Biopsy vrt bdy open thoracic at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$1,349.40
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.
$2,076.00
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.
$269.87 with Optum vs $7,458.24 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 |
|---|---|---|---|
| Optum | Managed Medicaid | $269.87 | ↓ -80% |
| Wellcare | Managed Medicaid | $305.11 | ↓ -77% |
| Molina | Managed Medicaid | $305.11 | ↓ -77% |
| Value Options | Managed Medicaid | $305.11 | ↓ -77% |
| Medicaid | Managed Medicaid | $305.11 | ↓ -77% |
| AmeriHealth | Managed Medicaid | $305.11 | ↓ -77% |
| Blue Cross | Health Options | $361.33 | ↓ -73% |
| Blue Cross | Network Blue | $370.21 | ↓ -73% |
| Blue Cross | Perferred Patient Care | $379.10 | ↓ -72% |
| Blue Cross | Traditional (PPS) | $379.10 | ↓ -72% |
| United | Medicare Advantage | $422.31 | ↓ -69% |
| Careplus | Medicare Advantage | $431.20 | ↓ -68% |
| Magellan | Medicare Advantage | $431.20 | ↓ -68% |
| Blue Cross | Medicare Advantage PPO | $431.20 | ↓ -68% |
| Blue Cross | Medicare Advantage HMO | $431.20 | ↓ -68% |
| Value Options | Medicare Advantage | $431.20 | ↓ -68% |
| Wellcare | Medicare Advantage | $431.20 | ↓ -68% |
| Avmed | Medicare Advantage | $431.20 | ↓ -68% |
| Independent Living Systems | Medicare Advantage | $443.43 | ↓ -67% |
| WellMed | Medicare Advantage | $452.76 | ↓ -66% |
| Freedom Health | Medicare Advantage | $452.76 | ↓ -66% |
| Clear Spring Health | All Products | $465.70 | ↓ -65% |
| Aetna | Medicare Advantage Behavioral Health | $517.44 | ↓ -62% |
| Aetna | Medicare Advantage PCP | $534.69 | ↓ -60% |
| Aetna | Medicare Advantage Specialist | $543.31 | ↓ -60% |
| Avmed | Exchange | $560.90 | ↓ -58% |
| Avmed | Select | $582.47 | ↓ -57% |
| Avmed | Broad | $625.62 | ↓ -54% |
| Aetna | PPO First Health | $655.41 | ↓ -51% |
| United | All Products | $816.37 | ↓ -40% |
| Aetna | POS First Health | $934.20 | ↓ -31% |
| The Legacy Companies | All Products | $1,349.40 | ↑ +0% |
| Three Rivers | All Products | $1,349.40 | ↑ +0% |
| Clarity Health | All Products | $1,349.40 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $1,557.00 | ↑ +15% |
| National Provider Network | All Products | $1,764.60 | ↑ +31% |
| Aetna | All Products First Health | $1,868.40 | ↑ +38% |
| Cigna | Individual Family Plan Mid-Level | $2,076.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $2,076.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $2,076.00 | ↑ +54% |
| Cigna | Surefit Physician | $2,076.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $2,076.00 | ↑ +54% |
| Cigna | All Products Physician | $2,076.00 | ↑ +54% |
| OPTUM | Managed Medicaid | $3,094.77 | ↑ +129% |
| HUMANA | Medicare Advantage HMO | $3,256.87 | ↑ +141% |
| BLUE CROSS | Medicare Advantage HMO | $3,256.87 | ↑ +141% |
| BLUE CROSS | Medicare Advantage PPO | $3,256.87 | ↑ +141% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $3,256.87 | ↑ +141% |
| Careplus | MEDICARE ADVANTAGE | $3,256.87 | ↑ +141% |
| Freedom Health | MEDICARE ADVANTAGE | $3,256.87 | ↑ +141% |
| UNITED | MEDICARE ADVANTAGE | $3,256.87 | ↑ +141% |
| AMERIHEALTH | Managed Medicaid | $3,257.65 | ↑ +141% |
| Molina | Florida Kidcare | $3,257.65 | ↑ +141% |
| MOLINA | Florida KidCare | $3,257.65 | ↑ +141% |
| Carelon BH Strategies | Managed Medicaid | $3,257.65 | ↑ +141% |
| SUNSHINE HEALTH | Managed Medicaid | $3,257.65 | ↑ +141% |
| AVMED | MEDICARE ADVANTAGE | $3,387.15 | ↑ +151% |
| Wellcare | MEDICARE ADVANTAGE | $3,416.88 | ↑ +153% |
| WellMed | MEDICARE ADVANTAGE | $3,416.88 | ↑ +153% |
| AETNA | MEDICARE ADVANTAGE | $3,416.88 | ↑ +153% |
| Independent Living Systems | MEDICARE ADVANTAGE | $3,419.72 | ↑ +153% |
| MOLINA | Managed Medicaid | $3,420.53 | ↑ +153% |
| AETNA | Managed Medicaid/CHIP | $3,583.42 | ↑ +166% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,758.57 | ↑ +179% |
| Independent Living Systems | Managed Medicaid | $3,909.18 | ↑ +190% |
| AVMED | EXCHANGE | $5,113.29 | ↑ +279% |
| AVMED | Select | $5,732.10 | ↑ +325% |
| AVMED | BROAD | $7,458.24 | ↑ +453% |
| 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 | — |
| Magellan | Pinnacle | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy vrt bdy open thoracic at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $1,349.40 | $269.87 – $3,758.57 |
| martin north hospital | Stuart | $1,349.40 | $302.09 – $3,758.57 |
| Baptist Hospital | MIAMI | $9,495.85 | $173.17 – $13,148.10 |
| Bethesda Hospital East | BOYNTON BEACH | $9,495.85 | $1,617.00 – $13,148.10 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $9,495.85 | $2,541.97 – $13,148.10 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,246.04 – $5,702.77 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $3,246.04 – $7,298.12 |
| Adventhealth Tampa | Tampa | not published | $614.00 – $7,585.48 |