Ustekinumab 45 mg/0.5 ml subcutaneous solution at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$68,214.47
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.
$104,945.34
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.
$159.91 with OPTUM vs $104,945.25 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 | Medicare Advantage Transplant | $159.91 | ↓ -100% |
| OPTUM | All Products VA | $159.91 | ↓ -100% |
| OPTUM | Managed Medicaid Transplant | $10,159.35 | ↓ -85% |
| Buckeye | Managed Medicaid | $10,694.05 | ↓ -84% |
| CARESOURCE | Managed Medicaid | $10,694.05 | ↓ -84% |
| MOLINA | Managed Medicaid | $11,228.75 | ↓ -84% |
| ANTHEM | Managed Medicaid | $11,228.75 | ↓ -84% |
| UNITED | Managed Medicaid | $11,228.75 | ↓ -84% |
| AMERIHEALTH | Managed Medicaid | $11,763.46 | ↓ -83% |
| OSCAR | ALL PRODUCTS | $29,678.52 | ↓ -56% |
| UNITED | MEDICARE ADVANTAGE | $31,483.58 | ↓ -54% |
| HUMANA | Medicare Advantage HMO | $31,483.58 | ↓ -54% |
| MMO | Medicare Advantage HMO & PPO | $31,483.58 | ↓ -54% |
| PHPHI | ALL PRODUCTS | $33,582.48 | ↓ -51% |
| PHP | ALL PRODUCTS | $33,582.48 | ↓ -51% |
| Summacare | MEDICARE ADVANTAGE | $33,582.48 | ↓ -51% |
| AETNA | MEDICARE ADVANTAGE | $33,582.48 | ↓ -51% |
| The Health Plan | Secure Care | $41,978.10 | ↓ -38% |
| Amish Community Aid Plan | ALL PRODUCTS | $47,225.36 | ↓ -31% |
| Aultcare | PPO/HMO | $50,478.67 | ↓ -26% |
| OHCP | ALL PRODUCTS | $51,003.39 | ↓ -25% |
| OMAS | ALL PRODUCTS | $52,472.63 | ↓ -23% |
| MMO | TRADITIONAL | $54,676.48 | ↓ -20% |
| Ohio Healthy | TRANSPLANT | $56,670.44 | ↓ -17% |
| ANTHEM | HPN | $57,300.11 | ↓ -16% |
| OPTUM | All Products Transplant | $59,399.01 | ↓ -13% |
| AETNA | Acop | $59,608.90 | ↓ -13% |
| Summacare | Preferred | $60,448.46 | ↓ -11% |
| Summacare | PREMIER | $62,967.15 | ↓ -8% |
| UPMC | ALL PRODUCTS | $62,967.15 | ↓ -8% |
| CIGNA | ALL PRODUCTS | $66,640.23 | ↓ -2% |
| ANTHEM | PPO/HMO | $67,416.83 | ↓ -1% |
| ANTHEM | TRADITIONAL | $69,515.73 | ↑ +2% |
| CC EHP | ALL PRODUCTS | $70,523.21 | ↑ +3% |
| AETNA | Asa_Whirlpool_Peia | $72,097.39 | ↑ +6% |
| UNITED | ALL PRODUCTS | $72,622.11 | ↑ +6% |
| AETNA | International | $72,832.00 | ↑ +7% |
| GMS | ALL PRODUCTS | $73,461.68 | ↑ +8% |
| Medical Benefit Corp | Transplant SMCP | $73,461.68 | ↑ +8% |
| AETNA | ALL PRODUCTS | $78,708.94 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $78,708.94 | ↑ +15% |
| The Health Plan | ALL PRODUCTS | $83,956.20 | ↑ +23% |
| Managed Care Services | TRANSPLANT | $94,450.73 | ↑ +38% |
| FrontPath | TRANSPLANT | $94,450.73 | ↑ +38% |
| Tertiary Care Network | TRANSPLANT | $94,450.73 | ↑ +38% |
| MULTIPLAN | ALL PRODUCTS | $94,450.73 | ↑ +38% |
| AETNA | Qhp/Ipf | $104,945.25 | ↑ +54% |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| ANTHEM | MEDICARE ADVANTAGE | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Ustekinumab 45 mg/0.5 ml subcutaneous solution at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| akron general | Akron | $68,214.47 | $1.10 – $94,450.73 |
| avon hospital | Avon | $68,214.47 | $159.91 – $94,450.73 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | $68,214.47 | $10,602.44 – $94,450.73 |
| euclid hospital | Euclid | $68,214.47 | $152.57 – $94,450.73 |
| fairview hospital | Cleveland | $68,214.47 | $2.17 – $94,450.73 |
| lutheran hospital | Cleveland | $68,214.47 | $159.91 – $94,450.73 |
| hillcrest hospital | Mayfield Heights | $68,214.47 | $2.17 – $94,450.73 |
| marymount hospital | Garfield Heights | $68,214.47 | $152.57 – $94,450.73 |