Consult comp w/report rfrd material at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
not published by hospital
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.
not published by hospital
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.
$56.79 with OPTUM vs $393.90 with AVMED — 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 | $56.79 | — |
| Molina | Florida Kidcare | $59.78 | — |
| SUNSHINE HEALTH | Managed Medicaid | $59.78 | — |
| Wellcare | Managed Medicaid | $59.78 | — |
| AMERIHEALTH | Managed Medicaid | $59.78 | — |
| Carelon BH Strategies | Managed Medicaid | $59.78 | — |
| Medicaid | Managed Medicaid | $59.78 | — |
| MOLINA | Florida KidCare | $59.78 | — |
| MOLINA | Managed Medicaid | $62.77 | — |
| AETNA | Managed Medicaid/CHIP | $65.76 | — |
| Independent Living Systems | Managed Medicaid | $71.74 | — |
| Freedom Health | MEDICARE ADVANTAGE | $172.01 | — |
| BLUE CROSS | Medicare Advantage HMO | $172.01 | — |
| BLUE CROSS | Medicare Advantage PPO | $172.01 | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $172.01 | — |
| Careplus | MEDICARE ADVANTAGE | $172.01 | — |
| HUMANA | Medicare Advantage HMO | $172.01 | — |
| UNITED | MEDICARE ADVANTAGE | $172.01 | — |
| WellMed | MEDICARE ADVANTAGE | $177.91 | — |
| Wellcare | MEDICARE ADVANTAGE | $177.91 | — |
| AETNA | MEDICARE ADVANTAGE | $177.91 | — |
| AVMED | MEDICARE ADVANTAGE | $178.89 | — |
| Independent Living Systems | MEDICARE ADVANTAGE | $180.61 | — |
| DEVOTED HEALTH | Medicare Advantage HMO | $195.71 | — |
| AVMED | EXCHANGE | $270.05 | — |
| AVMED | Select | $302.73 | — |
| AVMED | BROAD | $393.90 | — |
Visitor-reported prices
Comments
Consult comp w/report rfrd material at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $718.66 | $169.02 – $296.94 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $298.31 | $169.02 – $388.65 |
| Adventhealth Port Charlotte | Port Charlotte | $996.14 | $177.91 – $324.87 |
| cleveland clinic florida weston hospital | Weston | $796.90 | $56.79 – $613.00 |
| martin north hospital | Stuart | $187.85 | $49.47 – $216.75 |
| Baptist Hospital | MIAMI | $590.85 | $4.94 – $605.70 |
| Bethesda Hospital East | BOYNTON BEACH | $590.85 | $43.97 – $605.70 |
| Boca Raton Regional Hospital | BOCA RATON | $794.95 | $150.12 – $272.30 |