healthcosts.net
Vaccine pneumococcal conjugate 13 valent (pcv13) im at lodi hospital
225 Elyria Street, Lodi, OH · Cleveland Clinic · · NPI 1801807870
$1,089.31
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.
$1,675.86
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.
$22.44 with OPTUM vs $1,624.89 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 | $22.44 | ↓ -98% |
| Buckeye | Managed Medicaid | $23.62 | ↓ -98% |
| CARESOURCE | Managed Medicaid | $23.62 | ↓ -98% |
| ANTHEM | Managed Medicaid | $24.80 | ↓ -98% |
| UNITED | Managed Medicaid | $24.80 | ↓ -98% |
| MOLINA | Managed Medicaid | $24.80 | ↓ -98% |
| AMERIHEALTH | Managed Medicaid | $25.98 | ↓ -98% |
| OSCAR | ALL PRODUCTS | $459.52 | ↓ -58% |
| HUMANA | Medicare Advantage HMO | $487.47 | ↓ -55% |
| MMO | Medicare Advantage HMO & PPO | $487.47 | ↓ -55% |
| UNITED | MEDICARE ADVANTAGE | $487.47 | ↓ -55% |
| PHPHI | ALL PRODUCTS | $519.96 | ↓ -52% |
| AETNA | MEDICARE ADVANTAGE | $519.96 | ↓ -52% |
| PHP | ALL PRODUCTS | $519.96 | ↓ -52% |
| Summacare | MEDICARE ADVANTAGE | $519.96 | ↓ -52% |
| The Health Plan | Secure Care | $649.96 | ↓ -40% |
| Amish Community Aid Plan | ALL PRODUCTS | $731.20 | ↓ -33% |
| Aultcare | PPO/HMO | $781.57 | ↓ -28% |
| OHCP | ALL PRODUCTS | $789.70 | ↓ -28% |
| OMAS | ALL PRODUCTS | $812.45 | ↓ -25% |
| MMO | TRADITIONAL | $846.57 | ↓ -22% |
| Ohio Healthy | TRANSPLANT | $877.44 | ↓ -19% |
| ANTHEM | HPN | $887.19 | ↓ -19% |
| OPTUM | All Products Transplant | $919.69 | ↓ -16% |
| AETNA | Acop | $922.94 | ↓ -15% |
| Summacare | Preferred | $935.94 | ↓ -14% |
| Summacare | PREMIER | $974.93 | ↓ -11% |
| UPMC | ALL PRODUCTS | $974.93 | ↓ -11% |
| CIGNA | ALL PRODUCTS | $1,031.81 | ↓ -5% |
| ANTHEM | PPO/HMO | $1,043.83 | ↓ -4% |
| ANTHEM | TRADITIONAL | $1,076.33 | ↓ -1% |
| CC EHP | ALL PRODUCTS | $1,091.93 | ↑ +0% |
| AETNA | Asa_Whirlpool_Peia | $1,116.30 | ↑ +2% |
| UNITED | ALL PRODUCTS | $1,124.42 | ↑ +3% |
| AETNA | International | $1,127.67 | ↑ +4% |
| GMS | ALL PRODUCTS | $1,137.42 | ↑ +4% |
| Medical Benefit Corp | Transplant SMCP | $1,137.42 | ↑ +4% |
| AETNA | ALL PRODUCTS | $1,218.67 | ↑ +12% |
| Consociate Health | ALL PRODUCTS | $1,218.67 | ↑ +12% |
| The Health Plan | ALL PRODUCTS | $1,299.91 | ↑ +19% |
| MULTIPLAN | ALL PRODUCTS | $1,462.40 | ↑ +34% |
| Tertiary Care Network | TRANSPLANT | $1,462.40 | ↑ +34% |
| FrontPath | TRANSPLANT | $1,462.40 | ↑ +34% |
| Managed Care Services | TRANSPLANT | $1,462.40 | ↑ +34% |
| AETNA | Qhp/Ipf | $1,624.89 | ↑ +49% |
| CommuniCare | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| CIGNA | MEDICARE ADVANTAGE | not published by hospital | — |
| OPTUM | Medicare Advantage Transplant | not published by hospital | — |
| ANTHEM | MEDICARE ADVANTAGE | not published by hospital | — |
| OPTUM | All Products VA | not published by hospital | — |
Visitor-reported prices
Comments
Vaccine pneumococcal conjugate 13 valent (pcv13) im at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $529.10 | $1.10 – $732.60 |
| akron general | Akron | $1,089.31 | $1.10 – $732.60 |
| avon hospital | Avon | $1,089.31 | $14.34 – $732.60 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | $1,089.31 | $23.42 – $1,462.40 |
| euclid hospital | Euclid | $1,089.31 | $14.70 – $732.60 |
| fairview hospital | Cleveland | $1,089.31 | $13.80 – $732.60 |
| lutheran hospital | Cleveland | $1,089.31 | $13.14 – $732.60 |
| hillcrest hospital | Mayfield Heights | $1,089.31 | $14.38 – $732.60 |