Ot evaluation high complexity patient/family at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$547.95
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.
$843.00
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.
$128.99 with BLUE CROSS vs $758.70 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 | Medicare Advantage PPO | $128.99 | ↓ -76% |
| HUMANA | Medicare Advantage HMO | $128.99 | ↓ -76% |
| BLUE CROSS | Medicare Advantage HMO | $128.99 | ↓ -76% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $128.99 | ↓ -76% |
| UNITED | MEDICARE ADVANTAGE | $128.99 | ↓ -76% |
| Wellcare | MEDICARE ADVANTAGE | $129.28 | ↓ -76% |
| AETNA | MEDICARE ADVANTAGE | $129.28 | ↓ -76% |
| CIGNA | Individual Family Plan | $130.98 | ↓ -76% |
| AVMED | MEDICARE ADVANTAGE | $134.15 | ↓ -76% |
| Careplus | MEDICARE ADVANTAGE | $135.44 | ↓ -75% |
| Freedom Health | MEDICARE ADVANTAGE | $135.44 | ↓ -75% |
| MULTIPLAN | ALL PRODUCTS | $135.74 | ↓ -75% |
| Clear Spring Health | ALL PRODUCTS | $139.62 | ↓ -75% |
| DEVOTED HEALTH | Medicare Advantage HMO | $142.21 | ↓ -74% |
| CIGNA | SUREFIT | $175.35 | ↓ -68% |
| AETNA | QHP | $178.00 | ↓ -68% |
| AETNA | All Products New Business | $214.00 | ↓ -61% |
| UNITED | NHP | $219.00 | ↓ -60% |
| AETNA | ALL PRODUCTS | $241.00 | ↓ -56% |
| CIGNA | ALL PRODUCTS | $247.80 | ↓ -55% |
| AVMED | Select | $252.90 | ↓ -54% |
| AVMED | EXCHANGE | $252.90 | ↓ -54% |
| Simply | Managed Medicaid | $260.98 | ↓ -52% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $260.98 | ↓ -52% |
| Freedom Health | Managed Medicaid | $260.98 | ↓ -52% |
| SUNSHINE HEALTH | Managed Medicaid | $260.98 | ↓ -52% |
| UNITED | ALL PRODUCTS | $262.00 | ↓ -52% |
| AMERIHEALTH | Managed Medicaid | $268.81 | ↓ -51% |
| MOLINA | Managed Medicaid | $274.03 | ↓ -50% |
| Miami Childrens Health Plan | Managed Medicaid | $274.03 | ↓ -50% |
| MOLINA | Florida KidCare | $274.03 | ↓ -50% |
| UNITED | International | $287.00 | ↓ -48% |
| BLUE CROSS | MBN | $313.00 | ↓ -43% |
| AETNA | Managed Medicaid/CHIP | $313.18 | ↓ -43% |
| Independent Living Systems | Managed Medicaid | $313.18 | ↓ -43% |
| BLUE CROSS | BSL | $319.00 | ↓ -42% |
| AVMED | BROAD | $320.34 | ↓ -42% |
| BLUE CROSS | HMO | $394.00 | ↓ -28% |
| BMI | ALL PRODUCTS | $421.50 | ↓ -23% |
| BLUE CROSS | NWBI | $458.00 | ↓ -16% |
| BLUE CROSS | NWB | $458.00 | ↓ -16% |
| BLUE CROSS | PPO | $538.00 | ↓ -2% |
| The Legacy Companies | ALL PRODUCTS | $547.95 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $547.95 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $632.25 | ↑ +15% |
| BLUE CROSS | PHS | $723.00 | ↑ +32% |
| AETNA | All Products First Health | $758.70 | ↑ +38% |
| AETNA | NAP | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA ST. LUCIE HOSPITAL | STUART | $1,792.00 | $89.27 – $129.44 |
| Adventhealth Daytona Beach | Daytona Beach | $369.90 | $93.63 – $164.50 |
| Adventhealth Lake Wales | Lake Wales | $758.39 | $98.56 – $218.80 |
| Adventhealth Palm Coast Parkway | Palm Coast | $474.36 | not published |
| Adventhealth Tampa | Tampa | $846.31 | $98.56 – $218.80 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $562.30 | $93.63 – $215.30 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $1,109.00 | $69.39 – $104.08 |
| Adventhealth Port Charlotte | Port Charlotte | $906.00 | not published |