Products Mid-Level Non-Facility | $2,346.26 | ↓ -67% |
| Oscar | All Products | $2,755.46 | ↓ -61% |
| MMO | SuperMed | $2,994.43 | ↓ -58% |
| Aultcare | PPO/HMO | $3,882.15 | ↓ -45% |
| United | All Products - Mid-Level | $3,897.76 | ↓ -45% |
| OHCP | All Products | $4,218.32 | ↓ -40% |
| United | HMO & PPO | $4,330.84 | ↓ -39% |
| United | All Products | $4,330.84 | ↓ -39% |
| OMAS | All Products | $5,422.00 | ↓ -23% |
| UNITED | Managed Medicaid | $6,426.93 | ↓ -9% |
| PHPHI | All Products | $6,506.40 | ↓ -8% |
| CARESOURCE | Managed Medicaid | $6,619.74 | ↓ -6% |
| ANTHEM | Managed Medicaid | $6,748.28 | ↓ -4% |
| MOLINA | Managed Medicaid | $6,748.28 | ↓ -4% |
| AMERIHEALTH | Managed Medicaid | $7,069.62 | ↑ +0% |
| MMO | Traditional | $7,590.80 | ↑ +8% |
| GMS | All Products | $7,590.80 | ↑ +8% |
| Immergrun | All Products | $8,133.00 | ↑ +15% |
| Aetna | All Products First Health | $8,133.00 | ↑ +15% |
| Aetna | Asa | $8,675.20 | ↑ +23% |
| Multiplan | All Products | $9,759.60 | ↑ +38% |
| Aetna | Qhp/Ifp | $10,844.00 | ↑ +54% |
| ANTHEM | MEDICARE ADVANTAGE | $16,588.34 | ↑ +135% |
| Summacare | MEDICARE ADVANTAGE | $16,588.34 | ↑ +135% |
| AETNA | MEDICARE ADVANTAGE | $16,588.34 | ↑ +135% |
| CIGNA | MEDICARE ADVANTAGE | $17,085.99 | ↑ +142% |
| CommuniCare | MEDICARE ADVANTAGE | $17,417.76 | ↑ +147% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $17,915.41 | ↑ +154% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +18009% |
| The Health Plan | POS | $4,036,081.00 | ↑ +57161% |
| Cigna | All Products Physician | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Revise/replace knee joint at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $7,048.60 | $1.10 – $16,588.34 |
| akron general | Akron | $7,048.60 | $1.10 – $17,915.41 |
| avon hospital | Avon | not published | $6,710.17 – $18,247.18 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $10,955.28 – $12,685.06 |
| euclid hospital | Euclid | not published | $6,874.74 – $18,247.18 |
| fairview hospital | Cleveland | not published | $6,458.47 – $45,617.94 |
| lutheran hospital | Cleveland | not published | $6,148.69 – $18,247.18 |
| hillcrest hospital | Mayfield Heights | not published | $6,728.72 – $45,617.94 |