Drng of mouth lesion 40801 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$703.30
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.
$1,082.00
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.
$148.76 with Optum vs $1,170.59 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 | $148.76 | ↓ -79% |
| Value Options | Medicare Advantage | $200.76 | ↓ -71% |
| Careplus | Medicare Advantage | $200.76 | ↓ -71% |
| Blue Cross | Medicare Advantage PPO | $200.76 | ↓ -71% |
| Blue Cross | Medicare Advantage HMO | $200.76 | ↓ -71% |
| Avmed | Medicare Advantage | $200.76 | ↓ -71% |
| Magellan | Medicare Advantage | $200.76 | ↓ -71% |
| Wellcare | Medicare Advantage | $200.76 | ↓ -71% |
| United | Medicare Advantage | $204.73 | ↓ -71% |
| Blue Cross | Health Options | $206.56 | ↓ -71% |
| Freedom Health | Medicare Advantage | $210.80 | ↓ -70% |
| WellMed | Medicare Advantage | $210.80 | ↓ -70% |
| Independent Living Systems | Medicare Advantage | $210.80 | ↓ -70% |
| Blue Cross | Network Blue | $211.64 | ↓ -70% |
| Blue Cross | Traditional (PPS) | $216.72 | ↓ -69% |
| Blue Cross | Perferred Patient Care | $216.72 | ↓ -69% |
| Clear Spring Health | All Products | $216.82 | ↓ -69% |
| Wellcare | Managed Medicaid | $226.73 | ↓ -68% |
| Molina | Managed Medicaid | $226.73 | ↓ -68% |
| Medicaid | Managed Medicaid | $226.73 | ↓ -68% |
| Value Options | Managed Medicaid | $226.73 | ↓ -68% |
| AmeriHealth | Managed Medicaid | $226.73 | ↓ -68% |
| Aetna | Medicare Advantage Behavioral Health | $240.91 | ↓ -66% |
| Aetna | Medicare Advantage PCP | $248.94 | ↓ -65% |
| Aetna | Medicare Advantage Specialist | $252.96 | ↓ -64% |
| Avmed | Exchange | $267.50 | ↓ -62% |
| Avmed | Select | $277.79 | ↓ -61% |
| Avmed | Broad | $298.37 | ↓ -58% |
| Aetna | POS First Health | $341.30 | ↓ -51% |
| United | All Products | $389.34 | ↓ -45% |
| Cigna | Individual Family Plan Mid-Level | $395.64 | ↓ -44% |
| Cigna | Surefit Mid-Level | $403.19 | ↓ -43% |
| Cigna | All Products Mid-Level | $435.51 | ↓ -38% |
| Cigna | Individual Family Plan Physician | $465.49 | ↓ -34% |
| Cigna | Surefit Physician | $474.37 | ↓ -33% |
| Aetna | PPO First Health | $476.53 | ↓ -32% |
| HUMANA | Medicare Advantage HMO | $511.18 | ↓ -27% |
| BLUE CROSS | Medicare Advantage HMO | $511.18 | ↓ -27% |
| BLUE CROSS | Medicare Advantage PPO | $511.18 | ↓ -27% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $511.18 | ↓ -27% |
| Careplus | MEDICARE ADVANTAGE | $511.18 | ↓ -27% |
| Freedom Health | MEDICARE ADVANTAGE | $511.18 | ↓ -27% |
| UNITED | MEDICARE ADVANTAGE | $511.18 | ↓ -27% |
| Cigna | All Products Physician | $512.37 | ↓ -27% |
| AVMED | MEDICARE ADVANTAGE | $531.62 | ↓ -24% |
| Independent Living Systems | MEDICARE ADVANTAGE | $536.73 | ↓ -24% |
| AETNA | MEDICARE ADVANTAGE | $563.21 | ↓ -20% |
| Wellcare | MEDICARE ADVANTAGE | $563.21 | ↓ -20% |
| WellMed | MEDICARE ADVANTAGE | $563.21 | ↓ -20% |
| DEVOTED HEALTH | Medicare Advantage HMO | $619.53 | ↓ -12% |
| The Legacy Companies | All Products | $703.30 | ↑ +0% |
| Clarity Health | All Products | $703.30 | ↑ +0% |
| Three Rivers | All Products | $703.30 | ↑ +0% |
| AVMED | EXCHANGE | $802.54 | ↑ +14% |
| Consociate Health | ALL PRODUCTS | $811.50 | ↑ +15% |
| OPTUM | Managed Medicaid | $844.88 | ↑ +20% |
| MOLINA | Florida KidCare | $889.35 | ↑ +26% |
| Molina | Florida Kidcare | $889.35 | ↑ +26% |
| AMERIHEALTH | Managed Medicaid | $889.35 | ↑ +26% |
| SUNSHINE HEALTH | Managed Medicaid | $889.35 | ↑ +26% |
| Carelon BH Strategies | Managed Medicaid | $889.35 | ↑ +26% |
| AVMED | Select | $899.67 | ↑ +28% |
| National Provider Network | All Products | $919.70 | ↑ +31% |
| MOLINA | Managed Medicaid | $933.82 | ↑ +33% |
| Aetna | All Products First Health | $973.80 | ↑ +38% |
| AETNA | Managed Medicaid/CHIP | $978.29 | ↑ +39% |
| Independent Living Systems | Managed Medicaid | $1,067.22 | ↑ +52% |
| AVMED | BROAD | $1,170.59 | ↑ +66% |
| Aetna | All Products PCP | 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 | — |
| Magellan | Pinnacle | 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 | — |
Visitor-reported prices
Comments
Drng of mouth lesion 40801 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Tampa | Tampa | $10,354.21 | $537.00 – $1,250.32 |
| cleveland clinic florida weston hospital | Weston | $1,903.85 | $148.76 – $2,489.65 |
| martin north hospital | Stuart | $1,903.85 | $246.13 – $2,196.75 |
| AdventHealth Orlando | Orlando | $1,707.00 | $563.21 – $1,492.50 |
| Adventhealth Riverview | Riverview | $10,354.21 | not published |
| Adventhealth Carrollwood | Tampa | $10,354.21 | $537.00 – $1,250.32 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $535.05 – $940.00 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $535.05 – $1,202.96 |