healthcosts.net
Biopsy of tear sac at cleveland clinic main campus
9500 Euclid Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1679525919
$1,149.20
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.
$1,768.00
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 $6,813.79 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% |
| Aetna | ALL PRODUCTS | $3.19 | ↓ -100% |
| Summacare | Medicare Advantage Psych | $152.35 | ↓ -87% |
| Summacare | Medicare Advantage Lower Level | $155.20 | ↓ -86% |
| Optum | Managed Medicaid Transplant | $200.56 | ↓ -83% |
| Summacare | Medicare Advantage CNA | $202.95 | ↓ -82% |
| Humana | Medicare Advantage HMO | $203.13 | ↓ -82% |
| Valor | All Products | $203.13 | ↓ -82% |
| Aetna | Medicare Advantage | $203.13 | ↓ -82% |
| Aetna | Medicare Advantage Transplant | $203.13 | ↓ -82% |
| UPMC | Medicare Advantage | $203.13 | ↓ -82% |
| United | Medicare Advantage | $203.13 | ↓ -82% |
| The Health Plan | Medicare Advantage | $203.13 | ↓ -82% |
| Anthem | Medicare Advantage | $203.13 | ↓ -82% |
| Optum | Medicare Advantage Transplant | $203.13 | ↓ -82% |
| United | Managed Medicaid | $208.18 | ↓ -82% |
| Cigna | Medicare Advantage | $209.22 | ↓ -82% |
| CommuniCare | Medicare Advantage | $213.29 | ↓ -81% |
| Paramount | Managed Medicaid | $217.45 | ↓ -81% |
| Perennial Health | Medicare Advantage | $219.38 | ↓ -81% |
| Buckeye | Managed Medicaid | $221.68 | ↓ -81% |
| Caresource | Managed Medicaid | $221.68 | ↓ -81% |
| PPHP | All Products | $223.44 | ↓ -81% |
| Summacare | Medicare Advantage MD | $226.83 | ↓ -80% |
| Molina | Managed Medicaid | $232.23 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $232.23 | ↓ -80% |
| Devoted Health | Medicare Advantage | $238.77 | ↓ -79% |
| Humana Military | All Products | $320.34 | ↓ -72% |
| Aetna | All Products Transplant | $323.25 | ↓ -72% |
| Anthem | All Products Mid-Level Facility | $338.36 | ↓ -71% |
| Anthem | All Products Mid-Level Non-Facility | $338.36 | ↓ -71% |
| Oscar | All Products | $449.25 | ↓ -61% |
| CC EHP | All Products | $453.66 | ↓ -61% |
| Summacare | Preferred | $482.95 | ↓ -58% |
| Summacare | Premier | $526.29 | ↓ -54% |
| Aetna | Acop | $549.00 | ↓ -52% |
| United | All Products - Mid-Level | $687.02 | ↓ -40% |
| OHCP | All Products | $687.75 | ↓ -40% |
| Ohio Healthy | Transplant | $707.20 | ↓ -38% |
| United | All Products | $740.47 | ↓ -36% |
| United | HMO & PPO | $740.47 | ↓ -36% |
| Aultcare | PPO/HMO | $774.38 | ↓ -33% |
| Amish Community Aid Plan | All Products | $795.60 | ↓ -31% |
| Optum | Commercial CRS Care Solutions | $829.19 | ↓ -28% |
| Anthem | All Products Physician | $859.37 | ↓ -25% |
| Anthem | All Products Physician Facility | $859.37 | ↓ -25% |
| Anthem | All Products Physician Non-Facility | $859.37 | ↓ -25% |
| OMAS | All Products | $884.00 | ↓ -23% |
| MMO | Medicare HMO | $935.72 | ↓ -19% |
| MMO | Medicare PPO | $963.79 | ↓ -16% |
| The Health Plan | All Products | $972.40 | ↓ -15% |
| Healthsmart | All Products | $972.40 | ↓ -15% |
| Optum | All Products Transplant | $1,030.74 | ↓ -10% |
| PHPHI | All Products | $1,060.80 | ↓ -8% |
| UPMC | All Products | $1,060.80 | ↓ -8% |
| Optum | Commercial CHD Care Solutions | $1,073.18 | ↓ -7% |
| Three Rivers | All Products | $1,149.20 | ↑ +0% |
| Clarity Health | All Products | $1,149.20 | ↑ +0% |
| OPTUM | Managed Medicaid Transplant | $1,153.81 | ↑ +0% |
| CARESOURCE | Managed Medicaid | $1,214.54 | ↑ +6% |
| Quality Care Partners | All Products | $1,237.60 | ↑ +8% |
| GMS | All Products | $1,237.60 | ↑ +8% |
| ANTHEM | Managed Medicaid | $1,275.27 | ↑ +11% |
| MOLINA | Managed Medicaid | $1,275.27 | ↑ +11% |
| UNITED | Managed Medicaid | $1,299.56 | ↑ +13% |
| Aetna | All Products First Health | $1,326.00 | ↑ +15% |
| Consociate Health | All Products | $1,326.00 | ↑ +15% |
| United BH | Managed Medicaid | $1,335.99 | ↑ +16% |
| MMO | NASCO | $1,414.40 | ↑ +23% |
| Aetna | Asa | $1,414.40 | ↑ +23% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $1,414.40 | ↑ +23% |
| USA Managed Care | All Products | $1,591.20 | ↑ +38% |
| Multiplan | All Products | $1,591.20 | ↑ +38% |
| Aetna | Qhp/Ifp | $1,768.00 | ↑ +54% |
| UNITED | MEDICARE ADVANTAGE | $2,027.30 | ↑ +76% |
| OPTUM | All Products VA | $2,162.75 | ↑ +88% |
| OPTUM | Medicare Advantage Transplant | $2,162.75 | ↑ +88% |
| HUMANA | Medicare Advantage HMO | $2,162.75 | ↑ +88% |
| MMO | Medicare Advantage HMO | $2,162.75 | ↑ +88% |
| The Health Plan | MEDICARE ADVANTAGE | $2,162.75 | ↑ +88% |
| MMO | Medicare Advantage PPO | $2,227.63 | ↑ +94% |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $2,249.28 | ↑ +96% |
| Summacare | MEDICARE ADVANTAGE | $2,249.28 | ↑ +96% |
| ANTHEM | MEDICARE ADVANTAGE | $2,249.28 | ↑ +96% |
| CIGNA | Medicare Advantage Lifesource | $2,249.28 | ↑ +96% |
| AETNA | MEDICARE ADVANTAGE | $2,249.28 | ↑ +96% |
| UPMC | MEDICARE ADVANTAGE | $2,249.28 | ↑ +96% |
| Valor | ALL PRODUCTS | $2,249.28 | ↑ +96% |
| CIGNA | MEDICARE ADVANTAGE | $2,316.76 | ↑ +102% |
| Perennial Health | MEDICARE ADVANTAGE | $2,335.77 | ↑ +103% |
| CommuniCare | MEDICARE ADVANTAGE | $2,361.75 | ↑ +106% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $2,429.23 | ↑ +111% |
| PPHP | ALL PRODUCTS | $2,474.21 | ↑ +115% |
| MMO | SuperMed | $6,813.79 | ↑ +493% |
| Cigna | All Products Mid-Level | not published by hospital | — |
| United BH | All Products MD | not published by hospital | — |
| United BH | All Products PHD | not published by hospital | — |
| United BH | All Products RN | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
| United BH | All Products MA | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of tear sac at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,603.66 – $1,856.87 |
| fairview hospital | Cleveland | not published | $945.40 – $2,474.21 |
| lutheran hospital | Cleveland | not published | $900.06 – $2,474.21 |
| akron general | Akron | not published | $915.87 – $2,474.21 |
| avon hospital | Avon | not published | $982.25 – $2,474.21 |
| euclid hospital | Euclid | not published | $1,006.34 – $2,474.21 |
| hillcrest hospital | Mayfield Heights | not published | $984.97 – $2,474.21 |
| lodi hospital | Lodi | not published | $1,536.64 – $1,779.27 |