Observation direct referral from physician office for admission at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$1,593.80
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.
$2,452.00
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.
$91.53 with OPTUM vs $2,206.80 with FrontPath — 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 | Managed Medicaid Transplant | $91.53 | ↓ -94% |
| CARESOURCE | Managed Medicaid | $96.35 | ↓ -94% |
| Buckeye | Managed Medicaid | $96.35 | ↓ -94% |
| MOLINA | Managed Medicaid | $101.17 | ↓ -94% |
| UNITED | Managed Medicaid | $101.17 | ↓ -94% |
| ANTHEM | Managed Medicaid | $101.17 | ↓ -94% |
| AMERIHEALTH | Managed Medicaid | $105.99 | ↓ -93% |
| ANTHEM | MEDICARE ADVANTAGE | $608.43 | ↓ -62% |
| OPTUM | Medicare Advantage Transplant | $613.10 | ↓ -62% |
| OPTUM | All Products VA | $613.10 | ↓ -62% |
| OSCAR | ALL PRODUCTS | $693.43 | ↓ -56% |
| HUMANA | Medicare Advantage HMO | $735.60 | ↓ -54% |
| MMO | Medicare Advantage HMO & PPO | $735.60 | ↓ -54% |
| UNITED | MEDICARE ADVANTAGE | $735.60 | ↓ -54% |
| PHP | ALL PRODUCTS | $784.64 | ↓ -51% |
| Summacare | MEDICARE ADVANTAGE | $784.64 | ↓ -51% |
| PHPHI | ALL PRODUCTS | $784.64 | ↓ -51% |
| AETNA | MEDICARE ADVANTAGE | $784.64 | ↓ -51% |
| The Health Plan | Secure Care | $980.80 | ↓ -38% |
| Amish Community Aid Plan | ALL PRODUCTS | $1,103.40 | ↓ -31% |
| Aultcare | PPO/HMO | $1,179.41 | ↓ -26% |
| OHCP | ALL PRODUCTS | $1,191.67 | ↓ -25% |
| OMAS | ALL PRODUCTS | $1,226.00 | ↓ -23% |
| MMO | TRADITIONAL | $1,277.49 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $1,324.08 | ↓ -17% |
| ANTHEM | HPN | $1,338.79 | ↓ -16% |
| OPTUM | All Products Transplant | $1,387.83 | ↓ -13% |
| AETNA | Acop | $1,392.74 | ↓ -13% |
| Summacare | Preferred | $1,412.35 | ↓ -11% |
| UPMC | ALL PRODUCTS | $1,471.20 | ↓ -8% |
| Summacare | PREMIER | $1,534.95 | ↓ -4% |
| CIGNA | ALL PRODUCTS | $1,557.02 | ↓ -2% |
| ANTHEM | PPO/HMO | $1,575.16 | ↓ -1% |
| ANTHEM | TRADITIONAL | $1,624.20 | ↑ +2% |
| CC EHP | ALL PRODUCTS | $1,647.74 | ↑ +3% |
| AETNA | Asa_Whirlpool_Peia | $1,684.52 | ↑ +6% |
| AETNA | NAP | $1,686.98 | ↑ +6% |
| UNITED | ALL PRODUCTS | $1,696.78 | ↑ +6% |
| AETNA | International | $1,701.69 | ↑ +7% |
| Medical Benefit Corp | Transplant SMCP | $1,716.40 | ↑ +8% |
| AETNA | Qhp/Ipf | $1,716.40 | ↑ +8% |
| GMS | ALL PRODUCTS | $1,716.40 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $1,839.00 | ↑ +15% |
| AETNA | ALL PRODUCTS | $1,839.00 | ↑ +15% |
| The Health Plan | ALL PRODUCTS | $1,961.60 | ↑ +23% |
| Tertiary Care Network | TRANSPLANT | $2,206.80 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $2,206.80 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $2,206.80 | ↑ +38% |
| FrontPath | TRANSPLANT | $2,206.80 | ↑ +38% |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $1,593.80 | $68.73 – $2,206.80 |
| akron general | Akron | $1,593.80 | $54.56 – $2,206.80 |
| avon hospital | Avon | $1,593.80 | $58.51 – $2,206.80 |
| euclid hospital | Euclid | $1,593.80 | $59.95 – $2,206.80 |
| fairview hospital | Cleveland | $1,593.80 | $56.32 – $2,206.80 |
| lutheran hospital | Cleveland | $1,593.80 | $53.61 – $2,206.80 |
| hillcrest hospital | Mayfield Heights | $1,593.80 | $58.67 – $2,206.80 |
| marymount hospital | Garfield Heights | $1,593.80 | $52.93 – $2,206.80 |