ER Visit (level 5, high severity) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$3,437.20
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.
$5,288.00
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.
$89.52 with Optum vs $4,230.40 with MULTIPLAN — 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 | $89.52 | ↓ -97% |
| Magellan | Summit | $92.00 | ↓ -97% |
| Value Options | Managed Medicaid | $133.28 | ↓ -96% |
| Molina | Managed Medicaid | $133.28 | ↓ -96% |
| Medicaid | Managed Medicaid | $133.28 | ↓ -96% |
| AmeriHealth | Managed Medicaid | $133.28 | ↓ -96% |
| Wellcare | Managed Medicaid | $133.28 | ↓ -96% |
| Blue Cross | Health Options | $154.56 | ↓ -96% |
| Blue Cross | Network Blue | $158.36 | ↓ -95% |
| Blue Cross | Perferred Patient Care | $162.16 | ↓ -95% |
| Blue Cross | Traditional (PPS) | $162.16 | ↓ -95% |
| Magellan | Pinnacle | $163.65 | ↓ -95% |
| United | Medicare Advantage | $179.51 | ↓ -95% |
| Wellcare | Medicare Advantage | $185.50 | ↓ -95% |
| Blue Cross | Medicare Advantage PPO | $185.50 | ↓ -95% |
| Blue Cross | Medicare Advantage HMO | $185.50 | ↓ -95% |
| Avmed | Medicare Advantage | $185.50 | ↓ -95% |
| Careplus | Medicare Advantage | $185.50 | ↓ -95% |
| Value Options | Medicare Advantage | $185.50 | ↓ -95% |
| Magellan | Medicare Advantage | $185.50 | ↓ -95% |
| Independent Living Systems | Medicare Advantage | $188.49 | ↓ -95% |
| WellMed | Medicare Advantage | $194.78 | ↓ -94% |
| Freedom Health | Medicare Advantage | $194.78 | ↓ -94% |
| Clear Spring Health | All Products | $200.34 | ↓ -94% |
| Aetna | Medicare Advantage Behavioral Health | $222.60 | ↓ -94% |
| Aetna | Medicare Advantage PCP | $230.02 | ↓ -93% |
| Aetna | Medicare Advantage Specialist | $233.73 | ↓ -93% |
| Avmed | Exchange | $238.95 | ↓ -93% |
| Avmed | Select | $248.14 | ↓ -93% |
| Clear Spring Health | ALL PRODUCTS | $250.95 | ↓ -93% |
| Aetna | PPO First Health | $266.09 | ↓ -92% |
| Avmed | Broad | $266.52 | ↓ -92% |
| United | All Products | $310.75 | ↓ -91% |
| AETNA | QHP | $554.00 | ↓ -84% |
| HUMANA | Medicare Advantage HMO | $615.42 | ↓ -82% |
| BLUE CROSS | Medicare Advantage HMO | $615.42 | ↓ -82% |
| BLUE CROSS | Medicare Advantage PPO | $615.42 | ↓ -82% |
| UNITED | MEDICARE ADVANTAGE | $615.42 | ↓ -82% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $615.42 | ↓ -82% |
| Careplus | MEDICARE ADVANTAGE | $615.42 | ↓ -82% |
| Freedom Health | MEDICARE ADVANTAGE | $615.42 | ↓ -82% |
| Wellcare | MEDICARE ADVANTAGE | $621.90 | ↓ -82% |
| AETNA | MEDICARE ADVANTAGE | $621.90 | ↓ -82% |
| WellMed | MEDICARE ADVANTAGE | $621.90 | ↓ -82% |
| AVMED | MEDICARE ADVANTAGE | $640.03 | ↓ -81% |
| Independent Living Systems | MEDICARE ADVANTAGE | $646.19 | ↓ -81% |
| DEVOTED HEALTH | Medicare Advantage HMO | $684.09 | ↓ -80% |
| Aetna | POS First Health | $792.00 | ↓ -77% |
| UNITED | NHP | $850.00 | ↓ -75% |
| AETNA | ALL PRODUCTS | $874.00 | ↓ -75% |
| AVMED | EXCHANGE | $966.21 | ↓ -72% |
| AVMED | Select | $1,083.13 | ↓ -68% |
| Clarity Health | All Products | $1,144.00 | ↓ -67% |
| The Legacy Companies | All Products | $1,144.00 | ↓ -67% |
| Three Rivers | All Products | $1,144.00 | ↓ -67% |
| UNITED | ALL PRODUCTS | $1,151.00 | ↓ -67% |
| UNITED | International | $1,151.00 | ↓ -67% |
| BLUE CROSS | HMO | $1,308.00 | ↓ -62% |
| BLUE CROSS | BSL | $1,308.00 | ↓ -62% |
| Consociate Health | ALL PRODUCTS | $1,320.00 | ↓ -62% |
| CIGNA | Individual Family Plan | $1,359.02 | ↓ -60% |
| AVMED | BROAD | $1,409.31 | ↓ -59% |
| National Provider Network | All Products | $1,496.00 | ↓ -56% |
| Aetna | All Products First Health | $1,584.00 | ↓ -54% |
| CIGNA | SUREFIT | $1,639.28 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $1,681.58 | ↓ -51% |
| BLUE CROSS | NWBI | $1,710.00 | ↓ -50% |
| BLUE CROSS | NWB | $1,710.00 | ↓ -50% |
| Cigna | All Products Mid-Level | $1,760.00 | ↓ -49% |
| Cigna | Surefit Physician | $1,760.00 | ↓ -49% |
| Cigna | Individual Family Plan Physician | $1,760.00 | ↓ -49% |
| Cigna | Individual Family Plan Mid-Level | $1,760.00 | ↓ -49% |
| Cigna | Surefit Mid-Level | $1,760.00 | ↓ -49% |
| Cigna | All Products Physician | $1,760.00 | ↓ -49% |
| BMI | ALL PRODUCTS | $2,644.00 | ↓ -23% |
| BLUE CROSS | PPO | $2,806.00 | ↓ -18% |
| BLUE CROSS | PHS | $2,806.00 | ↓ -18% |
| MAGELLAN | ALL PRODUCTS | $3,172.80 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $3,437.20 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $3,437.20 | ↑ +0% |
| AETNA | All Products First Health | $4,230.40 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $4,230.40 | ↑ +23% |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Independent Living Systems | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Molina | Florida Kidcare | not published by hospital | — |
| MOLINA | Florida KidCare | not published by hospital | — |
| MOLINA | Managed Medicaid | not published by hospital | — |
| OPTUM | Managed Medicaid | not published by hospital | — |
| SUNSHINE HEALTH | Managed Medicaid | not published by hospital | — |
| Carelon BH Strategies | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| AMERIHEALTH | Managed Medicaid | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| AETNA | Managed Medicaid/CHIP | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 5, high severity) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $3,418.53 | $590.81 – $1,037.95 |
| Adventhealth Lake Wales | Lake Wales | $4,722.24 | $621.90 – $1,380.62 |
| Adventhealth Palm Coast Parkway | Palm Coast | $3,097.46 | $590.81 – $1,328.32 |
| Adventhealth Tampa | Tampa | $5,579.62 | $621.90 – $1,380.62 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $4,868.04 | $590.81 – $1,358.54 |
| Adventhealth Port Charlotte | Port Charlotte | $7,102.65 | $621.90 – $1,135.59 |
| cleveland clinic florida weston hospital | Weston | $3,437.20 | $89.52 – $4,494.80 |
| martin north hospital | Stuart | $3,437.20 | $129.22 – $2,644.00 |