healthcosts.net
Assay of phenylketones at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$17.55
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.
$27.00
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.
$1.89 with ANTHEM vs $27.00 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 |
|---|---|---|---|
| ANTHEM | HPN | $1.89 | ↓ -89% |
| ANTHEM | PPO/HMO | $2.22 | ↓ -87% |
| ANTHEM | MEDICARE ADVANTAGE | $3.98 | ↓ -77% |
| OPTUM | Medicare Advantage Transplant | $3.98 | ↓ -77% |
| OSCAR | ALL PRODUCTS | $7.64 | ↓ -56% |
| MMO | Medicare Advantage HMO & PPO | $8.10 | ↓ -54% |
| UNITED | MEDICARE ADVANTAGE | $8.10 | ↓ -54% |
| HUMANA | Medicare Advantage HMO | $8.10 | ↓ -54% |
| Summacare | MEDICARE ADVANTAGE | $8.64 | ↓ -51% |
| PHP | ALL PRODUCTS | $8.64 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $8.64 | ↓ -51% |
| AETNA | MEDICARE ADVANTAGE | $8.64 | ↓ -51% |
| The Health Plan | Secure Care | $10.80 | ↓ -38% |
| Amish Community Aid Plan | ALL PRODUCTS | $12.15 | ↓ -31% |
| Aultcare | PPO/HMO | $12.99 | ↓ -26% |
| OHCP | ALL PRODUCTS | $13.12 | ↓ -25% |
| OMAS | ALL PRODUCTS | $13.50 | ↓ -23% |
| MMO | TRADITIONAL | $14.07 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $14.58 | ↓ -17% |
| OPTUM | All Products Transplant | $15.28 | ↓ -13% |
| AETNA | Acop | $15.34 | ↓ -13% |
| Summacare | Preferred | $15.55 | ↓ -11% |
| OPTUM | Managed Medicaid Transplant | $15.66 | ↓ -11% |
| UPMC | ALL PRODUCTS | $16.20 | ↓ -8% |
| Buckeye | Managed Medicaid | $16.48 | ↓ -6% |
| CARESOURCE | Managed Medicaid | $16.48 | ↓ -6% |
| Summacare | PREMIER | $16.90 | ↓ -4% |
| CIGNA | ALL PRODUCTS | $17.15 | ↓ -2% |
| UNITED | Managed Medicaid | $17.30 | ↓ -1% |
| ANTHEM | Managed Medicaid | $17.30 | ↓ -1% |
| MOLINA | Managed Medicaid | $17.30 | ↓ -1% |
| ANTHEM | TRADITIONAL | $17.88 | ↑ +2% |
| AMERIHEALTH | Managed Medicaid | $18.13 | ↑ +3% |
| CC EHP | ALL PRODUCTS | $18.14 | ↑ +3% |
| AETNA | Asa_Whirlpool_Peia | $18.55 | ↑ +6% |
| UNITED | ALL PRODUCTS | $18.68 | ↑ +6% |
| AETNA | International | $18.74 | ↑ +7% |
| GMS | ALL PRODUCTS | $18.90 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $18.90 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $20.25 | ↑ +15% |
| AETNA | ALL PRODUCTS | $20.25 | ↑ +15% |
| The Health Plan | ALL PRODUCTS | $21.60 | ↑ +23% |
| FrontPath | TRANSPLANT | $24.30 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $24.30 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $24.30 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $24.30 | ↑ +38% |
| AETNA | Qhp/Ipf | $27.00 | ↑ +54% |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| OPTUM | All Products VA | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Assay of phenylketones at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $17.55 | $1.81 – $24.30 |
| akron general | Akron | $17.55 | $0.95 – $24.30 |
| avon hospital | Avon | not published | $3.33 – $10.20 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $16.33 – $18.91 |
| euclid hospital | Euclid | not published | $3.33 – $11.87 |
| fairview hospital | Cleveland | not published | $3.98 – $11.14 |
| lutheran hospital | Cleveland | not published | $3.33 – $10.62 |
| hillcrest hospital | Mayfield Heights | not published | $3.98 – $11.62 |