healthcosts.net
Tonsillectomy (child under 12) at martin north hospital
200 SE Hospital Avenue, Stuart, FL · Cleveland Clinic · · NPI 1194790055
$912.60
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.
$1,404.00
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.
$192.51 with Blue Cross vs $22,861.38 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 | $192.51 | ↓ -79% |
| Blue Cross | BlueSelect | $192.51 | ↓ -79% |
| Freedom Health | Managed Medicaid | $210.13 | ↓ -77% |
| AmeriHealth | Managed Medicaid | $216.43 | ↓ -76% |
| Miami Childrens Health Plan | Managed Medicaid | $220.64 | ↓ -76% |
| Molina | Managed Medicaid | $220.64 | ↓ -76% |
| Molina | Florida Kidcare | $220.64 | ↓ -76% |
| Sunshine Health | Managed Medicaid | $220.64 | ↓ -76% |
| Blue Cross | Network Blue | $232.14 | ↓ -75% |
| Blue Cross | Traditional (PPS) | $239.69 | ↓ -74% |
| Blue Cross | Perferred Patient Care | $239.69 | ↓ -74% |
| Independent Living Systems | Managed Medicaid | $252.16 | ↓ -72% |
| United | Medicare Advantage | $259.21 | ↓ -72% |
| Avmed | Medicare Advantage | $259.21 | ↓ -72% |
| Blue Cross | Medicare Advantage PPO | $259.21 | ↓ -72% |
| Miami Childrens Health Plan | Medicare Advantage | $259.21 | ↓ -72% |
| Blue Cross | Medicare Advantage HMO | $259.21 | ↓ -72% |
| Freedom Health | Medicare Advantage | $272.17 | ↓ -70% |
| Careplus | Medicare Advantage | $272.17 | ↓ -70% |
| Clear Spring Health | All Products | $279.95 | ↓ -69% |
| Independent Living Systems | Medicare Advantage | $292.57 | ↓ -68% |
| Aetna | Medicare Advantage PCP | $321.42 | ↓ -65% |
| Aetna | Medicare Advantage Specialist | $326.60 | ↓ -64% |
| Avmed | Exchange | $369.85 | ↓ -59% |
| Avmed | Select | $384.08 | ↓ -58% |
| Multiplan | All Products | $388.82 | ↓ -57% |
| Avmed | Broad | $412.53 | ↓ -55% |
| United | All Products | $538.30 | ↓ -41% |
| Clarity Health | All Products | $912.60 | ↑ +0% |
| The Legacy Companies | All Products | $912.60 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $1,053.00 | ↑ +15% |
| Aetna | All Products First Health | $1,263.60 | ↑ +38% |
| Simply | Managed Medicaid | $1,360.17 | ↑ +49% |
| AETNA | Managed Medicaid/CHIP Behavioral Health | $1,360.17 | ↑ +49% |
| SUNSHINE HEALTH | Managed Medicaid | $1,360.17 | ↑ +49% |
| AMERIHEALTH | Managed Medicaid | $1,400.98 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $1,404.00 | ↑ +54% |
| Cigna | Surefit Physician | $1,404.00 | ↑ +54% |
| Cigna | All Products Physician | $1,404.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $1,404.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $1,404.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $1,404.00 | ↑ +54% |
| MOLINA | Florida KidCare | $1,428.18 | ↑ +56% |
| MOLINA | Managed Medicaid | $1,428.18 | ↑ +56% |
| AETNA | Managed Medicaid/CHIP | $1,632.20 | ↑ +79% |
| UNITED | MEDICARE ADVANTAGE | $5,938.02 | ↑ +551% |
| BLUE CROSS | Medicare Advantage HMO | $5,938.02 | ↑ +551% |
| HUMANA | Medicare Advantage HMO | $5,938.02 | ↑ +551% |
| Miami Childrens Health Plan | MEDICARE ADVANTAGE | $5,938.02 | ↑ +551% |
| BLUE CROSS | Medicare Advantage PPO | $5,938.02 | ↑ +551% |
| AVMED | MEDICARE ADVANTAGE | $6,175.54 | ↑ +577% |
| Wellcare | MEDICARE ADVANTAGE | $6,181.95 | ↑ +577% |
| AETNA | MEDICARE ADVANTAGE | $6,181.95 | ↑ +577% |
| Careplus | MEDICARE ADVANTAGE | $6,234.92 | ↑ +583% |
| Freedom Health | MEDICARE ADVANTAGE | $6,234.92 | ↑ +583% |
| DEVOTED HEALTH | Medicare Advantage HMO | $6,800.15 | ↑ +645% |
| AVMED | EXCHANGE | $10,391.54 | ↑ +1039% |
| AVMED | Select | $17,517.16 | ↑ +1819% |
| AVMED | BROAD | $22,861.38 | ↑ +2405% |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
Visitor-reported prices
Comments
Tonsillectomy (child under 12) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $912.60 | $170.32 – $6,800.15 |
| indian river hospital | Vero Beach | not published | $1,292.16 – $6,800.15 |
| Baptist Hospital | MIAMI | not published | not published |