healthcosts.net
Treatment of mouth lesion physical 40820 at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$348.40
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.
$536.00
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% |
| United | Managed Medicaid | $87.10 | ↓ -75% |
| Caresource | Managed Medicaid | $89.71 | ↓ -74% |
| Buckeye | Managed Medicaid | $91.46 | ↓ -74% |
| Molina | Managed Medicaid | $95.81 | ↓ -73% |
| AmeriHealth | Managed Medicaid | $95.81 | ↓ -73% |
| Summacare | Preferred | $98.09 | ↓ -72% |
| Summacare | Medicare Advantage Lower Level | $98.09 | ↓ -72% |
| Summacare | Medicare Advantage Psych | $108.73 | ↓ -69% |
| Summacare | Medicare Advantage CNA | $128.27 | ↓ -63% |
| Oscar | All Products | $136.20 | ↓ -61% |
| Summacare | Medicare Advantage MD | $143.36 | ↓ -59% |
| The Health Plan | Medicare Advantage | $144.97 | ↓ -58% |
| Anthem | Medicare Advantage | $144.97 | ↓ -58% |
| Aetna | Medicare Advantage | $144.97 | ↓ -58% |
| United | Medicare Advantage | $144.97 | ↓ -58% |
| Cigna | Medicare Advantage | $144.97 | ↓ -58% |
| Humana | Medicare Advantage HMO | $144.97 | ↓ -58% |
| MMO | Medicare HMO & PPO | $149.32 | ↓ -57% |
| CommuniCare | Medicare Advantage | $152.22 | ↓ -56% |
| Summacare | Premier | $152.22 | ↓ -56% |
| The Health Plan | PPO | $155.12 | ↓ -55% |
| Perennial Health | Medicare Advantage | $156.57 | ↓ -55% |
| The Health Plan | All Products PCP | $159.47 | ↓ -54% |
| The Health Plan | All Products Specialty Physicians | $166.72 | ↓ -52% |
| The Health Plan | All Products Radiation Oncology Physicians | $188.46 | ↓ -46% |
| Aultcare | PPO/HMO | $191.89 | ↓ -45% |
| OHCP | All Products | $208.50 | ↓ -40% |
| OMAS | All Products | $268.00 | ↓ -23% |
| Cigna | All Products Mid-Level | $312.23 | ↓ -10% |
| PHPHI | All Products | $321.60 | ↓ -8% |
| Anthem | All Products Mid-Level Non-Facility | $333.93 | ↓ -4% |
| Aetna | Acop | $355.40 | ↑ +2% |
| Cigna | All Products Physician | $368.93 | ↑ +6% |
| GMS | All Products | $375.20 | ↑ +8% |
| MMO | Traditional | $375.20 | ↑ +8% |
| Immergrun | All Products | $402.00 | ↑ +15% |
| Aetna | All Products First Health | $402.00 | ↑ +15% |
| Aetna | Asa | $428.80 | ↑ +23% |
| Multiplan | All Products | $482.40 | ↑ +38% |
| Aetna | Qhp/Ifp | $536.00 | ↑ +54% |
| United | All Products - Mid-Level | $552.57 | ↑ +59% |
| United | All Products | $613.96 | ↑ +76% |
| United | HMO & PPO | $613.96 | ↑ +76% |
| UNITED | Managed Medicaid | $1,430.00 | ↑ +310% |
| CARESOURCE | Managed Medicaid | $1,472.90 | ↑ +323% |
| MOLINA | Managed Medicaid | $1,501.50 | ↑ +331% |
| ANTHEM | Managed Medicaid | $1,501.50 | ↑ +331% |
| AMERIHEALTH | Managed Medicaid | $1,573.00 | ↑ +351% |
| The Health Plan | MEDICARE ADVANTAGE | $2,696.88 | ↑ +674% |
| UNITED | MEDICARE ADVANTAGE | $2,996.53 | ↑ +760% |
| HUMANA | Medicare Advantage HMO | $2,996.53 | ↑ +760% |
| ANTHEM | MEDICARE ADVANTAGE | $3,136.68 | ↑ +800% |
| Summacare | MEDICARE ADVANTAGE | $3,136.68 | ↑ +800% |
| AETNA | MEDICARE ADVANTAGE | $3,136.68 | ↑ +800% |
| CIGNA | MEDICARE ADVANTAGE | $3,230.78 | ↑ +827% |
| Perennial Health | MEDICARE ADVANTAGE | $3,236.25 | ↑ +829% |
| CommuniCare | MEDICARE ADVANTAGE | $3,293.51 | ↑ +845% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $3,387.61 | ↑ +872% |
| MMO | ALL PRODUCTS | $4,872.30 | ↑ +1298% |
| MMO | SuperMed | $5,497.86 | ↑ +1478% |
| The Health Plan | HMO | $1,276,448.04 | ↑ +366274% |
| The Health Plan | POS | $4,036,081.00 | ↑ +1158362% |
| Aetna | ALL PRODUCTS | not published by hospital | — |
Visitor-reported prices
Comments
Treatment of mouth lesion physical 40820 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $9,696.70 | $0.01 – $13,426.20 |
| akron general | Akron | $348.40 | $1.10 – $3,236.25 |
| avon hospital | Avon | not published | $1,501.50 – $3,450.35 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,358.50 – $1,573.00 |
| euclid hospital | Euclid | not published | $1,358.50 – $3,450.35 |
| fairview hospital | Cleveland | not published | $1,358.50 – $3,450.35 |
| lutheran hospital | Cleveland | not published | $1,358.50 – $3,450.35 |
| hillcrest hospital | Mayfield Heights | not published | $1,358.50 – $3,450.35 |