Control oropharyngeal hemorr/simp 42960 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.
$197.05 with Clear Spring Health vs $4,027.00 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 |
|---|---|---|---|
| Clear Spring Health | ALL PRODUCTS | $197.05 | ↓ -90% |
| HUMANA | Medicare Advantage HMO | $511.18 | ↓ -73% |
| BLUE CROSS | Medicare Advantage HMO | $511.18 | ↓ -73% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| Careplus | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| BLUE CROSS | Medicare Advantage PPO | $511.18 | ↓ -73% |
| UNITED | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| Freedom Health | MEDICARE ADVANTAGE | $511.18 | ↓ -73% |
| AVMED | MEDICARE ADVANTAGE | $531.62 | ↓ -72% |
| Independent Living Systems | MEDICARE ADVANTAGE | $536.73 | ↓ -72% |
| AETNA | QHP | $554.00 | ↓ -71% |
| WellMed | MEDICARE ADVANTAGE | $563.21 | ↓ -70% |
| Wellcare | MEDICARE ADVANTAGE | $563.21 | ↓ -70% |
| AETNA | MEDICARE ADVANTAGE | $563.21 | ↓ -70% |
| DEVOTED HEALTH | Medicare Advantage HMO | $619.53 | ↓ -67% |
| CIGNA | Individual Family Plan | $752.75 | ↓ -60% |
| AVMED | EXCHANGE | $802.54 | ↓ -58% |
| OPTUM | Managed Medicaid | $839.72 | ↓ -56% |
| UNITED | NHP | $850.00 | ↓ -55% |
| AETNA | ALL PRODUCTS | $874.00 | ↓ -54% |
| AMERIHEALTH | Managed Medicaid | $883.92 | ↓ -54% |
| Carelon BH Strategies | Managed Medicaid | $883.92 | ↓ -54% |
| Medicaid | Managed Medicaid | $883.92 | ↓ -54% |
| Molina | Florida Kidcare | $883.92 | ↓ -54% |
| MOLINA | Florida KidCare | $883.92 | ↓ -54% |
| SUNSHINE HEALTH | Managed Medicaid | $883.92 | ↓ -54% |
| Wellcare | Managed Medicaid | $883.92 | ↓ -54% |
| AVMED | Select | $899.67 | ↓ -53% |
| CIGNA | SUREFIT | $907.99 | ↓ -52% |
| MOLINA | Managed Medicaid | $928.12 | ↓ -51% |
| CIGNA | ALL PRODUCTS | $931.42 | ↓ -51% |
| AETNA | Managed Medicaid/CHIP | $972.31 | ↓ -49% |
| Independent Living Systems | Managed Medicaid | $1,060.70 | ↓ -44% |
| UNITED | ALL PRODUCTS | $1,151.00 | ↓ -40% |
| UNITED | International | $1,151.00 | ↓ -40% |
| AVMED | BROAD | $1,170.59 | ↓ -39% |
| BMI | ALL PRODUCTS | $1,464.50 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $1,757.40 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $1,903.85 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $1,903.85 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $2,196.75 | ↑ +15% |
| AETNA | All Products First Health | $2,343.20 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $2,343.20 | ↑ +23% |
| BLUE CROSS | HMO | $2,467.00 | ↑ +30% |
| BLUE CROSS | BSL | $2,467.00 | ↑ +30% |
| BLUE CROSS | NWBI | $3,264.00 | ↑ +71% |
| BLUE CROSS | NWB | $3,264.00 | ↑ +71% |
| BLUE CROSS | PPO | $4,027.00 | ↑ +112% |
| BLUE CROSS | PHS | $4,027.00 | ↑ +112% |
| Consociate Health | Transplant | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Control oropharyngeal hemorr/simp 42960 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Tampa | Tampa | $1,706.04 | $401.00 – $1,250.32 |
| cleveland clinic florida weston hospital | Weston | $1,903.85 | $99.04 – $2,489.65 |
| martin north hospital | Stuart | $1,903.85 | $125.11 – $1,464.50 |
| Boca Raton Regional Hospital | BOCA RATON | $313.95 | $173.88 – $575.22 |
| AdventHealth Orlando | Orlando | $2,159.00 | $563.21 – $1,492.50 |
| Adventhealth Riverview | Riverview | $1,706.04 | 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 |