Ercp remove duct calculi 43264 at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$1,896.05
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.
$2,917.00
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.
$274.22 with Freedom Health vs $23,045.00 with BLUE CROSS — 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 |
|---|---|---|---|
| Freedom Health | Managed Medicaid | $274.22 | ↓ -86% |
| AmeriHealth | Managed Medicaid | $282.45 | ↓ -85% |
| Sunshine Health | Managed Medicaid | $287.93 | ↓ -85% |
| Miami Childrens Health Plan | Managed Medicaid | $287.93 | ↓ -85% |
| Molina | Florida Kidcare | $287.93 | ↓ -85% |
| Molina | Managed Medicaid | $287.93 | ↓ -85% |
| Independent Living Systems | Managed Medicaid | $329.06 | ↓ -83% |
| Avmed | Medicare Advantage | $339.43 | ↓ -82% |
| Miami Childrens Health Plan | Medicare Advantage | $339.43 | ↓ -82% |
| United | Medicare Advantage | $339.43 | ↓ -82% |
| Blue Cross | Medicare Advantage PPO | $339.43 | ↓ -82% |
| Blue Cross | Medicare Advantage HMO | $339.43 | ↓ -82% |
| Freedom Health | Medicare Advantage | $356.40 | ↓ -81% |
| Careplus | Medicare Advantage | $356.40 | ↓ -81% |
| Clear Spring Health | All Products | $366.58 | ↓ -81% |
| Independent Living Systems | Medicare Advantage | $385.20 | ↓ -80% |
| Blue Cross | BlueSelect | $406.37 | ↓ -79% |
| Blue Cross | Health Options | $406.37 | ↓ -79% |
| Aetna | Medicare Advantage PCP | $420.89 | ↓ -78% |
| Aetna | Medicare Advantage Specialist | $427.68 | ↓ -77% |
| Avmed | Exchange | $489.16 | ↓ -74% |
| Blue Cross | Network Blue | $490.04 | ↓ -74% |
| Blue Cross | Perferred Patient Care | $505.97 | ↓ -73% |
| Blue Cross | Traditional (PPS) | $505.97 | ↓ -73% |
| Avmed | Select | $507.98 | ↓ -73% |
| Multiplan | All Products | $509.15 | ↓ -73% |
| Avmed | Broad | $545.61 | ↓ -71% |
| United | All Products | $711.96 | ↓ -62% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $1,729.36 | ↓ -9% |
| SUNSHINE HEALTH | Managed Medicaid | $1,729.36 | ↓ -9% |
| Simply | Managed Medicaid | $1,729.36 | ↓ -9% |
| AMERIHEALTH | Managed Medicaid | $1,781.24 | ↓ -6% |
| MOLINA | Managed Medicaid | $1,815.83 | ↓ -4% |
| MOLINA | Florida KidCare | $1,815.83 | ↓ -4% |
| Clarity Health | All Products | $1,896.05 | ↑ +0% |
| The Legacy Companies | All Products | $1,896.05 | ↑ +0% |
| AETNA | Managed Medicaid/CHIP | $2,075.23 | ↑ +9% |
| Consociate Health | ALL PRODUCTS | $2,187.75 | ↑ +15% |
| Aetna | All Products First Health | $2,625.30 | ↑ +38% |
| Cigna | All Products Physician | $2,917.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $2,917.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $2,917.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $2,917.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $2,917.00 | ↑ +54% |
| Cigna | Surefit Physician | $2,917.00 | ↑ +54% |
| BLUE CROSS | Medicare Advantage PPO | $3,818.91 | ↑ +101% |
| HUMANA | Medicare Advantage HMO | $3,818.91 | ↑ +101% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $3,818.91 | ↑ +101% |
| BLUE CROSS | Medicare Advantage HMO | $3,818.91 | ↑ +101% |
| UNITED | MEDICARE ADVANTAGE | $3,818.91 | ↑ +101% |
| AVMED | MEDICARE ADVANTAGE | $3,971.67 | ↑ +109% |
| Careplus | MEDICARE ADVANTAGE | $4,009.86 | ↑ +111% |
| Freedom Health | MEDICARE ADVANTAGE | $4,009.86 | ↑ +111% |
| AETNA | MEDICARE ADVANTAGE | $4,026.19 | ↑ +112% |
| Wellcare | MEDICARE ADVANTAGE | $4,026.19 | ↑ +112% |
| DEVOTED HEALTH | Medicare Advantage HMO | $4,428.81 | ↑ +134% |
| AVMED | EXCHANGE | $6,683.09 | ↑ +252% |
| AVMED | Select | $11,265.79 | ↑ +494% |
| BLUE CROSS | MBN | $14,520.00 | ↑ +666% |
| AVMED | BROAD | $14,702.81 | ↑ +675% |
| BLUE CROSS | NWBI | $23,045.00 | ↑ +1115% |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
Visitor-reported prices
Comments
Ercp remove duct calculi 43264 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA ST. LUCIE HOSPITAL | STUART | not published | $1,821.31 – $1,859.65 |
| cleveland clinic florida weston hospital | Weston | $14,219.40 | $274.22 – $18,594.60 |
| indian river hospital | Vero Beach | $1,896.05 | $274.22 – $4,428.81 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,824.88 – $6,719.71 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $3,824.88 – $8,599.54 |
| Adventhealth Tampa | Tampa | not published | $537.00 – $8,938.14 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $3,824.88 – $8,795.21 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $1,747.98 – $1,784.78 |