Crtj pericardial window/prtl resecj w/drg/bx at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$7,231.25
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.
$11,125.00
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.
$554.00 with AETNA vs $8,967.36 with Independent Living Systems — 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 |
|---|---|---|---|
| AETNA | QHP | $554.00 | ↓ -92% |
| AmeriHealth | Managed Medicaid | $585.46 | ↓ -92% |
| Wellcare | Managed Medicaid | $585.46 | ↓ -92% |
| Medicaid | Managed Medicaid | $585.46 | ↓ -92% |
| Value Options | Managed Medicaid | $585.46 | ↓ -92% |
| Molina | Managed Medicaid | $585.46 | ↓ -92% |
| Optum | Managed Medicaid | $645.22 | ↓ -91% |
| Blue Cross | Health Options | $786.10 | ↓ -89% |
| Blue Cross | Network Blue | $805.43 | ↓ -89% |
| United | Medicare Advantage | $819.49 | ↓ -89% |
| Blue Cross | Perferred Patient Care | $824.76 | ↓ -89% |
| Blue Cross | Traditional (PPS) | $824.76 | ↓ -89% |
| Blue Cross | Medicare Advantage HMO | $832.77 | ↓ -88% |
| Careplus | Medicare Advantage | $832.77 | ↓ -88% |
| Value Options | Medicare Advantage | $832.77 | ↓ -88% |
| Blue Cross | Medicare Advantage PPO | $832.77 | ↓ -88% |
| Avmed | Medicare Advantage | $832.77 | ↓ -88% |
| Magellan | Medicare Advantage | $832.77 | ↓ -88% |
| Wellcare | Medicare Advantage | $832.77 | ↓ -88% |
| UNITED | NHP | $850.00 | ↓ -88% |
| Independent Living Systems | Medicare Advantage | $860.46 | ↓ -88% |
| WellMed | Medicare Advantage | $874.41 | ↓ -88% |
| Freedom Health | Medicare Advantage | $874.41 | ↓ -88% |
| Clear Spring Health | All Products | $899.39 | ↓ -88% |
| Clear Spring Health | ALL PRODUCTS | $994.32 | ↓ -86% |
| Aetna | Medicare Advantage Behavioral Health | $999.32 | ↓ -86% |
| Aetna | Medicare Advantage PCP | $1,032.63 | ↓ -86% |
| Aetna | Medicare Advantage Specialist | $1,049.29 | ↓ -85% |
| Avmed | Exchange | $1,092.14 | ↓ -85% |
| Avmed | Select | $1,134.15 | ↓ -84% |
| UNITED | International | $1,151.00 | ↓ -84% |
| UNITED | ALL PRODUCTS | $1,151.00 | ↓ -84% |
| Avmed | Broad | $1,218.16 | ↓ -83% |
| Aetna | PPO First Health | $1,314.66 | ↓ -82% |
| United | All Products | $1,589.57 | ↓ -78% |
| Aetna | POS First Health | $2,613.60 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $2,614.38 | ↓ -64% |
| AVMED | EXCHANGE | $2,670.00 | ↓ -63% |
| AVMED | Select | $2,670.00 | ↓ -63% |
| CIGNA | Individual Family Plan | $2,859.13 | ↓ -60% |
| CIGNA | SUREFIT | $3,448.75 | ↓ -52% |
| AVMED | BROAD | $3,448.75 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $3,537.75 | ↓ -51% |
| Clarity Health | All Products | $3,775.20 | ↓ -48% |
| The Legacy Companies | All Products | $3,775.20 | ↓ -48% |
| Three Rivers | All Products | $3,775.20 | ↓ -48% |
| Consociate Health | ALL PRODUCTS | $4,356.00 | ↓ -40% |
| National Provider Network | All Products | $4,936.80 | ↓ -32% |
| Aetna | All Products First Health | $5,227.20 | ↓ -28% |
| BMI | ALL PRODUCTS | $5,562.50 | ↓ -23% |
| Cigna | Surefit Mid-Level | $5,808.00 | ↓ -20% |
| Cigna | All Products Mid-Level | $5,808.00 | ↓ -20% |
| Cigna | All Products Physician | $5,808.00 | ↓ -20% |
| Cigna | Individual Family Plan Mid-Level | $5,808.00 | ↓ -20% |
| Cigna | Individual Family Plan Physician | $5,808.00 | ↓ -20% |
| Cigna | Surefit Physician | $5,808.00 | ↓ -20% |
| MAGELLAN | ALL PRODUCTS | $6,675.00 | ↓ -8% |
| OPTUM | Managed Medicaid | $7,099.16 | ↓ -2% |
| Clarity Health | ALL PRODUCTS | $7,231.25 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $7,231.25 | ↑ +0% |
| AMERIHEALTH | Managed Medicaid | $7,472.80 | ↑ +3% |
| Molina | Florida Kidcare | $7,472.80 | ↑ +3% |
| MOLINA | Florida KidCare | $7,472.80 | ↑ +3% |
| Carelon BH Strategies | Managed Medicaid | $7,472.80 | ↑ +3% |
| SUNSHINE HEALTH | Managed Medicaid | $7,472.80 | ↑ +3% |
| MOLINA | Managed Medicaid | $7,846.44 | ↑ +9% |
| AETNA | ALL PRODUCTS | $7,917.00 | ↑ +9% |
| AETNA | Managed Medicaid/CHIP | $8,220.08 | ↑ +14% |
| AETNA | All Products First Health | $8,900.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $8,900.00 | ↑ +23% |
| Independent Living Systems | Managed Medicaid | $8,967.36 | ↑ +24% |
| BLUE CROSS | NWB | not published by hospital | — |
| BLUE CROSS | Medicare Advantage PPO | not published by hospital | — |
| BLUE CROSS | Medicare Advantage HMO | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| AVMED | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| 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 | — |
| Wellcare | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| WellMed | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Careplus | MEDICARE ADVANTAGE | not published by hospital | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| DEVOTED HEALTH | Medicare Advantage HMO | not published by hospital | — |
| Freedom Health | MEDICARE ADVANTAGE | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
Visitor-reported prices
Comments
Crtj pericardial window/prtl resecj w/drg/bx at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $7,231.25 | $585.46 – $18,285.00 |
| martin north hospital | Stuart | $7,231.25 | $585.46 – $15,852.00 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $497.36 – $507.83 |
| HCA FLORIDA BRANDON HOSPITAL | TAMPA | not published | $504.90 – $515.53 |
| HCA FLORIDA JFK HOSPITAL | PALM BEACH GARDENS | not published | $522.22 – $533.21 |
| HCA FLORIDA KENDALL HOSPITAL | DORAL | not published | $542.30 – $553.71 |
| HCA FLORIDA CAPITAL HOSPITAL | TALLAHASSEE | not published | $462.73 – $487.08 |
| HCA FLORIDA CITRUS HOSPITAL | Inverness | not published | $469.80 – $479.69 |