Exc skn hdrdnt ax smpl/ntrm at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$837.20
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.
$1,288.00
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.
$127.89 with Optum vs $6,578.87 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 | $127.89 | ↓ -85% |
| Blue Cross | Health Options | $231.69 | ↓ -72% |
| Blue Cross | Network Blue | $237.38 | ↓ -72% |
| Blue Cross | Traditional (PPS) | $243.08 | ↓ -71% |
| Blue Cross | Perferred Patient Care | $243.08 | ↓ -71% |
| Magellan | Medicare Advantage | $277.29 | ↓ -67% |
| Wellcare | Medicare Advantage | $277.29 | ↓ -67% |
| Value Options | Medicare Advantage | $277.29 | ↓ -67% |
| Avmed | Medicare Advantage | $277.29 | ↓ -67% |
| Blue Cross | Medicare Advantage HMO | $277.29 | ↓ -67% |
| Blue Cross | Medicare Advantage PPO | $277.29 | ↓ -67% |
| Careplus | Medicare Advantage | $277.29 | ↓ -67% |
| United | Medicare Advantage | $277.34 | ↓ -67% |
| WellMed | Medicare Advantage | $291.15 | ↓ -65% |
| Independent Living Systems | Medicare Advantage | $291.15 | ↓ -65% |
| Freedom Health | Medicare Advantage | $291.15 | ↓ -65% |
| Clear Spring Health | All Products | $299.47 | ↓ -64% |
| Wellcare | Managed Medicaid | $328.35 | ↓ -61% |
| Medicaid | Managed Medicaid | $328.35 | ↓ -61% |
| Molina | Managed Medicaid | $328.35 | ↓ -61% |
| Value Options | Managed Medicaid | $328.35 | ↓ -61% |
| AmeriHealth | Managed Medicaid | $328.35 | ↓ -61% |
| Aetna | Medicare Advantage Behavioral Health | $332.75 | ↓ -60% |
| Aetna | Medicare Advantage PCP | $343.84 | ↓ -59% |
| Aetna | Medicare Advantage Specialist | $349.39 | ↓ -58% |
| Avmed | Exchange | $367.90 | ↓ -56% |
| Avmed | Select | $382.05 | ↓ -54% |
| Aetna | POS First Health | $407.88 | ↓ -51% |
| Avmed | Broad | $410.35 | ↓ -51% |
| Cigna | Individual Family Plan Mid-Level | $504.26 | ↓ -40% |
| Cigna | Surefit Mid-Level | $513.92 | ↓ -39% |
| United | All Products | $535.46 | ↓ -36% |
| Cigna | All Products Mid-Level | $554.97 | ↓ -34% |
| Cigna | Individual Family Plan Physician | $593.25 | ↓ -29% |
| Cigna | Surefit Physician | $604.60 | ↓ -28% |
| Aetna | PPO First Health | $611.75 | ↓ -27% |
| Cigna | All Products Physician | $652.90 | ↓ -22% |
| Three Rivers | All Products | $837.20 | ↑ +0% |
| The Legacy Companies | All Products | $837.20 | ↑ +0% |
| Clarity Health | All Products | $837.20 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $966.00 | ↑ +15% |
| National Provider Network | All Products | $1,094.80 | ↑ +31% |
| OPTUM | Managed Medicaid | $1,113.47 | ↑ +33% |
| Aetna | All Products First Health | $1,159.20 | ↑ +38% |
| MOLINA | Florida KidCare | $1,172.07 | ↑ +40% |
| AMERIHEALTH | Managed Medicaid | $1,172.07 | ↑ +40% |
| Carelon BH Strategies | Managed Medicaid | $1,172.07 | ↑ +40% |
| Molina | Florida Kidcare | $1,172.07 | ↑ +40% |
| SUNSHINE HEALTH | Managed Medicaid | $1,172.07 | ↑ +40% |
| MOLINA | Managed Medicaid | $1,230.67 | ↑ +47% |
| AETNA | Managed Medicaid/CHIP | $1,289.28 | ↑ +54% |
| Independent Living Systems | Managed Medicaid | $1,406.48 | ↑ +68% |
| Freedom Health | MEDICARE ADVANTAGE | $2,872.87 | ↑ +243% |
| Careplus | MEDICARE ADVANTAGE | $2,872.87 | ↑ +243% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $2,872.87 | ↑ +243% |
| BLUE CROSS | Medicare Advantage PPO | $2,872.87 | ↑ +243% |
| BLUE CROSS | Medicare Advantage HMO | $2,872.87 | ↑ +243% |
| UNITED | MEDICARE ADVANTAGE | $2,872.87 | ↑ +243% |
| HUMANA | Medicare Advantage HMO | $2,872.87 | ↑ +243% |
| AVMED | MEDICARE ADVANTAGE | $2,987.78 | ↑ +257% |
| Independent Living Systems | MEDICARE ADVANTAGE | $3,016.51 | ↑ +260% |
| AETNA | MEDICARE ADVANTAGE | $3,033.33 | ↑ +262% |
| WellMed | MEDICARE ADVANTAGE | $3,033.33 | ↑ +262% |
| Wellcare | MEDICARE ADVANTAGE | $3,033.33 | ↑ +262% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,336.67 | ↑ +299% |
| AVMED | EXCHANGE | $4,510.40 | ↑ +439% |
| AVMED | Select | $5,056.25 | ↑ +504% |
| AVMED | BROAD | $6,578.87 | ↑ +686% |
| Magellan | Pinnacle | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
Visitor-reported prices
Comments
Exc skn hdrdnt ax smpl/ntrm at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Port Charlotte | Port Charlotte | $6,154.89 | $3,033.33 – $5,538.87 |
| cleveland clinic florida weston hospital | Weston | $837.20 | $127.89 – $3,336.67 |
| martin north hospital | Stuart | $837.20 | $193.70 – $3,336.67 |
| Baptist Hospital | MIAMI | $6,162.65 | $173.17 – $4,266.00 |
| Bethesda Hospital East | BOYNTON BEACH | $6,162.65 | $952.74 – $4,266.00 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $3,081.00 | $824.76 – $4,266.00 |
| AdventHealth Orlando | Orlando | $7,905.00 | $3,033.33 – $8,038.33 |
| Adventhealth Carrollwood | Tampa | $8,626.82 | $537.00 – $6,734.00 |