healthcosts.net
Breast Biopsy (ultrasound-guided, percutaneous) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$9,083.75
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.
?
What you pay up front if you don't use insurance.
$13,975.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$126.35 with Optum vs $11,180.00 with AETNA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $126.35 | ↓ -99% |
| Avmed | Medicare Advantage | $140.71 | ↓ -98% |
| Value Options | Medicare Advantage | $140.71 | ↓ -98% |
| Magellan | Medicare Advantage | $140.71 | ↓ -98% |
| Careplus | Medicare Advantage | $140.71 | ↓ -98% |
| Wellcare | Medicare Advantage | $140.71 | ↓ -98% |
| Blue Cross | Medicare Advantage PPO | $140.71 | ↓ -98% |
| Blue Cross | Medicare Advantage HMO | $140.71 | ↓ -98% |
| Independent Living Systems | Medicare Advantage | $147.75 | ↓ -98% |
| Freedom Health | Medicare Advantage | $147.75 | ↓ -98% |
| WellMed | Medicare Advantage | $147.75 | ↓ -98% |
| Clear Spring Health | All Products | $151.97 | ↓ -98% |
| United | Medicare Advantage | $153.93 | ↓ -98% |
| Aetna | Medicare Advantage Behavioral Health | $168.85 | ↓ -98% |
| Aetna | Medicare Advantage PCP | $174.48 | ↓ -98% |
| Aetna | Medicare Advantage Specialist | $177.29 | ↓ -98% |
| Clear Spring Health | ALL PRODUCTS | $191.30 | ↓ -98% |
| Avmed | Exchange | $206.93 | ↓ -98% |
| Avmed | Select | $214.89 | ↓ -98% |
| Avmed | Broad | $230.81 | ↓ -97% |
| Aetna | POS First Health | $249.48 | ↓ -97% |
| United | All Products | $301.18 | ↓ -97% |
| Value Options | Managed Medicaid | $367.67 | ↓ -96% |
| Medicaid | Managed Medicaid | $367.67 | ↓ -96% |
| Molina | Managed Medicaid | $367.67 | ↓ -96% |
| Wellcare | Managed Medicaid | $367.67 | ↓ -96% |
| AmeriHealth | Managed Medicaid | $367.67 | ↓ -96% |
| OPTUM | Managed Medicaid | $816.59 | ↓ -91% |
| Cigna | Individual Family Plan Mid-Level | $837.67 | ↓ -91% |
| Cigna | Surefit Mid-Level | $853.70 | ↓ -91% |
| MOLINA | Florida KidCare | $859.57 | ↓ -91% |
| AMERIHEALTH | Managed Medicaid | $859.57 | ↓ -91% |
| Molina | Florida Kidcare | $859.57 | ↓ -91% |
| SUNSHINE HEALTH | Managed Medicaid | $859.57 | ↓ -91% |
| Carelon BH Strategies | Managed Medicaid | $859.57 | ↓ -91% |
| Clarity Health | All Products | $886.60 | ↓ -90% |
| Three Rivers | All Products | $886.60 | ↓ -90% |
| The Legacy Companies | All Products | $886.60 | ↓ -90% |
| MOLINA | Managed Medicaid | $902.55 | ↓ -90% |
| Cigna | All Products Mid-Level | $921.90 | ↓ -90% |
| AETNA | Managed Medicaid/CHIP | $945.53 | ↓ -90% |
| Aetna | PPO First Health | $950.05 | ↓ -90% |
| Cigna | Individual Family Plan Physician | $985.48 | ↓ -89% |
| Cigna | Surefit Physician | $1,004.34 | ↓ -89% |
| Consociate Health | ALL PRODUCTS | $1,023.00 | ↓ -89% |
| Independent Living Systems | Managed Medicaid | $1,031.48 | ↓ -89% |
| Cigna | All Products Physician | $1,084.58 | ↓ -88% |
| National Provider Network | All Products | $1,159.40 | ↓ -87% |
| Aetna | All Products First Health | $1,227.60 | ↓ -86% |
| UNITED | MEDICARE ADVANTAGE | $1,626.36 | ↓ -82% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $1,626.36 | ↓ -82% |
| Careplus | MEDICARE ADVANTAGE | $1,626.36 | ↓ -82% |
| Freedom Health | MEDICARE ADVANTAGE | $1,626.36 | ↓ -82% |
| BLUE CROSS | Medicare Advantage HMO | $1,626.36 | ↓ -82% |
| HUMANA | Medicare Advantage HMO | $1,626.36 | ↓ -82% |
| BLUE CROSS | Medicare Advantage PPO | $1,626.36 | ↓ -82% |
| AVMED | MEDICARE ADVANTAGE | $1,691.42 | ↓ -81% |
| Independent Living Systems | MEDICARE ADVANTAGE | $1,707.68 | ↓ -81% |
| Wellcare | MEDICARE ADVANTAGE | $1,724.73 | ↓ -81% |
| AETNA | MEDICARE ADVANTAGE | $1,724.73 | ↓ -81% |
| WellMed | MEDICARE ADVANTAGE | $1,724.73 | ↓ -81% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,897.20 | ↓ -79% |
| UNITED | NHP | $2,297.00 | ↓ -75% |
| UNITED | International | $2,307.00 | ↓ -75% |
| AVMED | EXCHANGE | $2,553.39 | ↓ -72% |
| UNITED | ALL PRODUCTS | $2,728.00 | ↓ -70% |
| AETNA | QHP | $2,789.00 | ↓ -69% |
| AVMED | Select | $2,862.40 | ↓ -68% |
| CIGNA | Individual Family Plan | $3,591.58 | ↓ -60% |
| AVMED | BROAD | $3,724.37 | ↓ -59% |
| BLUE CROSS | HMO | $4,328.00 | ↓ -52% |
| BLUE CROSS | BSL | $4,328.00 | ↓ -52% |
| CIGNA | SUREFIT | $4,332.25 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $4,444.05 | ↓ -51% |
| AETNA | ALL PRODUCTS | $4,542.00 | ↓ -50% |
| BLUE CROSS | NWBI | $5,723.00 | ↓ -37% |
| BLUE CROSS | NWB | $5,723.00 | ↓ -37% |
| BMI | ALL PRODUCTS | $6,987.50 | ↓ -23% |
| BLUE CROSS | PHS | $7,992.00 | ↓ -12% |
| BLUE CROSS | PPO | $7,992.00 | ↓ -12% |
| MAGELLAN | ALL PRODUCTS | $8,385.00 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $9,083.75 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $9,083.75 | ↑ +0% |
| MULTIPLAN | ALL PRODUCTS | $11,180.00 | ↑ +23% |
| AETNA | All Products First Health | $11,180.00 | ↑ +23% |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
| Blue Cross | Health Options | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
Visitor-reported prices
Comments
Breast Biopsy (ultrasound-guided, percutaneous) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $9,083.75 | $126.35 – $11,878.75 |
| martin north hospital | Stuart | $9,083.75 | $140.71 – $6,987.50 |
| Baptist Hospital | MIAMI | $7,027.80 | $173.17 – $4,865.40 |
| Bethesda Hospital East | BOYNTON BEACH | $7,027.80 | $841.09 – $4,865.40 |
| Boca Raton Regional Hospital | BOCA RATON | $4,024.80 | $1,693.75 – $4,707.00 |
| Doctors Hospital | CORAL GABLES | $7,027.80 | $803.00 – $4,865.40 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $7,027.80 | $803.00 – $4,865.40 |
| Homestead Hospital | HOMESTEAD | $7,027.80 | $167.89 – $4,865.40 |