healthcosts.net
Shoulder prosthesis removal at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$4,940.00
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.
?
What you pay up front if you don't use insurance.
$7,600.00
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.
?
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
?
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 →
?
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 | $780.99 | ↓ -84% |
| Summacare | Preferred | $780.99 | ↓ -84% |
| Summacare | Medicare Advantage Psych | $839.79 | ↓ -83% |
| United | Managed Medicaid | $977.91 | ↓ -80% |
| Caresource | Managed Medicaid | $1,007.25 | ↓ -80% |
| Summacare | Medicare Advantage CNA | $1,021.30 | ↓ -79% |
| Buckeye | Managed Medicaid | $1,026.81 | ↓ -79% |
| Molina | Managed Medicaid | $1,075.70 | ↓ -78% |
| AmeriHealth | Managed Medicaid | $1,075.70 | ↓ -78% |
| Cigna | Medicare Advantage | $1,119.72 | ↓ -77% |
| United | Medicare Advantage | $1,119.72 | ↓ -77% |
| Aetna | Medicare Advantage | $1,119.72 | ↓ -77% |
| The Health Plan | Medicare Advantage | $1,119.72 | ↓ -77% |
| Anthem | Medicare Advantage | $1,119.72 | ↓ -77% |
| Humana | Medicare Advantage HMO | $1,119.72 | ↓ -77% |
| Summacare | Medicare Advantage MD | $1,141.45 | ↓ -77% |
| MMO | Medicare HMO & PPO | $1,153.31 | ↓ -77% |
| Summacare | Premier | $1,175.71 | ↓ -76% |
| CommuniCare | Medicare Advantage | $1,175.71 | ↓ -76% |
| The Health Plan | PPO | $1,198.10 | ↓ -76% |
| Perennial Health | Medicare Advantage | $1,209.30 | ↓ -76% |
| The Health Plan | All Products PCP | $1,231.69 | ↓ -75% |
| The Health Plan | All Products Specialty Physicians | $1,287.68 | ↓ -74% |
| The Health Plan | All Products Radiation Oncology Physicians | $1,455.64 | ↓ -71% |
| Anthem | All Products Mid-Level Non-Facility | $1,696.10 | ↓ -66% |
| Oscar | All Products | $1,931.16 | ↓ -61% |
| MMO | SuperMed | $2,166.53 | ↓ -56% |
| UNITED | Managed Medicaid | $2,670.57 | ↓ -46% |
| Aultcare | PPO/HMO | $2,720.80 | ↓ -45% |
| CARESOURCE | Managed Medicaid | $2,750.69 | ↓ -44% |
| ANTHEM | Managed Medicaid | $2,804.10 | ↓ -43% |
| MOLINA | Managed Medicaid | $2,804.10 | ↓ -43% |
| United | All Products - Mid-Level | $2,820.69 | ↓ -43% |
| AMERIHEALTH | Managed Medicaid | $2,937.63 | ↓ -41% |
| OHCP | All Products | $2,956.40 | ↓ -40% |
| United | All Products | $3,134.10 | ↓ -37% |
| United | HMO & PPO | $3,134.10 | ↓ -37% |
| OMAS | All Products | $3,800.00 | ↓ -23% |
| PHPHI | All Products | $4,560.00 | ↓ -8% |
| GMS | All Products | $5,320.00 | ↑ +8% |
| MMO | Traditional | $5,320.00 | ↑ +8% |
| Immergrun | All Products | $5,700.00 | ↑ +15% |
| Aetna | All Products First Health | $5,700.00 | ↑ +15% |
| Aetna | Asa | $6,080.00 | ↑ +23% |
| Multiplan | All Products | $6,840.00 | ↑ +38% |
| AETNA | MEDICARE ADVANTAGE | $6,864.94 | ↑ +39% |
| ANTHEM | MEDICARE ADVANTAGE | $6,864.94 | ↑ +39% |
| Summacare | MEDICARE ADVANTAGE | $6,864.94 | ↑ +39% |
| CIGNA | MEDICARE ADVANTAGE | $7,070.89 | ↑ +43% |
| CommuniCare | MEDICARE ADVANTAGE | $7,208.19 | ↑ +46% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $7,414.13 | ↑ +50% |
| Aetna | Qhp/Ifp | $7,600.00 | ↑ +54% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +25739% |
| The Health Plan | POS | $4,036,081.00 | ↑ +81602% |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Aetna | Acop | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder prosthesis removal at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,940.00 | $1.10 – $6,864.94 |
| akron general | Akron | $4,940.00 | $1.10 – $7,414.13 |
| 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 – $18,878.58 |
| lutheran hospital | Cleveland | not published | $2,554.95 – $7,551.43 |
| hillcrest hospital | Mayfield Heights | not published | $2,795.97 – $18,878.58 |