Inj, lenacapavir, 1 mg at cleveland clinic childrens hospital for rehabilitation
2801 Martin Luther King Jr. Drive, Cleveland, OH · Cleveland Clinic · · NPI 1033161948
$15,210.00
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.
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What you pay up front if you don't use insurance.
$23,400.00
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.
$6,617.52 with OSCAR vs $23,400.00 with AETNA — 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 |
|---|---|---|---|
| OSCAR | ALL PRODUCTS | $6,617.52 | ↓ -56% |
| Aultcare | PPO/HMO | $6,669.00 | ↓ -56% |
| OPTUM | Managed Medicaid Transplant | $6,680.48 | ↓ -56% |
| Paramount | Managed Medicaid | $7,243.04 | ↓ -52% |
| MOLINA | Managed Medicaid | $7,383.68 | ↓ -51% |
| ANTHEM | Managed Medicaid | $7,383.68 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $7,488.00 | ↓ -51% |
| PHP | ALL PRODUCTS | $7,488.00 | ↓ -51% |
| CARESOURCE | Managed Medicaid | $7,524.33 | ↓ -51% |
| UNITED | Managed Medicaid | $7,524.33 | ↓ -51% |
| AMERIHEALTH | Managed Medicaid | $7,735.29 | ↓ -49% |
| Summacare | Preferred | $8,213.40 | ↓ -46% |
| CIGNA | ALL PRODUCTS | $8,658.00 | ↓ -43% |
| Summacare | PREMIER | $8,915.40 | ↓ -41% |
| MMO | TRADITIONAL | $9,523.80 | ↓ -37% |
| Buckeye | Managed Medicaid | $9,757.80 | ↓ -36% |
| ANTHEM | HPN | $9,797.58 | ↓ -36% |
| Amish Community Aid Plan | ALL PRODUCTS | $10,530.00 | ↓ -31% |
| OPTUM | All Products Transplant | $10,998.00 | ↓ -28% |
| ANTHEM | TRADITIONAL | $11,154.78 | ↓ -27% |
| UNITED | ALL PRODUCTS | $11,255.40 | ↓ -26% |
| OPTUM | Commercial CHD Care Solutions | $11,278.80 | ↓ -26% |
| OHCP | ALL PRODUCTS | $11,372.40 | ↓ -25% |
| ANTHEM | PPO/HMO | $11,526.84 | ↓ -24% |
| OPTUM | Commercial CRS Care Solutions | $11,957.40 | ↓ -21% |
| HEALTHSMART | ALL PRODUCTS | $12,870.00 | ↓ -15% |
| UPMC | ALL PRODUCTS | $14,040.00 | ↓ -8% |
| The Health Plan | ALL PRODUCTS | $14,040.00 | ↓ -8% |
| THREE RIVERS | ALL PRODUCTS | $15,210.00 | ↑ +0% |
| Quality Care Partners | ALL PRODUCTS | $16,380.00 | ↑ +8% |
| GMS | ALL PRODUCTS | $16,380.00 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $16,380.00 | ↑ +8% |
| CC EHP | ALL PRODUCTS | $16,590.60 | ↑ +9% |
| Consociate Health | ALL PRODUCTS | $17,550.00 | ↑ +15% |
| AETNA | ALL PRODUCTS | $17,550.00 | ↑ +15% |
| AETNA | Acop | $18,298.80 | ↑ +20% |
| Ohio Healthy | Transplant | $18,720.00 | ↑ +23% |
| Evernorth (Cigna BH) | All Products Psychiatrist | $18,720.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $21,060.00 | ↑ +38% |
| USA Managed Care | ALL PRODUCTS | $21,060.00 | ↑ +38% |
| AETNA | Asa_Whirlpool_Peia (Hmo) | $21,060.00 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $21,060.00 | ↑ +38% |
| AETNA | International | $22,230.00 | ↑ +46% |
| AETNA | Asa_Whirlpool_Peia (Pos_Epo_Ppo) | $22,323.60 | ↑ +47% |
| AETNA | Qhp/Ipf | $23,400.00 | ↑ +54% |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Inj, lenacapavir, 1 mg at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| fairview hospital | Cleveland | $15,210.00 | $2.17 – $21,060.00 |
| lutheran hospital | Cleveland | $15,210.00 | $21.99 – $21,060.00 |
| cleveland clinic main campus | Cleveland | not published | $2.79 – $5,565.45 |
| akron general | Akron | $15,210.00 | $2.17 – $21,060.00 |
| avon hospital | Avon | $15,210.00 | $21.99 – $21,060.00 |
| euclid hospital | Euclid | $15,210.00 | $21.99 – $21,060.00 |
| hillcrest hospital | Mayfield Heights | $15,210.00 | $2.17 – $21,060.00 |
| lodi hospital | Lodi | $15,210.00 | $21.99 – $21,060.00 |