Established Patient Office Visit (level 5) 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.
$68.00 with Magellan vs $1,008.00 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 |
|---|---|---|---|
| Magellan | Summit | $68.00 | ↓ -91% |
| Optum | Managed Medicaid | $69.86 | ↓ -90% |
| AETNA | MEDICARE ADVANTAGE | $70.50 | ↓ -90% |
| AVMED | Select | $72.00 | ↓ -90% |
| AVMED | EXCHANGE | $72.00 | ↓ -90% |
| CIGNA | Individual Family Plan | $77.10 | ↓ -89% |
| Magellan | Pinnacle | $78.74 | ↓ -89% |
| AVMED | BROAD | $93.00 | ↓ -87% |
| CIGNA | SUREFIT | $93.00 | ↓ -87% |
| Wellcare | Managed Medicaid | $94.00 | ↓ -87% |
| Value Options | Managed Medicaid | $94.00 | ↓ -87% |
| Molina | Managed Medicaid | $94.00 | ↓ -87% |
| AmeriHealth | Managed Medicaid | $94.00 | ↓ -87% |
| Medicaid | Managed Medicaid | $94.00 | ↓ -87% |
| CIGNA | ALL PRODUCTS | $95.40 | ↓ -87% |
| Blue Cross | Health Options | $97.93 | ↓ -87% |
| Blue Cross | Network Blue | $100.34 | ↓ -86% |
| Blue Cross | Perferred Patient Care | $102.75 | ↓ -86% |
| Blue Cross | Traditional (PPS) | $102.75 | ↓ -86% |
| Value Options | All Products | $114.13 | ↓ -84% |
| Careplus | Medicare Advantage | $132.24 | ↓ -82% |
| Wellcare | Medicare Advantage | $132.24 | ↓ -82% |
| Value Options | Medicare Advantage | $132.24 | ↓ -82% |
| Avmed | Medicare Advantage | $132.24 | ↓ -82% |
| Magellan | Medicare Advantage | $132.24 | ↓ -82% |
| Blue Cross | Medicare Advantage HMO | $132.24 | ↓ -82% |
| Blue Cross | Medicare Advantage PPO | $132.24 | ↓ -82% |
| Freedom Health | Medicare Advantage | $138.85 | ↓ -81% |
| Independent Living Systems | Medicare Advantage | $138.85 | ↓ -81% |
| WellMed | Medicare Advantage | $138.85 | ↓ -81% |
| Clear Spring Health | All Products | $142.82 | ↓ -80% |
| United | Medicare Advantage | $143.91 | ↓ -80% |
| BMI | ALL PRODUCTS | $150.00 | ↓ -79% |
| AETNA | QHP | $158.00 | ↓ -78% |
| AETNA | ALL PRODUCTS | $158.00 | ↓ -78% |
| Aetna | Medicare Advantage Behavioral Health | $158.69 | ↓ -78% |
| Aetna | Medicare Advantage PCP | $163.98 | ↓ -77% |
| Aetna | Medicare Advantage Specialist | $166.62 | ↓ -77% |
| Aetna | POS First Health | $167.54 | ↓ -77% |
| Cigna | Individual Family Plan Mid-Level | $173.07 | ↓ -76% |
| Cigna | Surefit Mid-Level | $176.40 | ↓ -76% |
| MAGELLAN | ALL PRODUCTS | $180.00 | ↓ -75% |
| Clear Spring Health | ALL PRODUCTS | $184.50 | ↓ -75% |
| Cigna | All Products Mid-Level | $190.12 | ↓ -74% |
| Avmed | Exchange | $192.87 | ↓ -74% |
| Clarity Health | ALL PRODUCTS | $195.00 | ↓ -73% |
| The Legacy Companies | ALL PRODUCTS | $195.00 | ↓ -73% |
| Avmed | Select | $200.29 | ↓ -72% |
| Cigna | Individual Family Plan Physician | $203.61 | ↓ -72% |
| Cigna | Surefit Physician | $207.50 | ↓ -71% |
| Avmed | Broad | $215.12 | ↓ -70% |
| Aetna | PPO First Health | $217.98 | ↓ -70% |
| Cigna | All Products Physician | $223.67 | ↓ -69% |
| Consociate Health | ALL PRODUCTS | $225.00 | ↓ -69% |
| MULTIPLAN | ALL PRODUCTS | $240.00 | ↓ -67% |
| AETNA | All Products First Health | $240.00 | ↓ -67% |
| United | All Products | $250.82 | ↓ -66% |
| Clarity Health | All Products | $728.00 | ↑ +0% |
| Three Rivers | All Products | $728.00 | ↑ +0% |
| The Legacy Companies | All Products | $728.00 | ↑ +0% |
| National Provider Network | All Products | $952.00 | ↑ +31% |
| Aetna | All Products First Health | $1,008.00 | ↑ +38% |
| Molina | Florida Kidcare | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| MOLINA | Florida KidCare | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| AETNA | Managed Medicaid/CHIP | not published by hospital | — |
| OPTUM | Managed Medicaid | not published by hospital | — |
| SUNSHINE HEALTH | Managed Medicaid | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Wellcare | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| WellMed | MEDICARE ADVANTAGE | not published by hospital | — |
| MOLINA | Managed Medicaid | not published by hospital | — |
| Carelon BH Strategies | Managed Medicaid | not published by hospital | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| Careplus | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
| BLUE CROSS | Medicare Advantage PPO | not published by hospital | — |
| BLUE CROSS | Medicare Advantage HMO | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| DEVOTED HEALTH | Medicare Advantage HMO | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| Freedom Health | MEDICARE ADVANTAGE | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| Independent Living Systems | Managed Medicaid | not published by hospital | — |
| AVMED | MEDICARE ADVANTAGE | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| AMERIHEALTH | Managed Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $486.05 | not published |
| Adventhealth Lake Wales | Lake Wales | $828.10 | not published |
| Adventhealth Palm Coast Parkway | Palm Coast | $1,062.55 | not published |
| Adventhealth Tampa | Tampa | $951.11 | not published |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $637.55 | not published |
| Adventhealth Port Charlotte | Port Charlotte | $1,107.88 | not published |
| cleveland clinic florida weston hospital | Weston | $728.00 | $50.40 – $560.00 |
| martin north hospital | Stuart | $728.00 | $62.40 – $225.00 |