Exc breast duct fistula 19112 at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$990.60
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.
$1,524.00
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.
$240.58 with Blue Cross vs $14,798.46 with AVMED — 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 | $240.58 | ↓ -76% |
| Blue Cross | Health Options | $240.58 | ↓ -76% |
| Blue Cross | Network Blue | $290.11 | ↓ -71% |
| Blue Cross | Traditional (PPS) | $299.55 | ↓ -70% |
| Blue Cross | Perferred Patient Care | $299.55 | ↓ -70% |
| Freedom Health | Managed Medicaid | $348.77 | ↓ -65% |
| AmeriHealth | Managed Medicaid | $359.23 | ↓ -64% |
| Independent Living Systems | Medicare Advantage | $362.20 | ↓ -63% |
| Blue Cross | Medicare Advantage PPO | $362.31 | ↓ -63% |
| Miami Childrens Health Plan | Medicare Advantage | $362.31 | ↓ -63% |
| Avmed | Medicare Advantage | $362.31 | ↓ -63% |
| United | Medicare Advantage | $362.31 | ↓ -63% |
| Blue Cross | Medicare Advantage HMO | $362.31 | ↓ -63% |
| Miami Childrens Health Plan | Managed Medicaid | $366.21 | ↓ -63% |
| Sunshine Health | Managed Medicaid | $366.21 | ↓ -63% |
| Molina | Managed Medicaid | $366.21 | ↓ -63% |
| Molina | Florida Kidcare | $366.21 | ↓ -63% |
| Careplus | Medicare Advantage | $380.43 | ↓ -62% |
| Freedom Health | Medicare Advantage | $380.43 | ↓ -62% |
| Clear Spring Health | All Products | $391.29 | ↓ -60% |
| Independent Living Systems | Managed Medicaid | $418.52 | ↓ -58% |
| Aetna | Medicare Advantage PCP | $449.26 | ↓ -55% |
| Aetna | Medicare Advantage Specialist | $456.51 | ↓ -54% |
| Avmed | Exchange | $457.17 | ↓ -54% |
| Avmed | Select | $474.75 | ↓ -52% |
| Avmed | Broad | $509.92 | ↓ -49% |
| Multiplan | All Products | $543.47 | ↓ -45% |
| Cigna | Individual Family Plan Mid-Level | $611.52 | ↓ -38% |
| Cigna | Surefit Mid-Level | $623.22 | ↓ -37% |
| United | All Products | $665.39 | ↓ -33% |
| Cigna | All Products Mid-Level | $673.01 | ↓ -32% |
| Cigna | Individual Family Plan Physician | $719.43 | ↓ -27% |
| Cigna | Surefit Physician | $733.19 | ↓ -26% |
| Cigna | All Products Physician | $791.77 | ↓ -20% |
| Simply | Managed Medicaid | $859.57 | ↓ -13% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $859.57 | ↓ -13% |
| SUNSHINE HEALTH | Managed Medicaid | $859.57 | ↓ -13% |
| AMERIHEALTH | Managed Medicaid | $885.36 | ↓ -11% |
| MOLINA | Managed Medicaid | $902.55 | ↓ -9% |
| MOLINA | Florida KidCare | $902.55 | ↓ -9% |
| Clarity Health | All Products | $990.60 | ↑ +0% |
| The Legacy Companies | All Products | $990.60 | ↑ +0% |
| AETNA | Managed Medicaid/CHIP | $1,031.48 | ↑ +4% |
| Consociate Health | ALL PRODUCTS | $1,143.00 | ↑ +15% |
| Aetna | All Products First Health | $1,371.60 | ↑ +38% |
| BLUE CROSS | Medicare Advantage HMO | $3,843.75 | ↑ +288% |
| HUMANA | Medicare Advantage HMO | $3,843.75 | ↑ +288% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $3,843.75 | ↑ +288% |
| BLUE CROSS | Medicare Advantage PPO | $3,843.75 | ↑ +288% |
| UNITED | MEDICARE ADVANTAGE | $3,843.75 | ↑ +288% |
| AVMED | MEDICARE ADVANTAGE | $3,997.50 | ↑ +304% |
| Freedom Health | MEDICARE ADVANTAGE | $4,035.94 | ↑ +307% |
| Careplus | MEDICARE ADVANTAGE | $4,035.94 | ↑ +307% |
| Wellcare | MEDICARE ADVANTAGE | $4,088.81 | ↑ +313% |
| AETNA | MEDICARE ADVANTAGE | $4,088.81 | ↑ +313% |
| DEVOTED HEALTH | Medicare Advantage HMO | $4,497.69 | ↑ +354% |
| AVMED | EXCHANGE | $6,726.57 | ↑ +579% |
| AVMED | Select | $11,339.08 | ↑ +1045% |
| AVMED | BROAD | $14,798.46 | ↑ +1394% |
| 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
Exc breast duct fistula 19112 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA ST. LUCIE HOSPITAL | STUART | not published | $4,277.91 – $4,367.97 |
| cleveland clinic florida weston hospital | Weston | $990.60 | $158.30 – $4,497.69 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,884.37 – $6,824.22 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $3,884.37 – $8,733.28 |
| Adventhealth Tampa | Tampa | not published | $614.00 – $9,077.15 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $3,884.37 – $8,932.00 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $4,105.66 – $4,192.10 |
| Adventhealth Port Charlotte | Port Charlotte | not published | $4,088.81 – $7,466.16 |