healthcosts.net
Clsd tx/prox/mid phalnx fx/no manp 26720 at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$716.95
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.
$1,103.00
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.
$239.88 with OPTUM vs $1,103.00 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 |
|---|---|---|---|
| OPTUM | All Products VA | $239.88 | ↓ -67% |
| OPTUM | Medicare Advantage Transplant | $239.88 | ↓ -67% |
| ANTHEM | MEDICARE ADVANTAGE | $252.01 | ↓ -65% |
| OSCAR | ALL PRODUCTS | $311.93 | ↓ -56% |
| UNITED | MEDICARE ADVANTAGE | $330.90 | ↓ -54% |
| HUMANA | Medicare Advantage HMO | $330.90 | ↓ -54% |
| MMO | Medicare Advantage HMO & PPO | $330.90 | ↓ -54% |
| PHPHI | ALL PRODUCTS | $352.96 | ↓ -51% |
| AETNA | MEDICARE ADVANTAGE | $352.96 | ↓ -51% |
| Summacare | MEDICARE ADVANTAGE | $352.96 | ↓ -51% |
| PHP | ALL PRODUCTS | $352.96 | ↓ -51% |
| OPTUM | Managed Medicaid Transplant | $393.02 | ↓ -45% |
| CARESOURCE | Managed Medicaid | $413.70 | ↓ -42% |
| Buckeye | Managed Medicaid | $413.70 | ↓ -42% |
| UNITED | Managed Medicaid | $434.39 | ↓ -39% |
| MOLINA | Managed Medicaid | $434.39 | ↓ -39% |
| ANTHEM | Managed Medicaid | $434.39 | ↓ -39% |
| The Health Plan | Secure Care | $441.20 | ↓ -38% |
| AMERIHEALTH | Managed Medicaid | $455.07 | ↓ -37% |
| Amish Community Aid Plan | ALL PRODUCTS | $496.35 | ↓ -31% |
| Aultcare | PPO/HMO | $530.54 | ↓ -26% |
| OHCP | ALL PRODUCTS | $536.06 | ↓ -25% |
| OMAS | ALL PRODUCTS | $551.50 | ↓ -23% |
| MMO | TRADITIONAL | $574.66 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $595.62 | ↓ -17% |
| ANTHEM | HPN | $602.24 | ↓ -16% |
| OPTUM | All Products Transplant | $624.30 | ↓ -13% |
| AETNA | Acop | $626.50 | ↓ -13% |
| Summacare | Preferred | $635.33 | ↓ -11% |
| UPMC | ALL PRODUCTS | $661.80 | ↓ -8% |
| Summacare | PREMIER | $690.48 | ↓ -4% |
| CIGNA | ALL PRODUCTS | $700.41 | ↓ -2% |
| ANTHEM | PPO/HMO | $708.57 | ↓ -1% |
| ANTHEM | TRADITIONAL | $730.63 | ↑ +2% |
| CC EHP | ALL PRODUCTS | $741.22 | ↑ +3% |
| AETNA | Asa_Whirlpool_Peia | $757.76 | ↑ +6% |
| UNITED | ALL PRODUCTS | $763.28 | ↑ +6% |
| AETNA | International | $765.48 | ↑ +7% |
| Medical Benefit Corp | Transplant SMCP | $772.10 | ↑ +8% |
| GMS | ALL PRODUCTS | $772.10 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $827.25 | ↑ +15% |
| AETNA | ALL PRODUCTS | $827.25 | ↑ +15% |
| The Health Plan | ALL PRODUCTS | $882.40 | ↑ +23% |
| FrontPath | TRANSPLANT | $992.70 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $992.70 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $992.70 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $992.70 | ↑ +38% |
| AETNA | Qhp/Ipf | $1,103.00 | ↑ +54% |
| AETNA | NAP | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
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Clsd tx/prox/mid phalnx fx/no manp 26720 at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $716.95 | $0.01 – $992.70 |
| akron general | Akron | $716.95 | $0.01 – $992.70 |
| avon hospital | Avon | $716.95 | $0.01 – $992.70 |
| euclid hospital | Euclid | $716.95 | $0.01 – $992.70 |
| fairview hospital | Cleveland | $716.95 | $0.01 – $992.70 |
| lutheran hospital | Cleveland | $716.95 | $0.01 – $992.70 |
| hillcrest hospital | Mayfield Heights | $716.95 | $0.01 – $992.70 |
| marymount hospital | Garfield Heights | $716.95 | $0.01 – $992.70 |