Inj, adalimumab, 1 mg at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$19,998.76
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.
$30,767.32
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.
$91.73 with OPTUM vs $11,537.70 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 | $91.73 | ↓ -100% |
| OPTUM | Medicare Advantage Transplant | $91.73 | ↓ -100% |
| OPTUM | Managed Medicaid Transplant | $267.24 | ↓ -99% |
| CARESOURCE | Managed Medicaid | $281.30 | ↓ -99% |
| Buckeye | Managed Medicaid | $281.30 | ↓ -99% |
| MOLINA | Managed Medicaid | $295.37 | ↓ -99% |
| ANTHEM | Managed Medicaid | $295.37 | ↓ -99% |
| UNITED | Managed Medicaid | $295.37 | ↓ -99% |
| AMERIHEALTH | Managed Medicaid | $309.43 | ↓ -98% |
| OSCAR | ALL PRODUCTS | $3,262.86 | ↓ -84% |
| UNITED | MEDICARE ADVANTAGE | $3,461.31 | ↓ -83% |
| HUMANA | Medicare Advantage HMO | $3,461.31 | ↓ -83% |
| MMO | Medicare Advantage HMO & PPO | $3,461.31 | ↓ -83% |
| PHP | ALL PRODUCTS | $3,692.06 | ↓ -82% |
| Summacare | MEDICARE ADVANTAGE | $3,692.06 | ↓ -82% |
| PHPHI | ALL PRODUCTS | $3,692.06 | ↓ -82% |
| AETNA | MEDICARE ADVANTAGE | $3,692.06 | ↓ -82% |
| The Health Plan | Secure Care | $4,615.08 | ↓ -77% |
| Amish Community Aid Plan | ALL PRODUCTS | $5,191.97 | ↓ -74% |
| Aultcare | PPO/HMO | $5,549.63 | ↓ -72% |
| OHCP | ALL PRODUCTS | $5,607.32 | ↓ -72% |
| OMAS | ALL PRODUCTS | $5,768.85 | ↓ -71% |
| MMO | TRADITIONAL | $6,011.14 | ↓ -70% |
| Ohio Healthy | TRANSPLANT | $6,230.36 | ↓ -69% |
| ANTHEM | HPN | $6,299.58 | ↓ -69% |
| OPTUM | All Products Transplant | $6,530.34 | ↓ -67% |
| AETNA | Acop | $6,553.41 | ↓ -67% |
| Summacare | Preferred | $6,645.72 | ↓ -67% |
| Summacare | PREMIER | $6,922.62 | ↓ -65% |
| UPMC | ALL PRODUCTS | $6,922.62 | ↓ -65% |
| CIGNA | ALL PRODUCTS | $7,326.44 | ↓ -63% |
| ANTHEM | PPO/HMO | $7,411.82 | ↓ -63% |
| ANTHEM | TRADITIONAL | $7,642.57 | ↓ -62% |
| CC EHP | ALL PRODUCTS | $7,753.33 | ↓ -61% |
| AETNA | Asa_Whirlpool_Peia | $7,926.40 | ↓ -60% |
| UNITED | ALL PRODUCTS | $7,984.09 | ↓ -60% |
| AETNA | International | $8,007.16 | ↓ -60% |
| GMS | ALL PRODUCTS | $8,076.39 | ↓ -60% |
| Medical Benefit Corp | Transplant SMCP | $8,076.39 | ↓ -60% |
| Consociate Health | ALL PRODUCTS | $8,653.28 | ↓ -57% |
| AETNA | ALL PRODUCTS | $8,653.28 | ↓ -57% |
| The Health Plan | ALL PRODUCTS | $9,230.16 | ↓ -54% |
| Tertiary Care Network | TRANSPLANT | $10,383.93 | ↓ -48% |
| FrontPath | TRANSPLANT | $10,383.93 | ↓ -48% |
| Managed Care Services | TRANSPLANT | $10,383.93 | ↓ -48% |
| MULTIPLAN | ALL PRODUCTS | $10,383.93 | ↓ -48% |
| AETNA | Qhp/Ipf | $11,537.70 | ↓ -42% |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| ANTHEM | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Inj, adalimumab, 1 mg at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Trinity Medical Center East | Steubenville | $3,618.81 | $4,378.20 – $5,618.69 |
| akron general | Akron | $19,998.76 | $2.17 – $10,383.93 |
| avon hospital | Avon | $19,998.76 | $91.73 – $10,383.93 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | $19,998.76 | $278.89 – $10,383.93 |
| euclid hospital | Euclid | $19,998.76 | $91.73 – $10,383.93 |
| fairview hospital | Cleveland | $19,998.76 | $2.17 – $10,383.93 |
| lutheran hospital | Cleveland | $19,998.76 | $91.73 – $10,383.93 |
| hillcrest hospital | Mayfield Heights | $19,998.76 | $2.17 – $10,383.93 |