Ex palate/uvula lesion without closure 42104 at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$12,121.20
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.
$18,648.00
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.
$109.89 with Blue Cross vs $16,783.20 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 |
|---|---|---|---|
| Blue Cross | BlueSelect | $109.89 | ↓ -99% |
| Blue Cross | Health Options | $109.89 | ↓ -99% |
| Blue Cross | Medicare Advantage HMO | $129.95 | ↓ -99% |
| United | Medicare Advantage | $129.95 | ↓ -99% |
| Avmed | Medicare Advantage | $129.95 | ↓ -99% |
| Blue Cross | Medicare Advantage PPO | $129.95 | ↓ -99% |
| Miami Childrens Health Plan | Medicare Advantage | $129.95 | ↓ -99% |
| Blue Cross | Network Blue | $132.52 | ↓ -99% |
| Freedom Health | Medicare Advantage | $136.45 | ↓ -99% |
| Careplus | Medicare Advantage | $136.45 | ↓ -99% |
| Blue Cross | Traditional (PPS) | $136.83 | ↓ -99% |
| Blue Cross | Perferred Patient Care | $136.83 | ↓ -99% |
| Clear Spring Health | All Products | $140.35 | ↓ -99% |
| Independent Living Systems | Medicare Advantage | $144.86 | ↓ -99% |
| MULTIPLAN | ALL PRODUCTS | $159.40 | ↓ -99% |
| Aetna | Medicare Advantage PCP | $161.14 | ↓ -99% |
| Aetna | Medicare Advantage Specialist | $163.74 | ↓ -99% |
| Clear Spring Health | ALL PRODUCTS | $163.95 | ↓ -99% |
| Freedom Health | Managed Medicaid | $165.96 | ↓ -99% |
| AmeriHealth | Managed Medicaid | $170.94 | ↓ -99% |
| Miami Childrens Health Plan | Managed Medicaid | $174.26 | ↓ -99% |
| Molina | Managed Medicaid | $174.26 | ↓ -99% |
| Molina | Florida Kidcare | $174.26 | ↓ -99% |
| Sunshine Health | Managed Medicaid | $174.26 | ↓ -99% |
| Avmed | Exchange | $184.03 | ↓ -98% |
| Avmed | Select | $191.11 | ↓ -98% |
| Multiplan | All Products | $194.93 | ↓ -98% |
| Independent Living Systems | Managed Medicaid | $199.15 | ↓ -98% |
| Avmed | Broad | $205.26 | ↓ -98% |
| Cigna | Individual Family Plan Mid-Level | $267.79 | ↓ -98% |
| United | All Products | $267.85 | ↓ -98% |
| Cigna | Surefit Mid-Level | $272.90 | ↓ -98% |
| Cigna | All Products Mid-Level | $294.78 | ↓ -98% |
| Cigna | Individual Family Plan Physician | $315.07 | ↓ -97% |
| Cigna | Surefit Physician | $321.08 | ↓ -97% |
| Cigna | All Products Physician | $346.80 | ↓ -97% |
| The Legacy Companies | All Products | $439.40 | ↓ -96% |
| Clarity Health | All Products | $439.40 | ↓ -96% |
| Consociate Health | ALL PRODUCTS | $507.00 | ↓ -96% |
| Aetna | All Products First Health | $608.40 | ↓ -95% |
| SUNSHINE HEALTH | Managed Medicaid | $1,720.08 | ↓ -86% |
| Simply | Managed Medicaid | $1,720.08 | ↓ -86% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $1,720.08 | ↓ -86% |
| AMERIHEALTH | Managed Medicaid | $1,771.68 | ↓ -85% |
| MOLINA | Florida KidCare | $1,806.08 | ↓ -85% |
| MOLINA | Managed Medicaid | $1,806.08 | ↓ -85% |
| BLUE CROSS | MBN | $1,914.00 | ↓ -84% |
| AETNA | Managed Medicaid/CHIP | $2,064.10 | ↓ -83% |
| BLUE CROSS | HMO | $2,552.00 | ↓ -79% |
| BLUE CROSS | Medicare Advantage HMO | $3,255.33 | ↓ -73% |
| UNITED | MEDICARE ADVANTAGE | $3,255.33 | ↓ -73% |
| HUMANA | Medicare Advantage HMO | $3,255.33 | ↓ -73% |
| BLUE CROSS | Medicare Advantage PPO | $3,255.33 | ↓ -73% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $3,255.33 | ↓ -73% |
| AVMED | MEDICARE ADVANTAGE | $3,385.54 | ↓ -72% |
| Freedom Health | MEDICARE ADVANTAGE | $3,418.10 | ↓ -72% |
| Careplus | MEDICARE ADVANTAGE | $3,418.10 | ↓ -72% |
| AETNA | MEDICARE ADVANTAGE | $3,462.26 | ↓ -71% |
| Wellcare | MEDICARE ADVANTAGE | $3,462.26 | ↓ -71% |
| BLUE CROSS | PPO | $3,782.00 | ↓ -69% |
| AETNA | QHP | $3,806.00 | ↓ -69% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,808.49 | ↓ -69% |
| AETNA | All Products New Business | $4,025.00 | ↓ -67% |
| AETNA | ALL PRODUCTS | $4,523.00 | ↓ -63% |
| BLUE CROSS | NWB | $4,598.00 | ↓ -62% |
| BLUE CROSS | NWBI | $4,598.00 | ↓ -62% |
| CIGNA | Individual Family Plan | $5,277.38 | ↓ -56% |
| AVMED | EXCHANGE | $5,696.83 | ↓ -53% |
| CIGNA | SUREFIT | $7,627.03 | ↓ -37% |
| BLUE CROSS | BSL | $7,992.00 | ↓ -34% |
| BMI | ALL PRODUCTS | $9,324.00 | ↓ -23% |
| AVMED | Select | $9,603.22 | ↓ -21% |
| BLUE CROSS | PHS | $9,694.00 | ↓ -20% |
| CIGNA | ALL PRODUCTS | $9,846.14 | ↓ -19% |
| The Legacy Companies | ALL PRODUCTS | $12,121.20 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $12,121.20 | ↑ +0% |
| AVMED | BROAD | $12,533.02 | ↑ +3% |
| AETNA | All Products First Health | $16,783.20 | ↑ +38% |
| AETNA | NAP | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
Visitor-reported prices
Comments
Ex palate/uvula lesion without closure 42104 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA ST. LUCIE HOSPITAL | STUART | not published | $521.24 – $532.21 |
| cleveland clinic florida weston hospital | Weston | $12,121.20 | $90.22 – $15,850.80 |
| indian river hospital | Vero Beach | $12,121.20 | $90.22 – $14,918.40 |
| Baptist Hospital | MIAMI | $8,548.80 | $173.17 – $11,836.80 |
| Boca Raton Regional Hospital | BOCA RATON | $8,307.00 | $476.00 – $6,090.53 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,289.15 – $5,778.52 |
| Adventhealth Tampa | Tampa | not published | $3,462.26 – $7,686.23 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $500.24 – $510.77 |