Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at HCA FLORIDA MERCY HOSPITAL
3663 South Miami Ave, MIAMI, FL · HCA Florida Healthcare · · NPI 1023387479
not published by hospital
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.
not published by hospital
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.
$45.30 with HUMANA vs $759.60 with AIDS Healthcare — 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 |
|---|---|---|---|
| HUMANA | MGMCRHMO | $45.30 | — |
| HUMANA | MGMCRPPO | $45.30 | — |
| Wellmed | MGMCR | $45.76 | — |
| Veterans Evaluation Services | MCR | $45.76 | — |
| Devoted Health | MCR | $45.76 | — |
| NDMS Definitive Care | MGMCR | $45.76 | — |
| Leon Health | MCR | $45.76 | — |
| CarePlus SFL | MGMCR | $45.76 | — |
| Cigna HealthSpring | MGMCR | $45.76 | — |
| United Behavioral Health | VACCN | $45.76 | — |
| United | GVT | $45.76 | — |
| Kindred Hospice | FEDERAL | $45.76 | — |
| BCBS | MCRPPO | $46.68 | — |
| United | MCR | $46.68 | — |
| BCBS | MCRHMO | $46.68 | — |
| Aetna | MCR | $47.13 | — |
| Prominence HealthFirst | MCRHMO | $48.05 | — |
| Oscar | MCR | $48.05 | — |
| Sunshine State | MCR | $48.05 | — |
| American Health Plan | MCR | $48.51 | — |
| Align | MCR | $48.96 | — |
| Florida Complete Care | MCR | $48.96 | — |
| AvMed | MCR | $49.42 | — |
| Humana | TRICR | $50.00 | — |
| Doctors Healthcare Plan | MCR | $50.34 | — |
| Sunshine State | MCD | $50.34 | — |
| Centurion | GVT | $50.34 | — |
| Gold Kidney | MCR | $51.25 | — |
| Freedom Health | MGMCR | $54.44 | — |
| Optimum | MGMCR | $54.44 | — |
| Longevity Health Plan | MCR | $54.91 | — |
| AmeriHealth Caritas | MGMCR | $54.91 | — |
| CorVel Corporation | WORKERSCOMP | $58.90 | — |
| CareWorks (Rockport) | WORKERSCOMP | $60.14 | — |
| Prime Health | WORKERSCOMP | $60.14 | — |
| Solis Health Plan | MCR | $66.35 | — |
| AvMed | HIX | $75.96 | — |
| Simply Healthcare Plans | MGMCR | $82.29 | — |
| Freedom Health | MGMCD | $101.28 | — |
| Oscar | HIX | $101.28 | — |
| AmeriHealth Caritas | HIX | $107.61 | — |
| Molina | MCR | $120.27 | — |
| Humana | HMO | $132.93 | — |
| Cigna | HMO | $132.93 | — |
| Cigna | PPO | $132.93 | — |
| AvMed | FullyInsured | $132.93 | — |
| Health Sun Health Plan | MGMCR | $134.83 | — |
| AIDS Healthcare | MGMCR | $139.26 | — |
| MMM of FL (Health Advantage Plan) | MCR | $145.59 | — |
| United PPO | OptionsPPO | $150.02 | — |
| AvMed | ASOEO | $151.92 | — |
| Sunshine State Health Plan | QHP | $164.58 | — |
| AvMed | Focus | $164.58 | — |
| AvMed | Engage | $164.58 | — |
| AvMed | Flex | $164.58 | — |
| AvMed | Empower | $164.58 | — |
| AvMed | Select | $164.58 | — |
| Molina | HIX | $170.91 | — |
| Aetna | ASA | $189.90 | — |
| Humana | PPO | $215.22 | — |
| United | GlobalBenefitPlanAppendix | $284.85 | — |
| Plotkin Health | COMM | $316.50 | — |
| AvMed | JHSSelectHMO | $316.50 | — |
| AvMed | JacksonFirstNetworkOON | $316.50 | — |
| AvMed | MDCSelectOON | $316.50 | — |
| Prime Health Sherriff | COMM | $316.50 | — |
| Medica HealthCare | MCR | $373.47 | — |
| Multiplan | COMMPPOPRIMARYNETWORK | $474.75 | — |
| Evernorth BH | COMM | $506.40 | — |
| Multiplan | COMMPPOCOMPLEMENTARYNETWORK | $538.05 | — |
| AIDS Healthcare | MGMCD | $759.60 | — |
| Aetna | QHP | not published by hospital | — |
| Aetna | HMO | not published by hospital | — |
| Aetna | PPO | not published by hospital | — |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Baptist Hospital | MIAMI | $121.55 | $22.42 – $173.17 |
| West Kendall Baptist Hospital | MIAMI | $121.55 | $21.73 – $168.30 |
| Adventhealth Daytona Beach | Daytona Beach | $146.42 | $46.35 – $81.43 |
| Adventhealth Lake Wales | Lake Wales | $297.69 | $48.79 – $108.31 |
| Adventhealth Palm Coast Parkway | Palm Coast | $110.07 | not published |
| Adventhealth Tampa | Tampa | $314.28 | $48.79 – $108.31 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $178.70 | $46.35 – $106.58 |
| Adventhealth Port Charlotte | Port Charlotte | $414.84 | not published |