Cricopharyngeal myotomy 43030 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$2,077.40
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.
$3,196.00
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.
$406.22 with Medicaid vs $13,598.07 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 |
|---|---|---|---|
| Medicaid | Managed Medicaid | $406.22 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $406.22 | ↓ -80% |
| Wellcare | Managed Medicaid | $406.22 | ↓ -80% |
| Molina | Managed Medicaid | $406.22 | ↓ -80% |
| Value Options | Managed Medicaid | $406.22 | ↓ -80% |
| Optum | Managed Medicaid | $410.58 | ↓ -80% |
| Blue Cross | Health Options | $493.59 | ↓ -76% |
| Avmed | Medicare Advantage | $504.19 | ↓ -76% |
| Value Options | Medicare Advantage | $504.19 | ↓ -76% |
| Careplus | Medicare Advantage | $504.19 | ↓ -76% |
| Blue Cross | Medicare Advantage HMO | $504.19 | ↓ -76% |
| Wellcare | Medicare Advantage | $504.19 | ↓ -76% |
| Blue Cross | Medicare Advantage PPO | $504.19 | ↓ -76% |
| Magellan | Medicare Advantage | $504.19 | ↓ -76% |
| Blue Cross | Network Blue | $505.73 | ↓ -76% |
| Blue Cross | Traditional (PPS) | $517.87 | ↓ -75% |
| Blue Cross | Perferred Patient Care | $517.87 | ↓ -75% |
| Independent Living Systems | Medicare Advantage | $529.40 | ↓ -75% |
| WellMed | Medicare Advantage | $529.40 | ↓ -75% |
| Freedom Health | Medicare Advantage | $529.40 | ↓ -75% |
| Clear Spring Health | All Products | $544.53 | ↓ -74% |
| United | Medicare Advantage | $545.09 | ↓ -74% |
| Aetna | Medicare Advantage Behavioral Health | $605.03 | ↓ -71% |
| Aetna | Medicare Advantage PCP | $625.20 | ↓ -70% |
| Aetna | Medicare Advantage Specialist | $635.28 | ↓ -69% |
| Avmed | Exchange | $726.64 | ↓ -65% |
| Avmed | Select | $754.58 | ↓ -64% |
| Avmed | Broad | $810.48 | ↓ -61% |
| Aetna | PPO First Health | $821.07 | ↓ -60% |
| United | All Products | $1,057.59 | ↓ -49% |
| Aetna | POS First Health | $1,438.20 | ↓ -31% |
| Three Rivers | All Products | $2,077.40 | ↑ +0% |
| Clarity Health | All Products | $2,077.40 | ↑ +0% |
| The Legacy Companies | All Products | $2,077.40 | ↑ +0% |
| OPTUM | Managed Medicaid | $2,132.36 | ↑ +3% |
| MOLINA | Florida KidCare | $2,244.59 | ↑ +8% |
| AMERIHEALTH | Managed Medicaid | $2,244.59 | ↑ +8% |
| Carelon BH Strategies | Managed Medicaid | $2,244.59 | ↑ +8% |
| Molina | Florida Kidcare | $2,244.59 | ↑ +8% |
| SUNSHINE HEALTH | Managed Medicaid | $2,244.59 | ↑ +8% |
| MOLINA | Managed Medicaid | $2,356.82 | ↑ +13% |
| Consociate Health | ALL PRODUCTS | $2,397.00 | ↑ +15% |
| AETNA | Managed Medicaid/CHIP | $2,469.05 | ↑ +19% |
| Independent Living Systems | Managed Medicaid | $2,693.51 | ↑ +30% |
| National Provider Network | All Products | $2,716.60 | ↑ +31% |
| Aetna | All Products First Health | $2,876.40 | ↑ +38% |
| Cigna | Surefit Mid-Level | $3,196.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $3,196.00 | ↑ +54% |
| Cigna | All Products Physician | $3,196.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $3,196.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $3,196.00 | ↑ +54% |
| Cigna | Surefit Physician | $3,196.00 | ↑ +54% |
| Freedom Health | MEDICARE ADVANTAGE | $5,938.02 | ↑ +186% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $5,938.02 | ↑ +186% |
| BLUE CROSS | Medicare Advantage PPO | $5,938.02 | ↑ +186% |
| BLUE CROSS | Medicare Advantage HMO | $5,938.02 | ↑ +186% |
| Careplus | MEDICARE ADVANTAGE | $5,938.02 | ↑ +186% |
| HUMANA | Medicare Advantage HMO | $5,938.02 | ↑ +186% |
| UNITED | MEDICARE ADVANTAGE | $5,938.02 | ↑ +186% |
| AVMED | MEDICARE ADVANTAGE | $6,175.54 | ↑ +197% |
| AETNA | MEDICARE ADVANTAGE | $6,181.95 | ↑ +198% |
| Wellcare | MEDICARE ADVANTAGE | $6,181.95 | ↑ +198% |
| WellMed | MEDICARE ADVANTAGE | $6,181.95 | ↑ +198% |
| Independent Living Systems | MEDICARE ADVANTAGE | $6,234.92 | ↑ +200% |
| DEVOTED HEALTH | Medicare Advantage HMO | $6,800.15 | ↑ +227% |
| AVMED | EXCHANGE | $9,322.69 | ↑ +349% |
| AVMED | Select | $10,450.92 | ↑ +403% |
| AVMED | BROAD | $13,598.07 | ↑ +555% |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
Visitor-reported prices
Comments
Cricopharyngeal myotomy 43030 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $2,077.40 | $406.22 – $6,800.15 |
| martin north hospital | Stuart | $2,077.40 | $406.22 – $6,800.15 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $5,872.86 – $10,317.68 |
| Adventhealth Tampa | Tampa | not published | $6,181.95 – $13,723.94 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $762.38 – $778.42 |
| HCA FLORIDA BRANDON HOSPITAL | TAMPA | not published | $773.91 – $790.20 |
| HCA FLORIDA JFK HOSPITAL | PALM BEACH GARDENS | not published | $800.46 – $817.31 |
| HCA FLORIDA KENDALL HOSPITAL | DORAL | not published | $831.24 – $848.74 |