Egd flx trnsorl rmvl balo at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$728.00
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.
$1,120.00
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.
$115.48 with Optum vs $2,155.13 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 | $115.48 | ↓ -84% |
| Careplus | Medicare Advantage | $151.67 | ↓ -79% |
| Wellcare | Medicare Advantage | $151.67 | ↓ -79% |
| Value Options | Medicare Advantage | $151.67 | ↓ -79% |
| Blue Cross | Medicare Advantage HMO | $151.67 | ↓ -79% |
| Magellan | Medicare Advantage | $151.67 | ↓ -79% |
| Avmed | Medicare Advantage | $151.67 | ↓ -79% |
| Blue Cross | Medicare Advantage PPO | $151.67 | ↓ -79% |
| Independent Living Systems | Medicare Advantage | $159.25 | ↓ -78% |
| WellMed | Medicare Advantage | $159.25 | ↓ -78% |
| Freedom Health | Medicare Advantage | $159.25 | ↓ -78% |
| Clear Spring Health | All Products | $163.80 | ↓ -78% |
| United | Medicare Advantage | $164.55 | ↓ -77% |
| Aetna | Medicare Advantage Behavioral Health | $182.00 | ↓ -75% |
| Aetna | Medicare Advantage PCP | $188.07 | ↓ -74% |
| Aetna | Medicare Advantage Specialist | $191.10 | ↓ -74% |
| Avmed | Exchange | $217.31 | ↓ -70% |
| Avmed | Select | $225.67 | ↓ -69% |
| Avmed | Broad | $242.38 | ↓ -67% |
| United | All Products | $316.28 | ↓ -57% |
| Aetna | POS First Health | $504.00 | ↓ -31% |
| Aetna | PPO First Health | $504.00 | ↓ -31% |
| OPTUM | Managed Medicaid | $616.53 | ↓ -15% |
| Cigna | Individual Family Plan Mid-Level | $628.42 | ↓ -14% |
| Cigna | Surefit Mid-Level | $640.45 | ↓ -12% |
| MOLINA | Florida KidCare | $648.98 | ↓ -11% |
| AMERIHEALTH | Managed Medicaid | $648.98 | ↓ -11% |
| Carelon BH Strategies | Managed Medicaid | $648.98 | ↓ -11% |
| Medicaid | Managed Medicaid | $648.98 | ↓ -11% |
| Molina | Florida Kidcare | $648.98 | ↓ -11% |
| SUNSHINE HEALTH | Managed Medicaid | $648.98 | ↓ -11% |
| Wellcare | Managed Medicaid | $648.98 | ↓ -11% |
| MOLINA | Managed Medicaid | $681.43 | ↓ -6% |
| Cigna | All Products Mid-Level | $691.61 | ↓ -5% |
| AETNA | Managed Medicaid/CHIP | $713.88 | ↓ -2% |
| The Legacy Companies | All Products | $728.00 | ↑ +0% |
| Clarity Health | All Products | $728.00 | ↑ +0% |
| Three Rivers | All Products | $728.00 | ↑ +0% |
| Cigna | Individual Family Plan Physician | $739.31 | ↑ +2% |
| Cigna | Surefit Physician | $753.45 | ↑ +3% |
| Independent Living Systems | Managed Medicaid | $778.78 | ↑ +7% |
| Cigna | All Products Physician | $813.65 | ↑ +12% |
| Consociate Health | ALL PRODUCTS | $840.00 | ↑ +15% |
| UNITED | MEDICARE ADVANTAGE | $941.10 | ↑ +29% |
| Careplus | MEDICARE ADVANTAGE | $941.10 | ↑ +29% |
| BLUE CROSS | Medicare Advantage PPO | $941.10 | ↑ +29% |
| BLUE CROSS | Medicare Advantage HMO | $941.10 | ↑ +29% |
| Freedom Health | MEDICARE ADVANTAGE | $941.10 | ↑ +29% |
| HUMANA | Medicare Advantage HMO | $941.10 | ↑ +29% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $941.10 | ↑ +29% |
| WellMed | MEDICARE ADVANTAGE | $947.15 | ↑ +30% |
| AETNA | MEDICARE ADVANTAGE | $947.15 | ↑ +30% |
| Wellcare | MEDICARE ADVANTAGE | $947.15 | ↑ +30% |
| National Provider Network | All Products | $952.00 | ↑ +31% |
| AVMED | MEDICARE ADVANTAGE | $978.75 | ↑ +34% |
| Independent Living Systems | MEDICARE ADVANTAGE | $988.16 | ↑ +36% |
| Aetna | All Products First Health | $1,008.00 | ↑ +38% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,041.86 | ↑ +43% |
| AVMED | EXCHANGE | $1,477.53 | ↑ +103% |
| AVMED | Select | $1,656.34 | ↑ +128% |
| AVMED | BROAD | $2,155.13 | ↑ +196% |
| AmeriHealth | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Value Options | Managed Medicaid | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| Blue Cross | Health Options | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
Visitor-reported prices
Comments
Egd flx trnsorl rmvl balo at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $728.00 | $115.48 – $1,041.86 |
| martin north hospital | Stuart | $728.00 | $151.67 – $1,041.86 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $899.79 – $1,580.79 |
| Adventhealth Lake Wales | Lake Wales | not published | $947.15 – $2,102.66 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $899.79 – $2,023.01 |
| Adventhealth Tampa | Tampa | not published | $947.15 – $2,102.66 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $899.79 – $2,069.04 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $1,747.98 – $1,784.78 |