Biopsy of heart lining at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$14,704.95
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.
$22,623.00
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.
$327.28 with Optum vs $18,098.40 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 |
|---|---|---|---|
| Optum | Managed Medicaid | $327.28 | ↓ -98% |
| AmeriHealth | Managed Medicaid | $473.63 | ↓ -97% |
| Wellcare | Managed Medicaid | $473.63 | ↓ -97% |
| Medicaid | Managed Medicaid | $473.63 | ↓ -97% |
| Molina | Managed Medicaid | $473.63 | ↓ -97% |
| Value Options | Managed Medicaid | $473.63 | ↓ -97% |
| United | Medicare Advantage | $618.82 | ↓ -96% |
| Independent Living Systems | Medicare Advantage | $649.76 | ↓ -96% |
| Blue Cross | Medicare Advantage PPO | $671.14 | ↓ -95% |
| Blue Cross | Medicare Advantage HMO | $671.14 | ↓ -95% |
| Wellcare | Medicare Advantage | $671.14 | ↓ -95% |
| Avmed | Medicare Advantage | $671.14 | ↓ -95% |
| Magellan | Medicare Advantage | $671.14 | ↓ -95% |
| Value Options | Medicare Advantage | $671.14 | ↓ -95% |
| Careplus | Medicare Advantage | $671.14 | ↓ -95% |
| WellMed | Medicare Advantage | $704.70 | ↓ -95% |
| Freedom Health | Medicare Advantage | $704.70 | ↓ -95% |
| Clear Spring Health | All Products | $724.83 | ↓ -95% |
| Blue Cross | Health Options | $741.44 | ↓ -95% |
| Blue Cross | Network Blue | $759.67 | ↓ -95% |
| Blue Cross | Traditional (PPS) | $777.90 | ↓ -95% |
| Blue Cross | Perferred Patient Care | $777.90 | ↓ -95% |
| Aetna | Medicare Advantage Behavioral Health | $805.37 | ↓ -95% |
| Aetna | POS First Health | $815.85 | ↓ -94% |
| Aetna | Medicare Advantage PCP | $832.21 | ↓ -94% |
| Aetna | Medicare Advantage Specialist | $845.64 | ↓ -94% |
| Avmed | Exchange | $852.49 | ↓ -94% |
| Avmed | Select | $885.28 | ↓ -94% |
| Clear Spring Health | ALL PRODUCTS | $946.67 | ↓ -94% |
| Avmed | Broad | $950.85 | ↓ -94% |
| Aetna | PPO First Health | $1,068.10 | ↓ -93% |
| United | All Products | $1,139.94 | ↓ -92% |
| The Legacy Companies | All Products | $1,178.45 | ↓ -92% |
| Clarity Health | All Products | $1,178.45 | ↓ -92% |
| Three Rivers | All Products | $1,178.45 | ↓ -92% |
| Consociate Health | ALL PRODUCTS | $1,359.75 | ↓ -91% |
| OPTUM | Managed Medicaid | $1,513.20 | ↓ -90% |
| National Provider Network | All Products | $1,541.05 | ↓ -90% |
| MOLINA | Florida KidCare | $1,592.84 | ↓ -89% |
| Molina | Florida Kidcare | $1,592.84 | ↓ -89% |
| SUNSHINE HEALTH | Managed Medicaid | $1,592.84 | ↓ -89% |
| Carelon BH Strategies | Managed Medicaid | $1,592.84 | ↓ -89% |
| AMERIHEALTH | Managed Medicaid | $1,592.84 | ↓ -89% |
| Aetna | All Products First Health | $1,631.70 | ↓ -89% |
| MOLINA | Managed Medicaid | $1,672.48 | ↓ -89% |
| AETNA | Managed Medicaid/CHIP | $1,752.12 | ↓ -88% |
| Cigna | Surefit Mid-Level | $1,813.00 | ↓ -88% |
| Cigna | All Products Mid-Level | $1,813.00 | ↓ -88% |
| Cigna | All Products Physician | $1,813.00 | ↓ -88% |
| Cigna | Individual Family Plan Mid-Level | $1,813.00 | ↓ -88% |
| Cigna | Individual Family Plan Physician | $1,813.00 | ↓ -88% |
| Cigna | Surefit Physician | $1,813.00 | ↓ -88% |
| Independent Living Systems | Managed Medicaid | $1,911.41 | ↓ -87% |
| BLUE CROSS | Medicare Advantage HMO | $3,159.40 | ↓ -79% |
| BLUE CROSS | Medicare Advantage PPO | $3,159.40 | ↓ -79% |
| HUMANA | Medicare Advantage HMO | $3,159.40 | ↓ -79% |
| Careplus | MEDICARE ADVANTAGE | $3,159.40 | ↓ -79% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $3,159.40 | ↓ -79% |
| UNITED | MEDICARE ADVANTAGE | $3,159.40 | ↓ -79% |
| Freedom Health | MEDICARE ADVANTAGE | $3,159.40 | ↓ -79% |
| AVMED | MEDICARE ADVANTAGE | $3,285.77 | ↓ -78% |
| AETNA | MEDICARE ADVANTAGE | $3,297.29 | ↓ -78% |
| Wellcare | MEDICARE ADVANTAGE | $3,297.29 | ↓ -78% |
| WellMed | MEDICARE ADVANTAGE | $3,297.29 | ↓ -78% |
| Independent Living Systems | MEDICARE ADVANTAGE | $3,317.37 | ↓ -77% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,627.02 | ↓ -75% |
| AVMED | EXCHANGE | $4,960.25 | ↓ -66% |
| BLUE CROSS | BSL | $5,209.00 | ↓ -65% |
| BLUE CROSS | HMO | $5,209.00 | ↓ -65% |
| AETNA | QHP | $5,386.00 | ↓ -63% |
| AVMED | Select | $5,560.54 | ↓ -62% |
| CIGNA | Individual Family Plan | $5,814.11 | ↓ -60% |
| UNITED | NHP | $6,386.00 | ↓ -57% |
| BLUE CROSS | NWBI | $6,786.00 | ↓ -54% |
| BLUE CROSS | NWB | $6,786.00 | ↓ -54% |
| CIGNA | SUREFIT | $7,013.13 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $7,194.11 | ↓ -51% |
| AVMED | BROAD | $7,235.02 | ↓ -51% |
| UNITED | ALL PRODUCTS | $7,578.00 | ↓ -48% |
| UNITED | International | $8,320.00 | ↓ -43% |
| AETNA | ALL PRODUCTS | $8,727.00 | ↓ -41% |
| BLUE CROSS | PPO | $9,255.00 | ↓ -37% |
| BLUE CROSS | PHS | $9,255.00 | ↓ -37% |
| BMI | ALL PRODUCTS | $11,311.50 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $13,573.80 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $14,704.95 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $14,704.95 | ↑ +0% |
| MULTIPLAN | ALL PRODUCTS | $18,098.40 | ↑ +23% |
| AETNA | All Products First Health | $18,098.40 | ↑ +23% |
| AETNA | NAP | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Magellan | Pinnacle | 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 | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of heart lining at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Tampa | Tampa | $8,333.83 | $3,297.29 – $7,319.99 |
| cleveland clinic florida weston hospital | Weston | $15,883.40 | $212.48 – $19,229.55 |
| martin north hospital | Stuart | $14,704.95 | $473.63 – $11,311.50 |
| Baptist Hospital | MIAMI | $9,134.45 | $173.17 – $12,647.70 |
| Bethesda Hospital East | BOYNTON BEACH | $9,134.45 | $1,324.00 – $12,647.70 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $9,134.45 | $1,521.09 – $12,647.70 |
| West Kendall Baptist Hospital | MIAMI | $9,134.45 | $1,521.09 – $12,647.70 |
| AdventHealth Orlando | Orlando | $8,976.00 | $3,297.29 – $8,737.82 |