Inj., emicizumab-kxwh 0.5 mg at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$42,437.44
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.
$65,288.37
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.
$52.82 with OPTUM vs $27,881.30 with AMERIHEALTH — 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 | Medicare Advantage Transplant | $52.82 | ↓ -100% |
| OPTUM | All Products VA | $52.82 | ↓ -100% |
| ANTHEM | MEDICARE ADVANTAGE | $56.46 | ↓ -100% |
| OSCAR | ALL PRODUCTS | $3,692.71 | ↓ -91% |
| UNITED | MEDICARE ADVANTAGE | $3,917.30 | ↓ -91% |
| MMO | Medicare Advantage HMO & PPO | $3,917.30 | ↓ -91% |
| HUMANA | Medicare Advantage HMO | $3,917.30 | ↓ -91% |
| PHPHI | ALL PRODUCTS | $4,178.46 | ↓ -90% |
| Summacare | MEDICARE ADVANTAGE | $4,178.46 | ↓ -90% |
| AETNA | MEDICARE ADVANTAGE | $4,178.46 | ↓ -90% |
| PHP | ALL PRODUCTS | $4,178.46 | ↓ -90% |
| The Health Plan | Secure Care | $5,223.07 | ↓ -88% |
| Amish Community Aid Plan | ALL PRODUCTS | $5,875.96 | ↓ -86% |
| Aultcare | PPO/HMO | $6,280.74 | ↓ -85% |
| OHCP | ALL PRODUCTS | $6,346.03 | ↓ -85% |
| OMAS | ALL PRODUCTS | $6,528.84 | ↓ -85% |
| MMO | TRADITIONAL | $6,803.05 | ↓ -84% |
| Ohio Healthy | TRANSPLANT | $7,051.15 | ↓ -83% |
| ANTHEM | HPN | $7,129.49 | ↓ -83% |
| OPTUM | All Products Transplant | $7,390.65 | ↓ -83% |
| AETNA | Acop | $7,416.76 | ↓ -83% |
| Summacare | Preferred | $7,521.22 | ↓ -82% |
| Summacare | PREMIER | $7,834.61 | ↓ -82% |
| UPMC | ALL PRODUCTS | $7,834.61 | ↓ -82% |
| CIGNA | ALL PRODUCTS | $8,291.63 | ↓ -80% |
| ANTHEM | PPO/HMO | $8,388.25 | ↓ -80% |
| ANTHEM | TRADITIONAL | $8,649.41 | ↓ -80% |
| CC EHP | ALL PRODUCTS | $8,774.76 | ↓ -79% |
| AETNA | Asa_Whirlpool_Peia | $8,970.63 | ↓ -79% |
| UNITED | ALL PRODUCTS | $9,035.91 | ↓ -79% |
| AETNA | International | $9,062.03 | ↓ -79% |
| Medical Benefit Corp | Transplant SMCP | $9,140.38 | ↓ -78% |
| GMS | ALL PRODUCTS | $9,140.38 | ↓ -78% |
| AETNA | ALL PRODUCTS | $9,793.26 | ↓ -77% |
| Consociate Health | ALL PRODUCTS | $9,793.26 | ↓ -77% |
| The Health Plan | ALL PRODUCTS | $10,446.14 | ↓ -75% |
| Managed Care Services | TRANSPLANT | $11,751.91 | ↓ -72% |
| FrontPath | TRANSPLANT | $11,751.91 | ↓ -72% |
| MULTIPLAN | ALL PRODUCTS | $11,751.91 | ↓ -72% |
| Tertiary Care Network | TRANSPLANT | $11,751.91 | ↓ -72% |
| AETNA | Qhp/Ipf | $13,057.68 | ↓ -69% |
| OPTUM | Managed Medicaid Transplant | $24,079.31 | ↓ -43% |
| Buckeye | Managed Medicaid | $25,346.64 | ↓ -40% |
| CARESOURCE | Managed Medicaid | $25,346.64 | ↓ -40% |
| ANTHEM | Managed Medicaid | $26,613.97 | ↓ -37% |
| MOLINA | Managed Medicaid | $26,613.97 | ↓ -37% |
| UNITED | Managed Medicaid | $26,613.97 | ↓ -37% |
| AMERIHEALTH | Managed Medicaid | $27,881.30 | ↓ -34% |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Inj., emicizumab-kxwh 0.5 mg at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| akron general | Akron | $42,437.44 | $2.17 – $16,617.81 |
| avon hospital | Avon | $42,437.44 | $52.82 – $15,685.16 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | $42,437.44 | $3,692.71 – $29,097.34 |
| euclid hospital | Euclid | $42,437.44 | $50.84 – $18,259.40 |
| fairview hospital | Cleveland | $42,437.44 | $2.17 – $17,153.79 |
| lutheran hospital | Cleveland | $42,437.44 | $52.82 – $16,330.97 |
| hillcrest hospital | Mayfield Heights | $42,437.44 | $2.17 – $17,871.56 |
| marymount hospital | Garfield Heights | $42,437.44 | $50.84 – $16,124.93 |