healthcosts.net
Pt evaluation moderate complexity patient/family at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$393.25
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.
$605.00
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.
$124.11 with OPTUM vs $605.00 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 | Managed Medicaid Transplant | $124.11 | ↓ -68% |
| OPTUM | Medicare Advantage Transplant | $126.19 | ↓ -68% |
| ANTHEM | MEDICARE ADVANTAGE | $126.43 | ↓ -68% |
| CARESOURCE | Managed Medicaid | $130.64 | ↓ -67% |
| Buckeye | Managed Medicaid | $130.64 | ↓ -67% |
| UNITED | Managed Medicaid | $137.17 | ↓ -65% |
| MOLINA | Managed Medicaid | $137.17 | ↓ -65% |
| ANTHEM | Managed Medicaid | $137.17 | ↓ -65% |
| AMERIHEALTH | Managed Medicaid | $143.70 | ↓ -63% |
| OSCAR | ALL PRODUCTS | $171.09 | ↓ -56% |
| HUMANA | Medicare Advantage HMO | $181.50 | ↓ -54% |
| UNITED | MEDICARE ADVANTAGE | $181.50 | ↓ -54% |
| MMO | Medicare Advantage HMO & PPO | $181.50 | ↓ -54% |
| PHPHI | ALL PRODUCTS | $193.60 | ↓ -51% |
| AETNA | MEDICARE ADVANTAGE | $193.60 | ↓ -51% |
| Summacare | MEDICARE ADVANTAGE | $193.60 | ↓ -51% |
| PHP | ALL PRODUCTS | $193.60 | ↓ -51% |
| The Health Plan | Secure Care | $242.00 | ↓ -38% |
| Amish Community Aid Plan | ALL PRODUCTS | $272.25 | ↓ -31% |
| Aultcare | PPO/HMO | $291.01 | ↓ -26% |
| OHCP | ALL PRODUCTS | $294.03 | ↓ -25% |
| OMAS | ALL PRODUCTS | $302.50 | ↓ -23% |
| MMO | TRADITIONAL | $315.21 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $326.70 | ↓ -17% |
| ANTHEM | HPN | $330.33 | ↓ -16% |
| OPTUM | All Products Transplant | $342.43 | ↓ -13% |
| AETNA | Acop | $343.64 | ↓ -13% |
| Summacare | Preferred | $348.48 | ↓ -11% |
| UPMC | ALL PRODUCTS | $363.00 | ↓ -8% |
| Summacare | PREMIER | $378.73 | ↓ -4% |
| CIGNA | ALL PRODUCTS | $384.18 | ↓ -2% |
| ANTHEM | PPO/HMO | $388.65 | ↓ -1% |
| ANTHEM | TRADITIONAL | $400.75 | ↑ +2% |
| CC EHP | ALL PRODUCTS | $406.56 | ↑ +3% |
| AETNA | Asa_Whirlpool_Peia | $415.64 | ↑ +6% |
| UNITED | ALL PRODUCTS | $418.66 | ↑ +6% |
| AETNA | International | $419.87 | ↑ +7% |
| GMS | ALL PRODUCTS | $423.50 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $423.50 | ↑ +8% |
| AETNA | ALL PRODUCTS | $453.75 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $453.75 | ↑ +15% |
| The Health Plan | ALL PRODUCTS | $484.00 | ↑ +23% |
| FrontPath | TRANSPLANT | $544.50 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $544.50 | ↑ +38% |
| Managed Care Services | TRANSPLANT | $544.50 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $544.50 | ↑ +38% |
| AETNA | Qhp/Ipf | $605.00 | ↑ +54% |
| AETNA | NAP | not published by hospital | — |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| OPTUM | All Products VA | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $400.40 | $1.10 – $554.40 |
| akron general | Akron | $393.25 | $73.97 – $544.50 |
| avon hospital | Avon | $393.25 | $79.33 – $544.50 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | $393.25 | $129.52 – $544.50 |
| euclid hospital | Euclid | $393.25 | $81.27 – $544.50 |
| fairview hospital | Cleveland | $393.25 | $76.35 – $544.50 |
| lutheran hospital | Cleveland | $393.25 | $72.69 – $544.50 |
| hillcrest hospital | Mayfield Heights | $393.25 | $79.55 – $544.50 |