healthcosts.net
Biopsy of salivary glnd;incisional 42405 at fairview hospital
18101 Lorain Avenue, Cleveland, OH · Cleveland Clinic · · NPI 1215989611
not published by hospital
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.
not published by hospital
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.
$1,323.06 with HUMANA vs $4,234.06 with ANTHEM — 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 |
|---|---|---|---|
| HUMANA | Medicare Advantage HMO | $1,323.06 | — |
| OPTUM | Managed Medicaid Transplant | $1,358.50 | — |
| UNITED | MEDICARE ADVANTAGE | $1,373.21 | — |
| MMO | Medicare Advantage HMO | $1,373.21 | — |
| OPTUM | Medicare Advantage Transplant | $1,373.21 | — |
| OPTUM | All Products VA | $1,373.21 | — |
| The Health Plan | MEDICARE ADVANTAGE | $1,373.21 | — |
| MMO | Medicare Advantage PPO | $1,414.40 | — |
| AETNA | MEDICARE ADVANTAGE | $1,467.92 | — |
| Valor | HMO & PPO | $1,467.92 | — |
| ANTHEM | MEDICARE ADVANTAGE | $1,467.92 | — |
| UPMC | MEDICARE ADVANTAGE | $1,467.92 | — |
| Summacare | MEDICARE ADVANTAGE | $1,467.92 | — |
| DEVOTED HEALTH | MEDICARE ADVANTAGE | $1,467.92 | — |
| Paramount | Managed Medicaid | $1,472.90 | — |
| Perennial Health | MEDICARE ADVANTAGE | $1,483.06 | — |
| MOLINA | Managed Medicaid | $1,501.50 | — |
| ANTHEM | Managed Medicaid | $1,501.50 | — |
| Buckeye | Managed Medicaid | $1,501.50 | — |
| CIGNA | MEDICARE ADVANTAGE | $1,511.96 | — |
| United BH | Managed Medicaid | $1,515.80 | — |
| UNITED | Managed Medicaid | $1,530.10 | — |
| CARESOURCE | Managed Medicaid | $1,530.10 | — |
| CommuniCare | MEDICARE ADVANTAGE | $1,541.31 | — |
| AMERIHEALTH | Managed Medicaid | $1,573.00 | — |
| Perennial Health | HMO I-SNP and HMO C-SNP | $1,585.35 | — |
| Zing Health | Medicare Advantage | $1,614.71 | — |
| PPHP | ALL PRODUCTS | $1,614.71 | — |
| ANTHEM | HPN | $3,598.89 | — |
| MMO | ALL PRODUCTS | $4,036.77 | — |
| ANTHEM | PPO/HMO | $4,234.06 | — |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $4,429.10 | $0.01 – $6,132.60 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $1,358.50 – $1,573.00 |
| lutheran hospital | Cleveland | not published | $1,358.50 – $1,614.71 |
| akron general | Akron | $868.40 | $1.10 – $1,573.00 |
| mercy hospital | Canton | $868.40 | $1.10 – $1,573.00 |
| University Hospitals Ahuja Medical Center | Beachwood | $1,768.50 | $521.12 – $2,642.25 |
| University Hospitals Beachwood Medical Center | Beachwood | $1,768.50 | $900.00 – $3,717.82 |
| University Hospitals Elyria Medical Center | Elyria | $1,768.50 | $1,467.92 – $2,642.25 |