Aco annual medicare visit (awv), initial g0438aco at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$676.00
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.
$1,040.00
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.
$126.22 with Blue Cross vs $1,040.00 with Cigna — 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 |
|---|---|---|---|
| Blue Cross | BlueSelect | $126.22 | ↓ -81% |
| Blue Cross | Health Options | $126.22 | ↓ -81% |
| Blue Cross | Network Blue | $152.20 | ↓ -77% |
| Blue Cross | Traditional (PPS) | $157.15 | ↓ -77% |
| Blue Cross | Perferred Patient Care | $157.15 | ↓ -77% |
| Independent Living Systems | Medicare Advantage | $172.49 | ↓ -74% |
| Avmed | Medicare Advantage | $180.90 | ↓ -73% |
| United | Medicare Advantage | $180.90 | ↓ -73% |
| Blue Cross | Medicare Advantage PPO | $180.90 | ↓ -73% |
| Blue Cross | Medicare Advantage HMO | $180.90 | ↓ -73% |
| Miami Childrens Health Plan | Medicare Advantage | $180.90 | ↓ -73% |
| Freedom Health | Medicare Advantage | $189.95 | ↓ -72% |
| Careplus | Medicare Advantage | $189.95 | ↓ -72% |
| Clear Spring Health | All Products | $195.37 | ↓ -71% |
| UNITED | MEDICARE ADVANTAGE | $206.14 | ↓ -70% |
| BLUE CROSS | Medicare Advantage HMO | $206.14 | ↓ -70% |
| BLUE CROSS | Medicare Advantage PPO | $206.14 | ↓ -70% |
| HUMANA | Medicare Advantage HMO | $206.14 | ↓ -70% |
| AETNA | QHP | $206.14 | ↓ -70% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $206.14 | ↓ -70% |
| AVMED | MEDICARE ADVANTAGE | $214.39 | ↓ -68% |
| Careplus | MEDICARE ADVANTAGE | $216.45 | ↓ -68% |
| Freedom Health | MEDICARE ADVANTAGE | $216.45 | ↓ -68% |
| AETNA | MEDICARE ADVANTAGE | $220.54 | ↓ -67% |
| Wellcare | MEDICARE ADVANTAGE | $220.54 | ↓ -67% |
| AETNA | NAP | $220.54 | ↓ -67% |
| AETNA | ALL PRODUCTS | $220.54 | ↓ -67% |
| Avmed | Exchange | $220.55 | ↓ -67% |
| Aetna | Medicare Advantage PCP | $224.32 | ↓ -67% |
| Aetna | Medicare Advantage Specialist | $227.93 | ↓ -66% |
| Avmed | Select | $229.03 | ↓ -66% |
| CIGNA | Individual Family Plan | $229.82 | ↓ -66% |
| MULTIPLAN | ALL PRODUCTS | $231.57 | ↓ -66% |
| Clear Spring Health | ALL PRODUCTS | $238.18 | ↓ -65% |
| DEVOTED HEALTH | Medicare Advantage HMO | $242.59 | ↓ -64% |
| Avmed | Broad | $245.99 | ↓ -64% |
| Multiplan | All Products | $271.35 | ↓ -60% |
| United | All Products | $286.81 | ↓ -58% |
| CIGNA | SUREFIT | $304.16 | ↓ -55% |
| AETNA | All Products New Business | $309.13 | ↓ -54% |
| CIGNA | ALL PRODUCTS | $404.61 | ↓ -40% |
| The Legacy Companies | All Products | $676.00 | ↑ +0% |
| Clarity Health | All Products | $676.00 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $780.00 | ↑ +15% |
| Aetna | All Products First Health | $936.00 | ↑ +38% |
| Cigna | Surefit Mid-Level | $1,040.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $1,040.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $1,040.00 | ↑ +54% |
| Cigna | All Products Physician | $1,040.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $1,040.00 | ↑ +54% |
| Cigna | Surefit Physician | $1,040.00 | ↑ +54% |
| Molina | Florida Kidcare | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| AmeriHealth | Managed Medicaid | not published by hospital | — |
| Sunshine Health | Managed Medicaid | not published by hospital | — |
| Independent Living Systems | Managed Medicaid | not published by hospital | — |
| Freedom Health | Managed Medicaid | not published by hospital | — |
| Miami Childrens Health Plan | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), initial g0438aco at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA ST. LUCIE HOSPITAL | STUART | not published | $148.41 – $1,989.00 |
| cleveland clinic florida weston hospital | Weston | $676.00 | $141.07 – $1,040.00 |
| indian river hospital | Vero Beach | $676.00 | $22.66 – $1,040.00 |
| Ascension St. Vincent's Southside (St. Luke's-St. Vincent's HealthCare, Inc.) | Jacksonville | $253.36 | $396.48 – $396.48 |
| Ascension St. Vincent's Riverside (St. Vincent's Medical Center, Inc.) | Jacksonville | $253.36 | $396.48 – $396.48 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $138.89 – $208.33 |
| HCA FLORIDA JFK HOSPITAL | PALM BEACH GARDENS | not published | $148.41 – $369.00 |
| HCA FLORIDA KENDALL HOSPITAL | DORAL | not published | $153.68 – $568.49 |