App high cost ss f/n/g/h/f >100sq cm addl 100sq cm at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$4,459.00
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.
$6,860.00
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.
$27.46 with Optum vs $5,761.00 with BLUE CROSS — 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 |
|---|---|---|---|
| Optum | Managed Medicaid | $27.46 | ↓ -99% |
| Blue Cross | Health Options | $50.97 | ↓ -99% |
| Blue Cross | Network Blue | $52.22 | ↓ -99% |
| Blue Cross | Perferred Patient Care | $53.47 | ↓ -99% |
| Blue Cross | Traditional (PPS) | $53.47 | ↓ -99% |
| Avmed | Medicare Advantage | $54.56 | ↓ -99% |
| Value Options | Medicare Advantage | $54.56 | ↓ -99% |
| Blue Cross | Medicare Advantage PPO | $54.56 | ↓ -99% |
| Blue Cross | Medicare Advantage HMO | $54.56 | ↓ -99% |
| Wellcare | Medicare Advantage | $54.56 | ↓ -99% |
| Magellan | Medicare Advantage | $54.56 | ↓ -99% |
| Careplus | Medicare Advantage | $54.56 | ↓ -99% |
| WellMed | Medicare Advantage | $57.29 | ↓ -99% |
| Freedom Health | Medicare Advantage | $57.29 | ↓ -99% |
| Independent Living Systems | Medicare Advantage | $57.29 | ↓ -99% |
| Clear Spring Health | All Products | $58.92 | ↓ -99% |
| United | Medicare Advantage | $59.22 | ↓ -99% |
| Aetna | Medicare Advantage Behavioral Health | $65.47 | ↓ -99% |
| Aetna | Medicare Advantage PCP | $67.65 | ↓ -98% |
| Clear Spring Health | ALL PRODUCTS | $67.76 | ↓ -98% |
| Aetna | Medicare Advantage Specialist | $68.75 | ↓ -98% |
| AmeriHealth | Managed Medicaid | $72.00 | ↓ -98% |
| Value Options | Managed Medicaid | $72.00 | ↓ -98% |
| Medicaid | Managed Medicaid | $72.00 | ↓ -98% |
| Molina | Managed Medicaid | $72.00 | ↓ -98% |
| Wellcare | Managed Medicaid | $72.00 | ↓ -98% |
| Avmed | Exchange | $78.03 | ↓ -98% |
| Avmed | Select | $81.03 | ↓ -98% |
| Avmed | Broad | $87.03 | ↓ -98% |
| Aetna | POS First Health | $93.78 | ↓ -98% |
| Cigna | Individual Family Plan Mid-Level | $96.53 | ↓ -98% |
| Cigna | Surefit Mid-Level | $98.38 | ↓ -98% |
| Cigna | All Products Mid-Level | $106.26 | ↓ -98% |
| United | All Products | $113.56 | ↓ -97% |
| Cigna | Individual Family Plan Physician | $113.57 | ↓ -97% |
| Cigna | Surefit Physician | $115.75 | ↓ -97% |
| Cigna | All Products Physician | $125.00 | ↓ -97% |
| Aetna | PPO First Health | $139.55 | ↓ -97% |
| The Legacy Companies | All Products | $260.00 | ↓ -94% |
| Three Rivers | All Products | $260.00 | ↓ -94% |
| Clarity Health | All Products | $260.00 | ↓ -94% |
| Consociate Health | ALL PRODUCTS | $300.00 | ↓ -93% |
| National Provider Network | All Products | $340.00 | ↓ -92% |
| Aetna | All Products First Health | $360.00 | ↓ -92% |
| OPTUM | Managed Medicaid | $1,181.56 | ↓ -74% |
| AMERIHEALTH | Managed Medicaid | $1,243.75 | ↓ -72% |
| MOLINA | Florida KidCare | $1,243.75 | ↓ -72% |
| Molina | Florida Kidcare | $1,243.75 | ↓ -72% |
| SUNSHINE HEALTH | Managed Medicaid | $1,243.75 | ↓ -72% |
| Carelon BH Strategies | Managed Medicaid | $1,243.75 | ↓ -72% |
| MOLINA | Managed Medicaid | $1,305.94 | ↓ -71% |
| AETNA | Managed Medicaid/CHIP | $1,368.13 | ↓ -69% |
| Independent Living Systems | Managed Medicaid | $1,492.50 | ↓ -67% |
| AETNA | QHP | $1,605.24 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $1,612.10 | ↓ -64% |
| AVMED | Select | $1,646.40 | ↓ -63% |
| AVMED | EXCHANGE | $1,646.40 | ↓ -63% |
| CIGNA | Individual Family Plan | $1,763.02 | ↓ -60% |
| AVMED | BROAD | $2,126.60 | ↓ -52% |
| CIGNA | SUREFIT | $2,126.60 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $2,181.48 | ↓ -51% |
| AETNA | ALL PRODUCTS | $2,442.16 | ↓ -45% |
| BLUE CROSS | HMO | $2,971.00 | ↓ -33% |
| BLUE CROSS | BSL | $2,971.00 | ↓ -33% |
| BMI | ALL PRODUCTS | $3,430.00 | ↓ -23% |
| BLUE CROSS | NWB | $3,928.00 | ↓ -12% |
| BLUE CROSS | NWBI | $3,928.00 | ↓ -12% |
| MAGELLAN | ALL PRODUCTS | $4,116.00 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $4,459.00 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $4,459.00 | ↑ +0% |
| MULTIPLAN | ALL PRODUCTS | $5,488.00 | ↑ +23% |
| AETNA | All Products First Health | $5,488.00 | ↑ +23% |
| BLUE CROSS | PPO | $5,761.00 | ↑ +29% |
| BLUE CROSS | PHS | $5,761.00 | ↑ +29% |
| AVMED | MEDICARE ADVANTAGE | not published by hospital | — |
| WellMed | MEDICARE ADVANTAGE | not published by hospital | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Freedom Health | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | Medicare Advantage PPO | not published by hospital | — |
| BLUE CROSS | Medicare Advantage HMO | not published by hospital | — |
| DEVOTED HEALTH | Medicare Advantage HMO | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Wellcare | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Careplus | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
App high cost ss f/n/g/h/f >100sq cm addl 100sq cm at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Tampa | Tampa | $2,000.57 | not published |
| Adventhealth Port Charlotte | Port Charlotte | $6,154.89 | not published |
| cleveland clinic florida weston hospital | Weston | $260.00 | $27.46 – $1,492.50 |
| martin north hospital | Stuart | $4,459.00 | $42.61 – $3,430.00 |
| Baptist Hospital | MIAMI | $908.05 | $173.17 – $1,301.89 |
| Bethesda Hospital East | BOYNTON BEACH | $908.05 | $280.80 – $1,289.61 |
| Boca Raton Regional Hospital | BOCA RATON | $585.00 | $324.00 – $900.00 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $908.05 | $243.08 – $1,285.86 |