healthcosts.net
Established Patient Office Visit (level 1) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$122.20
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.
?
What you pay up front if you don't use insurance.
$188.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$5.59 with Optum vs $150.40 with AETNA — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $5.59 | ↓ -95% |
| Avmed | Medicare Advantage | $8.01 | ↓ -93% |
| Value Options | Medicare Advantage | $8.01 | ↓ -93% |
| Magellan | Medicare Advantage | $8.01 | ↓ -93% |
| Careplus | Medicare Advantage | $8.01 | ↓ -93% |
| Wellcare | Medicare Advantage | $8.01 | ↓ -93% |
| Blue Cross | Medicare Advantage PPO | $8.01 | ↓ -93% |
| Blue Cross | Medicare Advantage HMO | $8.01 | ↓ -93% |
| Blue Cross | Health Options | $8.36 | ↓ -93% |
| Independent Living Systems | Medicare Advantage | $8.41 | ↓ -93% |
| Freedom Health | Medicare Advantage | $8.41 | ↓ -93% |
| WellMed | Medicare Advantage | $8.41 | ↓ -93% |
| Blue Cross | Network Blue | $8.57 | ↓ -93% |
| United | Medicare Advantage | $8.65 | ↓ -93% |
| Clear Spring Health | All Products | $8.65 | ↓ -93% |
| Blue Cross | Traditional (PPS) | $8.78 | ↓ -93% |
| Blue Cross | Perferred Patient Care | $8.78 | ↓ -93% |
| Value Options | All Products | $9.30 | ↓ -92% |
| Aetna | Medicare Advantage Behavioral Health | $9.61 | ↓ -92% |
| Aetna | Medicare Advantage PCP | $9.93 | ↓ -92% |
| Aetna | Medicare Advantage Specialist | $10.09 | ↓ -92% |
| Clear Spring Health | ALL PRODUCTS | $11.48 | ↓ -91% |
| Avmed | Exchange | $11.58 | ↓ -91% |
| Avmed | Select | $12.03 | ↓ -90% |
| Avmed | Broad | $12.92 | ↓ -89% |
| Aetna | POS First Health | $13.82 | ↓ -89% |
| United | All Products | $15.06 | ↓ -88% |
| Value Options | Managed Medicaid | $17.87 | ↓ -85% |
| Medicaid | Managed Medicaid | $17.87 | ↓ -85% |
| Molina | Managed Medicaid | $17.87 | ↓ -85% |
| Wellcare | Managed Medicaid | $17.87 | ↓ -85% |
| AmeriHealth | Managed Medicaid | $17.87 | ↓ -85% |
| Magellan | Summit | $20.00 | ↓ -84% |
| Cigna | Individual Family Plan Mid-Level | $23.50 | ↓ -81% |
| Cigna | Surefit Mid-Level | $23.95 | ↓ -80% |
| Cigna | All Products Mid-Level | $25.81 | ↓ -79% |
| Cigna | Individual Family Plan Physician | $27.64 | ↓ -77% |
| Cigna | Surefit Physician | $28.17 | ↓ -77% |
| Cigna | All Products Physician | $30.37 | ↓ -75% |
| Aetna | PPO First Health | $33.58 | ↓ -73% |
| AETNA | QHP | $43.99 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $44.18 | ↓ -64% |
| AVMED | Select | $45.12 | ↓ -63% |
| AVMED | EXCHANGE | $45.12 | ↓ -63% |
| CIGNA | Individual Family Plan | $48.32 | ↓ -60% |
| Clarity Health | All Products | $51.35 | ↓ -58% |
| Three Rivers | All Products | $51.35 | ↓ -58% |
| The Legacy Companies | All Products | $51.35 | ↓ -58% |
| Magellan | Pinnacle | $58.20 | ↓ -52% |
| AVMED | BROAD | $58.28 | ↓ -52% |
| CIGNA | SUREFIT | $58.28 | ↓ -52% |
| Consociate Health | ALL PRODUCTS | $59.25 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $59.78 | ↓ -51% |
| AETNA | ALL PRODUCTS | $66.93 | ↓ -45% |
| National Provider Network | All Products | $67.15 | ↓ -45% |
| Aetna | All Products First Health | $71.10 | ↓ -42% |
| BMI | ALL PRODUCTS | $94.00 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $112.80 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $122.20 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $122.20 | ↑ +0% |
| MULTIPLAN | ALL PRODUCTS | $150.40 | ↑ +23% |
| AETNA | All Products First Health | $150.40 | ↑ +23% |
| DEVOTED HEALTH | Medicare Advantage HMO | not published by hospital | — |
| BLUE CROSS | Medicare Advantage PPO | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| AETNA | Managed Medicaid/CHIP | not published by hospital | — |
| WellMed | MEDICARE ADVANTAGE | not published by hospital | — |
| Carelon BH Strategies | Managed Medicaid | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| SUNSHINE HEALTH | Managed Medicaid | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| Wellcare | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | Medicare Advantage HMO | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| MOLINA | Managed Medicaid | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| Molina | Florida Kidcare | not published by hospital | — |
| Freedom Health | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| AVMED | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| Careplus | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIHEALTH | Managed Medicaid | not published by hospital | — |
| OPTUM | Managed Medicaid | not published by hospital | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | not published by hospital | — |
| Independent Living Systems | Managed Medicaid | not published by hospital | — |
| MOLINA | Florida KidCare | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 1) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $122.20 | $5.59 – $159.80 |
| martin north hospital | Stuart | $122.20 | $6.99 – $94.00 |
| Baptist Hospital | MIAMI | $360.75 | $7.79 – $173.17 |
| Bethesda Hospital East | BOYNTON BEACH | $439.40 | $10.31 – $101.71 |
| Boca Raton Regional Hospital | BOCA RATON | $945.75 | $132.44 – $403.00 |
| Doctors Hospital | CORAL GABLES | $360.75 | $28.35 – $145.80 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $439.40 | $7.83 – $40.50 |
| Fishermens Community Hospital | MARATHON | $439.40 | $84.50 – $455.40 |