Biopsy vestibule of mouth 40808 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$1,903.85
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.
$2,929.00
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.
$78.99 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 | $78.99 | ↓ -96% |
| Wellcare | Medicare Advantage | $87.28 | ↓ -95% |
| Magellan | Medicare Advantage | $87.28 | ↓ -95% |
| Careplus | Medicare Advantage | $87.28 | ↓ -95% |
| Blue Cross | Medicare Advantage PPO | $87.28 | ↓ -95% |
| Avmed | Medicare Advantage | $87.28 | ↓ -95% |
| Blue Cross | Medicare Advantage HMO | $87.28 | ↓ -95% |
| Value Options | Medicare Advantage | $87.28 | ↓ -95% |
| United | Medicare Advantage | $91.44 | ↓ -95% |
| Independent Living Systems | Medicare Advantage | $91.64 | ↓ -95% |
| WellMed | Medicare Advantage | $91.64 | ↓ -95% |
| Freedom Health | Medicare Advantage | $91.64 | ↓ -95% |
| Clear Spring Health | All Products | $94.26 | ↓ -95% |
| Blue Cross | Health Options | $100.91 | ↓ -95% |
| Blue Cross | Network Blue | $103.39 | ↓ -95% |
| Aetna | Medicare Advantage Behavioral Health | $104.74 | ↓ -94% |
| Blue Cross | Perferred Patient Care | $105.87 | ↓ -94% |
| Blue Cross | Traditional (PPS) | $105.87 | ↓ -94% |
| Aetna | Medicare Advantage PCP | $108.23 | ↓ -94% |
| Aetna | Medicare Advantage Specialist | $109.97 | ↓ -94% |
| Clear Spring Health | ALL PRODUCTS | $111.69 | ↓ -94% |
| Avmed | Exchange | $120.60 | ↓ -94% |
| Avmed | Select | $125.24 | ↓ -93% |
| Medicaid | Managed Medicaid | $128.94 | ↓ -93% |
| Molina | Managed Medicaid | $128.94 | ↓ -93% |
| Value Options | Managed Medicaid | $128.94 | ↓ -93% |
| Wellcare | Managed Medicaid | $128.94 | ↓ -93% |
| AmeriHealth | Managed Medicaid | $128.94 | ↓ -93% |
| Avmed | Broad | $134.52 | ↓ -93% |
| Aetna | POS First Health | $164.98 | ↓ -91% |
| United | All Products | $175.53 | ↓ -91% |
| Cigna | Individual Family Plan Mid-Level | $230.83 | ↓ -88% |
| Cigna | Surefit Mid-Level | $235.24 | ↓ -88% |
| Cigna | All Products Mid-Level | $254.09 | ↓ -87% |
| Cigna | Individual Family Plan Physician | $271.59 | ↓ -86% |
| The Legacy Companies | All Products | $273.00 | ↓ -86% |
| Three Rivers | All Products | $273.00 | ↓ -86% |
| Clarity Health | All Products | $273.00 | ↓ -86% |
| Cigna | Surefit Physician | $276.77 | ↓ -85% |
| Aetna | PPO First Health | $285.12 | ↓ -85% |
| Cigna | All Products Physician | $298.93 | ↓ -84% |
| Consociate Health | ALL PRODUCTS | $315.00 | ↓ -83% |
| National Provider Network | All Products | $357.00 | ↓ -81% |
| Aetna | All Products First Health | $378.00 | ↓ -80% |
| BLUE CROSS | Medicare Advantage HMO | $511.18 | ↓ -73% |
| Careplus | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| Freedom Health | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| UNITED | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| BLUE CROSS | Medicare Advantage PPO | $511.18 | ↓ -73% |
| HUMANA | Medicare Advantage HMO | $511.18 | ↓ -73% |
| AVMED | MEDICARE ADVANTAGE | $531.62 | ↓ -72% |
| Independent Living Systems | MEDICARE ADVANTAGE | $536.73 | ↓ -72% |
| AETNA | MEDICARE ADVANTAGE | $563.21 | ↓ -70% |
| WellMed | MEDICARE ADVANTAGE | $563.21 | ↓ -70% |
| Wellcare | MEDICARE ADVANTAGE | $563.21 | ↓ -70% |
| DEVOTED HEALTH | Medicare Advantage HMO | $619.53 | ↓ -67% |
| AETNA | QHP | $685.39 | ↓ -64% |
| CIGNA | Individual Family Plan | $752.75 | ↓ -60% |
| AVMED | EXCHANGE | $802.54 | ↓ -58% |
| OPTUM | Managed Medicaid | $844.88 | ↓ -56% |
| Molina | Florida Kidcare | $889.35 | ↓ -53% |
| Carelon BH Strategies | Managed Medicaid | $889.35 | ↓ -53% |
| SUNSHINE HEALTH | Managed Medicaid | $889.35 | ↓ -53% |
| AMERIHEALTH | Managed Medicaid | $889.35 | ↓ -53% |
| MOLINA | Florida KidCare | $889.35 | ↓ -53% |
| AVMED | Select | $899.67 | ↓ -53% |
| CIGNA | SUREFIT | $907.99 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $931.42 | ↓ -51% |
| MOLINA | Managed Medicaid | $933.82 | ↓ -51% |
| AETNA | Managed Medicaid/CHIP | $978.29 | ↓ -49% |
| AETNA | ALL PRODUCTS | $1,042.72 | ↓ -45% |
| Independent Living Systems | Managed Medicaid | $1,067.22 | ↓ -44% |
| AVMED | BROAD | $1,170.59 | ↓ -39% |
| BMI | ALL PRODUCTS | $1,464.50 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $1,757.40 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $1,903.85 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $1,903.85 | ↑ +0% |
| AETNA | All Products First Health | $2,343.20 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $2,343.20 | ↑ +23% |
| BLUE CROSS | HMO | $2,971.00 | ↑ +56% |
| BLUE CROSS | BSL | $2,971.00 | ↑ +56% |
| BLUE CROSS | NWBI | $3,928.00 | ↑ +106% |
| BLUE CROSS | NWB | $3,928.00 | ↑ +106% |
| BLUE CROSS | PPO | $5,761.00 | ↑ +203% |
| BLUE CROSS | PHS | $5,761.00 | ↑ +203% |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy vestibule of mouth 40808 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $1,903.85 | $78.99 – $2,489.65 |
| martin north hospital | Stuart | $1,903.85 | $84.37 – $1,464.50 |
| Baptist Hospital | MIAMI | $1,575.60 | $173.17 – $2,181.60 |
| Boca Raton Regional Hospital | BOCA RATON | $1,531.40 | $221.24 – $1,538.47 |
| AdventHealth Orlando | Orlando | $1,707.00 | $563.21 – $1,492.50 |
| Adventhealth Carrollwood | Tampa | $5,519.35 | not published |
| Adventhealth Daytona Beach | Daytona Beach | not published | $535.05 – $940.00 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $535.05 – $1,202.96 |