Biopsy of salivary glnd;incisional 42405 at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$868.40
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.
?
What you pay up front if you don't use insurance.
$1,336.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$178.19 with Blue Cross vs $5,724.48 with AVMED — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | Health Options | $178.19 | ↓ -79% |
| Blue Cross | BlueSelect | $178.19 | ↓ -79% |
| Blue Cross | Network Blue | $214.87 | ↓ -75% |
| Miami Childrens Health Plan | Medicare Advantage | $216.58 | ↓ -75% |
| United | Medicare Advantage | $216.58 | ↓ -75% |
| Blue Cross | Medicare Advantage PPO | $216.58 | ↓ -75% |
| Blue Cross | Medicare Advantage HMO | $216.58 | ↓ -75% |
| Avmed | Medicare Advantage | $216.58 | ↓ -75% |
| Blue Cross | Perferred Patient Care | $221.86 | ↓ -74% |
| Blue Cross | Traditional (PPS) | $221.86 | ↓ -74% |
| Freedom Health | Medicare Advantage | $227.41 | ↓ -74% |
| Careplus | Medicare Advantage | $227.41 | ↓ -74% |
| Clear Spring Health | All Products | $233.91 | ↓ -73% |
| Freedom Health | Managed Medicaid | $234.39 | ↓ -73% |
| AmeriHealth | Managed Medicaid | $241.42 | ↓ -72% |
| Sunshine Health | Managed Medicaid | $246.11 | ↓ -72% |
| Miami Childrens Health Plan | Managed Medicaid | $246.11 | ↓ -72% |
| Molina | Florida Kidcare | $246.11 | ↓ -72% |
| Molina | Managed Medicaid | $246.11 | ↓ -72% |
| Independent Living Systems | Medicare Advantage | $246.61 | ↓ -72% |
| Aetna | Medicare Advantage PCP | $268.56 | ↓ -69% |
| Aetna | Medicare Advantage Specialist | $272.89 | ↓ -69% |
| Independent Living Systems | Managed Medicaid | $281.27 | ↓ -68% |
| Avmed | Exchange | $312.26 | ↓ -64% |
| Avmed | Select | $324.27 | ↓ -63% |
| Multiplan | All Products | $324.87 | ↓ -63% |
| Avmed | Broad | $348.29 | ↓ -60% |
| Cigna | Individual Family Plan Mid-Level | $370.64 | ↓ -57% |
| Cigna | Surefit Mid-Level | $377.72 | ↓ -57% |
| Cigna | All Products Mid-Level | $407.99 | ↓ -53% |
| Cigna | Individual Family Plan Physician | $436.08 | ↓ -50% |
| Cigna | Surefit Physician | $444.40 | ↓ -49% |
| United | All Products | $454.48 | ↓ -48% |
| Cigna | All Products Physician | $479.99 | ↓ -45% |
| The Legacy Companies | All Products | $868.40 | ↑ +0% |
| Clarity Health | All Products | $868.40 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $1,002.00 | ↑ +15% |
| Aetna | All Products First Health | $1,202.40 | ↑ +38% |
| Simply | Managed Medicaid | $1,273.61 | ↑ +47% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $1,273.61 | ↑ +47% |
| SUNSHINE HEALTH | Managed Medicaid | $1,273.61 | ↑ +47% |
| AMERIHEALTH | Managed Medicaid | $1,311.82 | ↑ +51% |
| MOLINA | Managed Medicaid | $1,337.29 | ↑ +54% |
| MOLINA | Florida KidCare | $1,337.29 | ↑ +54% |
| HUMANA | Medicare Advantage HMO | $1,486.88 | ↑ +71% |
| BLUE CROSS | Medicare Advantage HMO | $1,486.88 | ↑ +71% |
| UNITED | MEDICARE ADVANTAGE | $1,486.88 | ↑ +71% |
| BLUE CROSS | Medicare Advantage PPO | $1,486.88 | ↑ +71% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $1,486.88 | ↑ +71% |
| AETNA | Managed Medicaid/CHIP | $1,528.33 | ↑ +76% |
| AVMED | MEDICARE ADVANTAGE | $1,546.35 | ↑ +78% |
| Careplus | MEDICARE ADVANTAGE | $1,561.22 | ↑ +80% |
| Freedom Health | MEDICARE ADVANTAGE | $1,561.22 | ↑ +80% |
| Wellcare | MEDICARE ADVANTAGE | $1,620.29 | ↑ +87% |
| AETNA | MEDICARE ADVANTAGE | $1,620.29 | ↑ +87% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,782.31 | ↑ +105% |
| AVMED | EXCHANGE | $2,602.04 | ↑ +200% |
| AVMED | Select | $4,386.29 | ↑ +405% |
| AVMED | BROAD | $5,724.48 | ↑ +559% |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary glnd;incisional 42405 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA ST. LUCIE HOSPITAL | STUART | not published | $8.00 – $8.17 |
| cleveland clinic florida weston hospital | Weston | $5,536.70 | $137.01 – $7,240.30 |
| indian river hospital | Vero Beach | $5,536.70 | $137.01 – $6,814.40 |
| Baptist Hospital | MIAMI | $4,403.10 | $173.17 – $6,096.60 |
| Boca Raton Regional Hospital | BOCA RATON | $4,278.95 | $476.00 – $4,298.70 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $1,539.27 – $2,704.26 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $1,539.27 – $3,460.77 |
| Adventhealth Tampa | Tampa | not published | $537.00 – $3,597.04 |