Cleveland Clinic Mercy Hospital
Cleveland Clinic Mercy Hospital in Canton, OH publishes cash prices for 74 common procedures listed here, from its own machine-readable price file updated Jun 15, 2026. Click a procedure to compare it with other hospitals nearby.
1320 Mercy Drive Northwest, Canton, OH 44708 Collected Sep 23, 2026 Source price file
Scans and imaging
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST | $2,122.25 | $3,265.00 | 35% |
| CT scan of abdomen and pelvis, with contrast dye inpatient CPT 74177 CT ABDOMEN & PELVIS W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | 35% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL | $477.10 | $734.00 | 35% |
| CT scan of the head or brain, no contrast dye inpatient CPT 70450 CT HEAD/BRAIN W/O CONTRAST MATERIAL | $477.10 | $734.00 | 35% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/CONTRAST MATERIAL | $798.20 | $1,228.00 | 35% |
| CT scan of the pelvis, with contrast dye inpatient CPT 72193 CT PELVIS W/CONTRAST MATERIAL | $798.20 | $1,228.00 | 35% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $458.90 | $706.00 | 35% |
| Diagnostic mammogram, both breasts inpatient both sides CPT 77066 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI | $458.90 | $706.00 | 35% |
| Diagnostic mammogram, one breast CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $365.95 | $563.00 | 35% |
| Diagnostic mammogram, one breast inpatient CPT 77065 DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI | $365.95 | $563.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | 35% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient CPT 73721 MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL | $1,084.20 | $1,668.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,601.60 | $2,464.00 | 35% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient CPT 73723 MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL | $1,601.60 | $2,464.00 | 35% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | 35% |
| MRI of the brain, no contrast dye inpatient CPT 70551 MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | 35% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | 35% |
| MRI of the brain, with and without contrast dye inpatient CPT 70553 MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL | $1,601.60 | $2,464.00 | 35% |
| MRI of the lower back, no contrast dye CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | 35% |
| MRI of the lower back, no contrast dye inpatient CPT 72148 MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL | $1,084.20 | $1,668.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $477.10 | $734.00 | 35% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient CPT 76805 US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION | $477.10 | $734.00 | 35% |
| Screening mammogram, both breasts both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $395.85 | $609.00 | 35% |
| Screening mammogram, both breasts inpatient both sides CPT 77067 SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD | $395.85 | $609.00 | 35% |
| Sleep study in a lab (polysomnography) CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,563.00 | $7,020.00 | 35% |
| Sleep study in a lab (polysomnography) inpatient CPT 95810 POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND | $4,563.00 | $7,020.00 | 35% |
| Transvaginal pelvic ultrasound CPT 76830 US TRANSVAGINAL | $477.10 | $734.00 | 35% |
| Transvaginal pelvic ultrasound inpatient CPT 76830 US TRANSVAGINAL | $477.10 | $734.00 | 35% |
| Ultrasound of the abdomen, complete CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $477.10 | $734.00 | 35% |
| Ultrasound of the abdomen, complete inpatient CPT 76700 US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION | $477.10 | $734.00 | 35% |
| X-ray of the lower back, 4 or more views CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $477.10 | $734.00 | 35% |
| X-ray of the lower back, 4 or more views inpatient CPT 72110 RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS | $477.10 | $734.00 | 35% |
Lab tests
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Basic metabolic panel (blood test) CPT 80048 BASIC METABOLIC PANEL | $37.70 | $58.00 | 35% |
| Basic metabolic panel (blood test) inpatient CPT 80048 BASIC METABOLIC PANEL | $37.70 | $58.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID-LIPO PANEL 1 (POINT OF CARE LAB) | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID-LIPO PANEL 1 | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 %NMRLIP CHOLESTEROL | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPOEL LIPID PANEL | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 %NMRLIP CHOLESTEROL | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID-LIPO PANEL 1 (POINT OF CARE LAB) | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPOEL LIPID PANEL | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID-LIPO PANEL 1 | $59.80 | $92.00 | 35% |
| Cholesterol and triglycerides (lipid panel) blood test inpatient CPT 80061 LIPID PANEL | $59.80 | $92.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC | $35.10 | $54.00 | 35% |
| Complete blood count (CBC) with differential CPT 85025 CBC AUTO W AUTO DIFF | $35.10 | $54.00 | 35% |
| Complete blood count (CBC) with differential inpatient CPT 85025 CBC AUTO W AUTO DIFF | $35.10 | $54.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 BLOOD COUNT COMPLETE AUTOMATED | $29.25 | $45.00 | 35% |
| Complete blood count (CBC), no differential CPT 85027 CBC AUTO WO DIFF | $29.25 | $45.00 | 35% |
| Complete blood count (CBC), no differential inpatient CPT 85027 CBC AUTO WO DIFF | $29.25 | $45.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPRE META PANL | $47.45 | $73.00 | 35% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHENSIVE METABOLIC PANEL | $47.45 | $73.00 | 35% |
| Comprehensive metabolic panel (blood test) inpatient CPT 80053 COMPRE META PANL | $47.45 | $73.00 | 35% |
| Kidney function blood test panel CPT 80069 RENAL FUNC PANL | $39.00 | $60.00 | 35% |
| Kidney function blood test panel inpatient CPT 80069 RENAL FUNC PANL | $39.00 | $60.00 | 35% |
| Liver function blood test panel CPT 80076 HEP FUNC PANL | $36.40 | $56.00 | 35% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PNL | $36.40 | $56.00 | 35% |
| Liver function blood test panel inpatient CPT 80076 HEP FUNC PANL | $36.40 | $56.00 | 35% |
| Obstetric blood test panel CPT 80055 OB PANEL | $214.50 | $330.00 | 35% |
| Obstetric blood test panel inpatient CPT 80055 OB PANEL | $214.50 | $330.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 %PHI PROST SPEC AG FREE | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 PSA FREE | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 %PHI PROST SPEC AG FREE | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, free inpatient CPT 84154 PSA FREE | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA DIAGNOSTIC | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PHI PROST SPEC AG TOT | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 %PHI PROST SPEC AG TOT | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 PSA SCREENING | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PHI PROST SPEC AG TOT | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 %PHI PROST SPEC AG TOT | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA DIAGNOSTIC | $82.55 | $127.00 | 35% |
| PSA (prostate-specific antigen) blood test, total inpatient CPT 84153 PSA SCREENING | $82.55 | $127.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 *PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | 35% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 MANUAL HEME - PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 *PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | 35% |
| Partial thromboplastin time (PTT) clotting test inpatient CPT 85730 MANUAL HEME - PTT PLASMA/WHOLE BLOOD | $26.65 | $41.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME AND INR (POINT OF CARE LAB) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTIME (MANUALLY RESULTED IN BEAKER) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 MANUAL HEME - PRO TIME | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PRO TIME (POINT OF CARE LAB) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 *PRO TIME | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test CPT 85610 CLOTTING TEST (POINT OF CARE LAB) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTIME (MANUALLY RESULTED IN BEAKER) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 *PRO TIME | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 MANUAL HEME - PRO TIME | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME AND INR (POINT OF CARE LAB) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PROTHROMBIN TIME | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 CLOTTING TEST (POINT OF CARE LAB) | $19.50 | $30.00 | 35% |
| Prothrombin time (PT/INR) clotting test inpatient CPT 85610 PRO TIME (POINT OF CARE LAB) | $19.50 | $30.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 THYROID STIMULATING HORMONE (TSH) | $75.40 | $116.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 %NEO TSH | $75.40 | $116.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 THYROID STIMULATING HORMONE (TSH) | $75.40 | $116.00 | 35% |
| Thyroid-stimulating hormone (TSH) blood test inpatient CPT 84443 %NEO TSH | $75.40 | $116.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS WITH MICRO (POINT OF CARE LAB) | $14.30 | $22.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY | $14.30 | $22.00 | 35% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W SCPE | $14.30 | $22.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS WITH MICRO (POINT OF CARE LAB) | $14.30 | $22.00 | 35% |
| Urinalysis with microscope exam, automated inpatient CPT 81001 URINALYSIS AUTO W SCPE | $14.30 | $22.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY | $18.20 | $28.00 | 35% |
| Urinalysis with microscope exam, manual CPT 81000 URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB) | $18.20 | $28.00 | 35% |
| Urinalysis with microscope exam, manual inpatient CPT 81000 URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB) | $18.20 | $28.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS ONLY | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS (POINT OF CARE LAB) | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS (POINT OF CARE LAB) | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS ONLY | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, automated inpatient CPT 81003 URINALYSIS AUTO WO SCPE (POINT OF CARE LAB) | $10.40 | $16.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 UA NON-AUTO W/O MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | 35% |
| Urinalysis without microscope exam, manual CPT 81002 URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP | $15.60 | $24.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | 35% |
| Urinalysis without microscope exam, manual inpatient CPT 81002 UA NON-AUTO W/O MICRO (POINT OF CARE LAB) | $15.60 | $24.00 | 35% |
Surgery and procedures
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Cataract surgery with lens implant CPT 66984 XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP | $2,102.10 | $3,234.00 | 35% |
| Cesarean delivery, including prenatal and postpartum care CPT 59510 OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM | $10,673.00 | $16,420.00 | 35% |
| Colonoscopy with endoscopic ultrasound CPT 45391 COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX | $1,206.40 | $1,856.00 | 35% |
| Colonoscopy with polyp removal CPT 45385 LESION REMOVAL COLONOSCOPY | $630.50 | $970.00 | 35% |
| Colonoscopy with polyp removal CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $3,525.60 | $5,424.00 | 35% |
| Colonoscopy with polyp removal inpatient CPT 45385 COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ | $3,525.60 | $5,424.00 | 35% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY AND BIOPSY | $458.90 | $706.00 | 35% |
| Colonoscopy with tissue sample CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $3,525.60 | $5,424.00 | 35% |
| Colonoscopy with tissue sample inpatient CPT 45380 COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE | $3,525.60 | $5,424.00 | 35% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY | $409.50 | $630.00 | 35% |
| Colonoscopy, diagnostic CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $2,726.10 | $4,194.00 | 35% |
| Colonoscopy, diagnostic inpatient CPT 45378 COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD | $2,726.10 | $4,194.00 | 35% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPIC CHOLECYSTECTOMY | $913.90 | $1,406.00 | 35% |
| Gallbladder removal, laparoscopic CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $17,444.70 | $26,838.00 | 35% |
| Gallbladder removal, laparoscopic inpatient CPT 47562 LAPAROSCOPY SURG CHOLECYSTECTOMY | $17,444.70 | $26,838.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 REPAIR INGUINAL HERNIA | $682.50 | $1,050.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $10,552.10 | $16,234.00 | 35% |
| Inguinal (groin) hernia repair, age 5 or older inpatient CPT 49505 RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE | $10,552.10 | $16,234.00 | 35% |
| Knee arthroscopy with meniscus trim CPT 29881 ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG | $2,010.45 | $3,093.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) CPT 66821 POST-CATARACT LASER SURGERY | $1,640.60 | $2,524.00 | 35% |
| Laser treatment of clouding after cataract surgery (YAG) inpatient CPT 66821 POST-CATARACT LASER SURGERY | $1,640.60 | $2,524.00 | 35% |
| Left heart catheterization, diagnostic CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $12,021.10 | $18,494.00 | 35% |
| Left heart catheterization, diagnostic inpatient CPT 93452 L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I | $12,021.10 | $18,494.00 | 35% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $3,105.70 | $4,778.00 | 35% |
| Lower-back epidural injection, with imaging guidance inpatient CPT 62323 NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN | $3,105.70 | $4,778.00 | 35% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $3,992.95 | $6,143.00 | 35% |
| Lower-back epidural injection, without imaging guidance inpatient CPT 62322 NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN | $3,992.95 | $6,143.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $3,992.95 | $6,143.00 | 35% |
| Lower-back nerve root steroid injection, with imaging guidance inpatient CPT 64483 NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL | $3,992.95 | $6,143.00 | 35% |
| Prostate removal (prostatectomy), laparoscopic CPT 55866 LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT | $6,423.30 | $9,882.00 | 35% |
| Removal of a breast lump, open surgery CPT 19120 REMOVAL OF BREAST LESION | $427.05 | $657.00 | 35% |
| Removal of a breast lump, open surgery CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $7,467.20 | $11,488.00 | 35% |
| Removal of a breast lump, open surgery inpatient CPT 19120 EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION | $7,467.20 | $11,488.00 | 35% |
| Shoulder arthroscopy: shaving of the shoulder bone (add-on to another shoulder surgery) CPT 29826 SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS | $858.00 | $1,320.00 | 35% |
| Tonsil and adenoid removal, child under 12 CPT 42820 TONSILLECTOMY & ADENOIDECTOMY <AGE 12 | $1,097.20 | $1,688.00 | 35% |
| Total hip replacement CPT 27130 ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT | $5,605.60 | $8,624.00 | 35% |
| Total knee replacement CPT 27447 ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS | $5,096.00 | $7,840.00 | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 UPPER GI ENDOSCOPY, BIOPSY | $330.20 | $508.00 | 35% |
| Upper endoscopy (EGD) with biopsy CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $2,803.45 | $4,313.00 | 35% |
| Upper endoscopy (EGD) with biopsy inpatient CPT 43239 EGD TRANSORAL BIOPSY SINGLE/MULTIPLE | $2,803.45 | $4,313.00 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 UPPR GI ENDOSCOPY, DIAGNOSIS | $304.20 | $468.00 | 35% |
| Upper endoscopy (EGD), diagnostic CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,803.45 | $4,313.00 | 35% |
| Upper endoscopy (EGD), diagnostic inpatient CPT 43235 ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC | $2,803.45 | $4,313.00 | 35% |
| Vaginal birth after cesarean (VBAC), including prenatal and postpartum care CPT 59610 ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB | $10,064.60 | $15,484.00 | 35% |
| Vaginal delivery, including prenatal and postpartum care CPT 59400 OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM | $9,620.00 | $14,800.00 | 35% |
Doctor visits and therapy
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $269.75 | $415.00 | 35% |
| Electrocardiogram (ECG/EKG) with interpretation inpatient CPT 93000 ECG ROUTINE ECG W/LEAST 12 LDS W/I&R | $269.75 | $415.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $313.30 | $482.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 FAM THERAPY W PATIENT DTOX | $313.30 | $482.00 | 35% |
| Family therapy with the patient, 50 minutes CPT 90847 VIRTUAL VISIT FAMILY PSYTX W/PATIENT | $712.40 | $1,096.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAM THERAPY W PATIENT DTOX | $313.30 | $482.00 | 35% |
| Family therapy with the patient, 50 minutes inpatient CPT 90847 FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS | $313.30 | $482.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $313.30 | $482.00 | 35% |
| Family therapy without the patient, 50 minutes CPT 90846 VIRTUAL VISIT FAMILY PSYCHOTHERAPY W/O PATIENT | $683.80 | $1,052.00 | 35% |
| Family therapy without the patient, 50 minutes inpatient CPT 90846 FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS | $313.30 | $482.00 | 35% |
| Group psychotherapy session CPT 90853 GROUP PSYCHOTHERAPY | $169.00 | $260.00 | 35% |
| Group psychotherapy session CPT 90853 VIRTUAL VISIT GROUP PSYCHOTHERAPY | $169.00 | $260.00 | 35% |
| Group psychotherapy session CPT 90853 VIRTUAL VISIT GROUP THERAPY | $180.70 | $278.00 | 35% |
| Group psychotherapy session CPT 90853 GROUP THERAPY | $180.70 | $278.00 | 35% |
| Group psychotherapy session CPT 90853 VIRTUAL VISIT AFTERCARE GROUP | $180.70 | $278.00 | 35% |
| Group psychotherapy session CPT 90853 EXT AFTERCARE THPY GRP OP ONLY | $180.70 | $278.00 | 35% |
| Group psychotherapy session CPT 90853 VIRTUAL VISIT MH IOP GROUP THERAPY | $180.70 | $278.00 | 35% |
| Group psychotherapy session CPT 90853 VIRTUAL VISIT CD IOP DAY | $542.10 | $834.00 | 35% |
| Group psychotherapy session CPT 90853 CD IOP DAY | $542.10 | $834.00 | 35% |
| Group psychotherapy session CPT 90853 VIRTUAL VISIT IOP HALF DAY RATE | $542.10 | $834.00 | 35% |
| Group psychotherapy session CPT 90853 IOP HALF DAY RATE | $542.10 | $834.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 EXT AFTERCARE THPY GRP OP ONLY | $180.70 | $278.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 GROUP THERAPY | $180.70 | $278.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT MH IOP GROUP THERAPY | $180.70 | $278.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT GROUP THERAPY | $180.70 | $278.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT AFTERCARE GROUP | $180.70 | $278.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 IOP HALF DAY RATE | $542.10 | $834.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 CD IOP DAY | $542.10 | $834.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT IOP HALF DAY RATE | $542.10 | $834.00 | 35% |
| Group psychotherapy session inpatient CPT 90853 VIRTUAL VISIT CD IOP DAY | $542.10 | $834.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT VISIT NEW | $66.95 | $103.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES | $90.35 | $139.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES | $416.00 | $640.00 | 35% |
| New patient office visit, about 30 minutes CPT 99203 OD NEW ONLINE E&M LEVEL 3 | $416.00 | $640.00 | 35% |
| New patient office visit, about 30 minutes inpatient CPT 99203 OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES | $90.35 | $139.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES | $113.10 | $174.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT VISIT NEW | $113.75 | $175.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 OD NEW ONLINE E&M LEVEL 4 | $676.00 | $1,040.00 | 35% |
| New patient office visit, about 45 minutes CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES | $676.00 | $1,040.00 | 35% |
| New patient office visit, about 45 minutes inpatient CPT 99204 OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES | $113.10 | $174.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES | $152.75 | $235.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 OD NEW ONLINE E&M LEVEL 5 | $910.00 | $1,400.00 | 35% |
| New patient office visit, about 60 minutes CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES | $910.00 | $1,400.00 | 35% |
| New patient office visit, about 60 minutes inpatient CPT 99205 OFFICE/OUTPATIENT NEW HIGH MDM 60-74 MINUTES | $152.75 | $235.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES RE, EA 15 MIN | $29.25 | $45.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES RE, EA 15 MIN. | $128.70 | $198.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 1 | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 15MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THER EX 15 MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE OT (97110) | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 OT THERAPEUT PROC/EXER 15 MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER 15MIN GO | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERA EXER EA 15 MINS | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 VV THERAPEUTIC EXERCISE PT (97110) | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE OT (97110) | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 PT THERAPEUT PROC/EXER, 15 MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 OT THERAPEUT PROC/EXER 15 MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 VV THERAPEUTIC EXERCISE PT (97110) | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 15MIN GO | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 1 | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER 15MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THER EX 15 MIN | $167.70 | $258.00 | 35% |
| Physical therapy, therapeutic exercise (15-minute unit) inpatient CPT 97110 THERA EXER EA 15 MINS | $167.70 | $258.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39 | $16.25 | $25.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $119.60 | $184.00 | 35% |
| Preventive checkup, new patient aged 18–39 CPT 99385 WELLNESS EXAM NEW 18-39 YRS | $499.20 | $768.00 | 35% |
| Preventive checkup, new patient aged 18–39 inpatient CPT 99385 INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS | $119.60 | $184.00 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $165.10 | $254.00 | 35% |
| Preventive checkup, new patient aged 40–64 CPT 99386 WELLNESS EXAMS NEW 40-64 YRS | $605.80 | $932.00 | 35% |
| Preventive checkup, new patient aged 40–64 inpatient CPT 99386 INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS | $165.10 | $254.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $313.30 | $482.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS | $483.60 | $744.00 | 35% |
| Psychotherapy session, 30 minutes CPT 90832 PSYCHOTHERAPY 30 MINUTES PATIENT | $483.60 | $744.00 | 35% |
| Psychotherapy session, 30 minutes inpatient CPT 90832 PSYCHOTHERAPY W/PATIENT 30 MINUTES | $313.30 | $482.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $313.30 | $482.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 PSYCHOTHERAPY 45 MINUTES WITH PATIENT | $637.00 | $980.00 | 35% |
| Psychotherapy session, 45 minutes CPT 90834 VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS | $637.00 | $980.00 | 35% |
| Psychotherapy session, 45 minutes inpatient CPT 90834 PSYCHOTHERAPY W/PATIENT 45 MINUTES | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $313.30 | $482.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS | $943.80 | $1,452.00 | 35% |
| Psychotherapy session, 60 minutes CPT 90837 PSYCHOTHERAPY 60 MINUTES WITH PATIENT | $943.80 | $1,452.00 | 35% |
| Psychotherapy session, 60 minutes inpatient CPT 90837 PSYCHOTHERAPY W/PATIENT 60 MINUTES | $313.30 | $482.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $468.00 | $720.00 | 35% |
| Specialist consultation, low complexity or 30+ minutes CPT 99243 VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES | $468.00 | $720.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $699.40 | $1,076.00 | 35% |
| Specialist consultation, moderate complexity or 40+ minutes CPT 99244 VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES | $699.40 | $1,076.00 | 35% |
Dental
| Procedure | Cash price | List price | Off list |
|---|---|---|---|
| Dental implant, surgical placement CDT D6010 SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT | $1,625.00 | $2,500.00 | 35% |
| Porcelain crown CDT D2740 CROWN - PORCELAIN/CERAMIC | $1,040.00 | $1,600.00 | 35% |
Source file: https://clevelandclinic.pt.panaceainc.com/MRFDownload/clevelandclinic/mercy