healthcosts.net
Diagnostic Mammogram (one breast) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$457.60
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.
$704.00
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.
$27.88 with OPTUM vs $563.20 with AETNA — 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 | $27.88 | ↓ -94% |
| MOLINA | Florida KidCare | $29.35 | ↓ -94% |
| Medicaid | Managed Medicaid | $29.35 | ↓ -94% |
| AMERIHEALTH | Managed Medicaid | $29.35 | ↓ -94% |
| Molina | Florida Kidcare | $29.35 | ↓ -94% |
| Wellcare | Managed Medicaid | $29.35 | ↓ -94% |
| SUNSHINE HEALTH | Managed Medicaid | $29.35 | ↓ -94% |
| Carelon BH Strategies | Managed Medicaid | $29.35 | ↓ -94% |
| MOLINA | Managed Medicaid | $30.82 | ↓ -93% |
| Aetna | PPO First Health | $30.94 | ↓ -93% |
| AETNA | Managed Medicaid/CHIP | $32.29 | ↓ -93% |
| Independent Living Systems | Managed Medicaid | $35.22 | ↓ -92% |
| United | Medicare Advantage | $37.85 | ↓ -92% |
| Avmed | Medicare Advantage | $39.41 | ↓ -91% |
| Value Options | Medicare Advantage | $39.41 | ↓ -91% |
| Magellan | Medicare Advantage | $39.41 | ↓ -91% |
| Careplus | Medicare Advantage | $39.41 | ↓ -91% |
| Wellcare | Medicare Advantage | $39.41 | ↓ -91% |
| Blue Cross | Medicare Advantage PPO | $39.41 | ↓ -91% |
| Blue Cross | Medicare Advantage HMO | $39.41 | ↓ -91% |
| Independent Living Systems | Medicare Advantage | $39.74 | ↓ -91% |
| Freedom Health | Medicare Advantage | $41.38 | ↓ -91% |
| WellMed | Medicare Advantage | $41.38 | ↓ -91% |
| Clear Spring Health | All Products | $42.56 | ↓ -91% |
| Aetna | Medicare Advantage Behavioral Health | $47.29 | ↓ -90% |
| Blue Cross | Health Options | $48.00 | ↓ -90% |
| Aetna | Medicare Advantage PCP | $48.87 | ↓ -89% |
| Blue Cross | Network Blue | $49.24 | ↓ -89% |
| Aetna | Medicare Advantage Specialist | $49.66 | ↓ -89% |
| United | All Products | $50.01 | ↓ -89% |
| Blue Cross | Traditional (PPS) | $50.49 | ↓ -89% |
| Blue Cross | Perferred Patient Care | $50.49 | ↓ -89% |
| Avmed | Exchange | $50.64 | ↓ -89% |
| Avmed | Select | $52.58 | ↓ -89% |
| Avmed | Broad | $56.48 | ↓ -88% |
| Aetna | POS First Health | $145.80 | ↓ -68% |
| BLUE CROSS | HMO | $152.00 | ↓ -67% |
| BLUE CROSS | BSL | $152.00 | ↓ -67% |
| CIGNA | Individual Family Plan | $157.78 | ↓ -66% |
| UNITED | MEDICARE ADVANTAGE | $164.52 | ↓ -64% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $164.52 | ↓ -64% |
| Careplus | MEDICARE ADVANTAGE | $164.52 | ↓ -64% |
| Freedom Health | MEDICARE ADVANTAGE | $164.52 | ↓ -64% |
| BLUE CROSS | Medicare Advantage HMO | $164.52 | ↓ -64% |
| HUMANA | Medicare Advantage HMO | $164.52 | ↓ -64% |
| BLUE CROSS | Medicare Advantage PPO | $164.52 | ↓ -64% |
| AETNA | QHP | $164.74 | ↓ -64% |
| Wellcare | MEDICARE ADVANTAGE | $168.11 | ↓ -63% |
| AETNA | MEDICARE ADVANTAGE | $168.11 | ↓ -63% |
| WellMed | MEDICARE ADVANTAGE | $168.11 | ↓ -63% |
| AVMED | Select | $168.96 | ↓ -63% |
| AVMED | EXCHANGE | $168.96 | ↓ -63% |
| BLUE CROSS | NWBI | $169.00 | ↓ -63% |
| BLUE CROSS | NWB | $169.00 | ↓ -63% |
| AVMED | MEDICARE ADVANTAGE | $171.10 | ↓ -63% |
| Independent Living Systems | MEDICARE ADVANTAGE | $172.75 | ↓ -62% |
| Clear Spring Health | ALL PRODUCTS | $181.56 | ↓ -60% |
| DEVOTED HEALTH | Medicare Advantage HMO | $184.92 | ↓ -60% |
| BLUE CROSS | PHS | $189.00 | ↓ -59% |
| BLUE CROSS | PPO | $189.00 | ↓ -59% |
| CIGNA | SUREFIT | $191.04 | ↓ -58% |
| CIGNA | ALL PRODUCTS | $199.75 | ↓ -56% |
| Clarity Health | All Products | $210.60 | ↓ -54% |
| Three Rivers | All Products | $210.60 | ↓ -54% |
| The Legacy Companies | All Products | $210.60 | ↓ -54% |
| AVMED | BROAD | $218.24 | ↓ -52% |
| Consociate Health | ALL PRODUCTS | $243.00 | ↓ -47% |
| AETNA | ALL PRODUCTS | $250.62 | ↓ -45% |
| National Provider Network | All Products | $275.40 | ↓ -40% |
| Aetna | All Products First Health | $291.60 | ↓ -36% |
| Cigna | Individual Family Plan Mid-Level | $324.00 | ↓ -29% |
| Cigna | Surefit Physician | $324.00 | ↓ -29% |
| Cigna | All Products Physician | $324.00 | ↓ -29% |
| Cigna | All Products Mid-Level | $324.00 | ↓ -29% |
| Cigna | Individual Family Plan Physician | $324.00 | ↓ -29% |
| Cigna | Surefit Mid-Level | $324.00 | ↓ -29% |
| BMI | ALL PRODUCTS | $352.00 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $422.40 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $457.60 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $457.60 | ↑ +0% |
| MULTIPLAN | ALL PRODUCTS | $563.20 | ↑ +23% |
| AETNA | All Products First Health | $563.20 | ↑ +23% |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| Optum | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| AmeriHealth | Managed Medicaid | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |
| Value Options | Managed Medicaid | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
Visitor-reported prices
Comments
Diagnostic Mammogram (one breast) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $668.20 | $27.88 – $598.40 |
| martin north hospital | Stuart | $457.60 | $29.35 – $352.00 |
| Baptist Hospital | MIAMI | $432.25 | $14.85 – $598.50 |
| Boca Raton Regional Hospital | BOCA RATON | $386.75 | $87.56 – $388.54 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $432.25 | $14.40 – $598.50 |
| Fishermens Community Hospital | MARATHON | $432.25 | $14.40 – $598.50 |
| Homestead Hospital | HOMESTEAD | $432.25 | $14.40 – $598.50 |
| Mariners Hospital | TAVERNIER | $432.25 | $14.40 – $598.50 |