Cystorrhaphy wound simple 51860 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$3,276.00
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.
$5,040.00
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.
$521.27 with Optum vs $21,256.02 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 |
|---|---|---|---|
| Optum | Managed Medicaid | $521.27 | ↓ -84% |
| Medicaid | Managed Medicaid | $571.67 | ↓ -83% |
| Molina | Managed Medicaid | $571.67 | ↓ -83% |
| Wellcare | Managed Medicaid | $571.67 | ↓ -83% |
| AmeriHealth | Managed Medicaid | $571.67 | ↓ -83% |
| Value Options | Managed Medicaid | $571.67 | ↓ -83% |
| Blue Cross | Health Options | $702.95 | ↓ -79% |
| Blue Cross | Network Blue | $720.24 | ↓ -78% |
| Blue Cross | Perferred Patient Care | $737.53 | ↓ -77% |
| Blue Cross | Traditional (PPS) | $737.53 | ↓ -77% |
| Blue Cross | Medicare Advantage HMO | $742.10 | ↓ -77% |
| Magellan | Medicare Advantage | $742.10 | ↓ -77% |
| Careplus | Medicare Advantage | $742.10 | ↓ -77% |
| Value Options | Medicare Advantage | $742.10 | ↓ -77% |
| Wellcare | Medicare Advantage | $742.10 | ↓ -77% |
| Avmed | Medicare Advantage | $742.10 | ↓ -77% |
| Blue Cross | Medicare Advantage PPO | $742.10 | ↓ -77% |
| United | Medicare Advantage | $771.30 | ↓ -76% |
| Freedom Health | Medicare Advantage | $779.21 | ↓ -76% |
| WellMed | Medicare Advantage | $779.21 | ↓ -76% |
| Independent Living Systems | Medicare Advantage | $779.21 | ↓ -76% |
| Clear Spring Health | All Products | $801.47 | ↓ -76% |
| Aetna | Medicare Advantage Behavioral Health | $890.52 | ↓ -73% |
| Aetna | Medicare Advantage PCP | $920.20 | ↓ -72% |
| Aetna | Medicare Advantage Specialist | $935.05 | ↓ -71% |
| Avmed | Exchange | $1,030.03 | ↓ -69% |
| Avmed | Select | $1,069.65 | ↓ -67% |
| Avmed | Broad | $1,148.88 | ↓ -65% |
| Aetna | PPO First Health | $1,188.04 | ↓ -64% |
| United | All Products | $1,499.17 | ↓ -54% |
| Aetna | POS First Health | $2,268.00 | ↓ -31% |
| OPTUM | Managed Medicaid | $2,586.74 | ↓ -21% |
| MOLINA | Florida KidCare | $2,722.88 | ↓ -17% |
| AMERIHEALTH | Managed Medicaid | $2,722.88 | ↓ -17% |
| Carelon BH Strategies | Managed Medicaid | $2,722.88 | ↓ -17% |
| Molina | Florida Kidcare | $2,722.88 | ↓ -17% |
| SUNSHINE HEALTH | Managed Medicaid | $2,722.88 | ↓ -17% |
| MOLINA | Managed Medicaid | $2,859.02 | ↓ -13% |
| AETNA | Managed Medicaid/CHIP | $2,995.17 | ↓ -9% |
| Independent Living Systems | Managed Medicaid | $3,267.46 | ↓ -0% |
| Three Rivers | All Products | $3,276.00 | ↑ +0% |
| Clarity Health | All Products | $3,276.00 | ↑ +0% |
| The Legacy Companies | All Products | $3,276.00 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $3,780.00 | ↑ +15% |
| National Provider Network | All Products | $4,284.00 | ↑ +31% |
| Aetna | All Products First Health | $4,536.00 | ↑ +38% |
| Cigna | Individual Family Plan Mid-Level | $5,040.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $5,040.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $5,040.00 | ↑ +54% |
| Cigna | Surefit Physician | $5,040.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $5,040.00 | ↑ +54% |
| Cigna | All Products Physician | $5,040.00 | ↑ +54% |
| BLUE CROSS | Medicare Advantage HMO | $9,282.10 | ↑ +183% |
| BLUE CROSS | Medicare Advantage PPO | $9,282.10 | ↑ +183% |
| HUMANA | Medicare Advantage HMO | $9,282.10 | ↑ +183% |
| Freedom Health | MEDICARE ADVANTAGE | $9,282.10 | ↑ +183% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $9,282.10 | ↑ +183% |
| UNITED | MEDICARE ADVANTAGE | $9,282.10 | ↑ +183% |
| Careplus | MEDICARE ADVANTAGE | $9,282.10 | ↑ +183% |
| AVMED | MEDICARE ADVANTAGE | $9,653.39 | ↑ +195% |
| Independent Living Systems | MEDICARE ADVANTAGE | $9,746.21 | ↑ +198% |
| Wellcare | MEDICARE ADVANTAGE | $9,885.63 | ↑ +202% |
| WellMed | MEDICARE ADVANTAGE | $9,885.63 | ↑ +202% |
| AETNA | MEDICARE ADVANTAGE | $9,885.63 | ↑ +202% |
| DEVOTED HEALTH | Medicare Advantage HMO | $10,874.19 | ↑ +232% |
| AVMED | EXCHANGE | $14,572.90 | ↑ +345% |
| AVMED | Select | $16,336.50 | ↑ +399% |
| AVMED | BROAD | $21,256.02 | ↑ +549% |
| Aetna | All Products Specialist | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
Visitor-reported prices
Comments
Cystorrhaphy wound simple 51860 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $3,276.00 | $521.27 – $10,874.19 |
| martin north hospital | Stuart | $3,276.00 | $571.67 – $10,874.19 |
| Boca Raton Regional Hospital | BOCA RATON | $7,343.05 | $4,066.92 – $10,096.38 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $9,391.35 – $16,499.11 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $9,391.35 – $21,114.71 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $3,208.87 – $3,276.43 |
| Adventhealth Port Charlotte | Port Charlotte | not published | $9,885.63 – $18,051.15 |
| Baptist Hospital | MIAMI | not published | not published |