Exc subq tum/sft tis/pel/hip 3cm/> 27043 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$1,788.80
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.
$2,752.00
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.
$257.95 with Optum vs $6,578.87 with AVMED — 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 | $257.95 | ↓ -86% |
| Medicaid | Managed Medicaid | $366.14 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $366.14 | ↓ -80% |
| Wellcare | Managed Medicaid | $366.14 | ↓ -80% |
| Molina | Managed Medicaid | $366.14 | ↓ -80% |
| Value Options | Managed Medicaid | $366.14 | ↓ -80% |
| Blue Cross | Health Options | $445.29 | ↓ -75% |
| Blue Cross | Network Blue | $456.24 | ↓ -74% |
| Blue Cross | Traditional (PPS) | $467.19 | ↓ -74% |
| Blue Cross | Perferred Patient Care | $467.19 | ↓ -74% |
| Careplus | Medicare Advantage | $503.22 | ↓ -72% |
| Value Options | Medicare Advantage | $503.22 | ↓ -72% |
| Wellcare | Medicare Advantage | $503.22 | ↓ -72% |
| Avmed | Medicare Advantage | $503.22 | ↓ -72% |
| Blue Cross | Medicare Advantage HMO | $503.22 | ↓ -72% |
| Magellan | Medicare Advantage | $503.22 | ↓ -72% |
| Blue Cross | Medicare Advantage PPO | $503.22 | ↓ -72% |
| United | Medicare Advantage | $504.32 | ↓ -72% |
| WellMed | Medicare Advantage | $528.38 | ↓ -70% |
| Freedom Health | Medicare Advantage | $528.38 | ↓ -70% |
| Independent Living Systems | Medicare Advantage | $528.38 | ↓ -70% |
| Clear Spring Health | All Products | $543.48 | ↓ -70% |
| Aetna | Medicare Advantage Behavioral Health | $603.86 | ↓ -66% |
| Aetna | Medicare Advantage PCP | $623.99 | ↓ -65% |
| Aetna | Medicare Advantage Specialist | $634.06 | ↓ -65% |
| Avmed | Exchange | $670.27 | ↓ -63% |
| Avmed | Select | $696.05 | ↓ -61% |
| Avmed | Broad | $747.61 | ↓ -58% |
| Aetna | PPO First Health | $763.29 | ↓ -57% |
| United | All Products | $975.55 | ↓ -45% |
| OPTUM | Managed Medicaid | $1,112.95 | ↓ -38% |
| SUNSHINE HEALTH | Managed Medicaid | $1,171.53 | ↓ -35% |
| AMERIHEALTH | Managed Medicaid | $1,171.53 | ↓ -35% |
| MOLINA | Florida KidCare | $1,171.53 | ↓ -35% |
| Molina | Florida Kidcare | $1,171.53 | ↓ -35% |
| Carelon BH Strategies | Managed Medicaid | $1,171.53 | ↓ -35% |
| MOLINA | Managed Medicaid | $1,230.11 | ↓ -31% |
| Aetna | POS First Health | $1,238.40 | ↓ -31% |
| AETNA | Managed Medicaid/CHIP | $1,288.68 | ↓ -28% |
| Independent Living Systems | Managed Medicaid | $1,405.84 | ↓ -21% |
| The Legacy Companies | All Products | $1,788.80 | ↑ +0% |
| Clarity Health | All Products | $1,788.80 | ↑ +0% |
| Three Rivers | All Products | $1,788.80 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $2,064.00 | ↑ +15% |
| National Provider Network | All Products | $2,339.20 | ↑ +31% |
| Aetna | All Products First Health | $2,476.80 | ↑ +38% |
| Cigna | Individual Family Plan Physician | $2,752.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $2,752.00 | ↑ +54% |
| Cigna | All Products Physician | $2,752.00 | ↑ +54% |
| Cigna | Surefit Physician | $2,752.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $2,752.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $2,752.00 | ↑ +54% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $2,872.87 | ↑ +61% |
| Freedom Health | MEDICARE ADVANTAGE | $2,872.87 | ↑ +61% |
| HUMANA | Medicare Advantage HMO | $2,872.87 | ↑ +61% |
| Careplus | MEDICARE ADVANTAGE | $2,872.87 | ↑ +61% |
| UNITED | MEDICARE ADVANTAGE | $2,872.87 | ↑ +61% |
| BLUE CROSS | Medicare Advantage PPO | $2,872.87 | ↑ +61% |
| BLUE CROSS | Medicare Advantage HMO | $2,872.87 | ↑ +61% |
| AVMED | MEDICARE ADVANTAGE | $2,987.78 | ↑ +67% |
| Independent Living Systems | MEDICARE ADVANTAGE | $3,016.51 | ↑ +69% |
| WellMed | MEDICARE ADVANTAGE | $3,033.33 | ↑ +70% |
| AETNA | MEDICARE ADVANTAGE | $3,033.33 | ↑ +70% |
| Wellcare | MEDICARE ADVANTAGE | $3,033.33 | ↑ +70% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,336.67 | ↑ +87% |
| BLUE CROSS | BSL | $4,383.00 | ↑ +145% |
| AVMED | EXCHANGE | $4,510.40 | ↑ +152% |
| AVMED | Select | $5,056.25 | ↑ +183% |
| AVMED | BROAD | $6,578.87 | ↑ +268% |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
Visitor-reported prices
Comments
Exc subq tum/sft tis/pel/hip 3cm/> 27043 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $1,788.80 | $257.95 – $3,336.67 |
| martin north hospital | Stuart | $10,696.40 | $366.14 – $8,228.00 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $2,881.67 – $5,062.63 |
| Adventhealth Lake Wales | Lake Wales | not published | $3,033.33 – $6,734.00 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $2,881.67 – $6,478.90 |
| Adventhealth Tampa | Tampa | not published | $3,033.33 – $6,734.00 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $2,881.67 – $6,626.32 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $1,057.63 – $1,079.89 |