Removal of adenoids <12yrs 42835 at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$618.80
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.
$952.00
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.
$151.88 with Blue Cross vs $12,533.02 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 | Health Options | $151.88 | ↓ -75% |
| Blue Cross | BlueSelect | $151.88 | ↓ -75% |
| Freedom Health | Managed Medicaid | $155.49 | ↓ -75% |
| AmeriHealth | Managed Medicaid | $160.15 | ↓ -74% |
| Molina | Managed Medicaid | $163.26 | ↓ -74% |
| Sunshine Health | Managed Medicaid | $163.26 | ↓ -74% |
| Miami Childrens Health Plan | Managed Medicaid | $163.26 | ↓ -74% |
| Molina | Florida Kidcare | $163.26 | ↓ -74% |
| Blue Cross | Network Blue | $183.14 | ↓ -70% |
| Independent Living Systems | Managed Medicaid | $186.59 | ↓ -70% |
| Blue Cross | Perferred Patient Care | $189.10 | ↓ -69% |
| Blue Cross | Traditional (PPS) | $189.10 | ↓ -69% |
| Avmed | Medicare Advantage | $195.01 | ↓ -68% |
| United | Medicare Advantage | $195.01 | ↓ -68% |
| Blue Cross | Medicare Advantage HMO | $195.01 | ↓ -68% |
| Blue Cross | Medicare Advantage PPO | $195.01 | ↓ -68% |
| Miami Childrens Health Plan | Medicare Advantage | $195.01 | ↓ -68% |
| Freedom Health | Medicare Advantage | $204.76 | ↓ -67% |
| Careplus | Medicare Advantage | $204.76 | ↓ -67% |
| Clear Spring Health | All Products | $210.61 | ↓ -66% |
| Independent Living Systems | Medicare Advantage | $215.76 | ↓ -65% |
| Aetna | Medicare Advantage PCP | $241.81 | ↓ -61% |
| Aetna | Medicare Advantage Specialist | $245.71 | ↓ -60% |
| Avmed | Exchange | $273.61 | ↓ -56% |
| Avmed | Select | $284.13 | ↓ -54% |
| Multiplan | All Products | $292.52 | ↓ -53% |
| Avmed | Broad | $305.18 | ↓ -51% |
| United | All Products | $398.23 | ↓ -36% |
| The Legacy Companies | All Products | $618.80 | ↑ +0% |
| Clarity Health | All Products | $618.80 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $714.00 | ↑ +15% |
| Aetna | All Products First Health | $856.80 | ↑ +38% |
| Cigna | Individual Family Plan Mid-Level | $952.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $952.00 | ↑ +54% |
| Cigna | All Products Physician | $952.00 | ↑ +54% |
| Cigna | Surefit Physician | $952.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $952.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $952.00 | ↑ +54% |
| Simply | Managed Medicaid | $1,360.17 | ↑ +120% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $1,360.17 | ↑ +120% |
| SUNSHINE HEALTH | Managed Medicaid | $1,360.17 | ↑ +120% |
| AMERIHEALTH | Managed Medicaid | $1,400.98 | ↑ +126% |
| MOLINA | Managed Medicaid | $1,428.18 | ↑ +131% |
| MOLINA | Florida KidCare | $1,428.18 | ↑ +131% |
| AETNA | Managed Medicaid/CHIP | $1,632.20 | ↑ +164% |
| HUMANA | Medicare Advantage HMO | $3,255.33 | ↑ +426% |
| BLUE CROSS | Medicare Advantage PPO | $3,255.33 | ↑ +426% |
| UNITED | MEDICARE ADVANTAGE | $3,255.33 | ↑ +426% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $3,255.33 | ↑ +426% |
| BLUE CROSS | Medicare Advantage HMO | $3,255.33 | ↑ +426% |
| AVMED | MEDICARE ADVANTAGE | $3,385.54 | ↑ +447% |
| Freedom Health | MEDICARE ADVANTAGE | $3,418.10 | ↑ +452% |
| Careplus | MEDICARE ADVANTAGE | $3,418.10 | ↑ +452% |
| Wellcare | MEDICARE ADVANTAGE | $3,462.26 | ↑ +460% |
| AETNA | MEDICARE ADVANTAGE | $3,462.26 | ↑ +460% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,808.49 | ↑ +515% |
| AVMED | EXCHANGE | $5,696.83 | ↑ +821% |
| AVMED | Select | $9,603.22 | ↑ +1452% |
| AVMED | BROAD | $12,533.02 | ↑ +1925% |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
Visitor-reported prices
Comments
Removal of adenoids <12yrs 42835 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,289.15 – $5,778.52 |
| Adventhealth Tampa | Tampa | not published | $758.00 – $7,686.23 |
| Adventhealth Port Charlotte | Port Charlotte | not published | $3,462.26 – $6,322.09 |
| cleveland clinic florida weston hospital | Weston | not published | $1,292.16 – $3,808.49 |
| indian river hospital | Vero Beach | not published | $1,292.16 – $3,808.49 |
| Adventhealth Waterman | Tavares | not published | $3,462.26 – $6,986.16 |
| AdventHealth Orlando | Orlando | not published | $3,462.26 – $9,175.00 |
| Adventhealth Wesley Chapel | Wesley Chapel | not published | $3,462.26 – $7,686.23 |