Factor ix at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$107.90
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.
$166.00
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.
$12.26 with OPTUM vs $132.80 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 |
|---|---|---|---|
| OPTUM | Managed Medicaid | $12.26 | ↓ -89% |
| MOLINA | Florida KidCare | $12.90 | ↓ -88% |
| Carelon BH Strategies | Managed Medicaid | $12.90 | ↓ -88% |
| Molina | Florida Kidcare | $12.90 | ↓ -88% |
| Wellcare | Managed Medicaid | $12.90 | ↓ -88% |
| AMERIHEALTH | Managed Medicaid | $12.90 | ↓ -88% |
| SUNSHINE HEALTH | Managed Medicaid | $12.90 | ↓ -88% |
| Medicaid | Managed Medicaid | $12.90 | ↓ -88% |
| MOLINA | Managed Medicaid | $13.55 | ↓ -87% |
| AETNA | Managed Medicaid/CHIP | $14.19 | ↓ -87% |
| Independent Living Systems | Managed Medicaid | $15.48 | ↓ -86% |
| Freedom Health | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| WellMed | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| AETNA | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| Wellcare | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| UNITED | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| BLUE CROSS | Medicare Advantage HMO | $19.04 | ↓ -82% |
| BLUE CROSS | Medicare Advantage PPO | $19.04 | ↓ -82% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| Careplus | MEDICARE ADVANTAGE | $19.04 | ↓ -82% |
| HUMANA | Medicare Advantage HMO | $19.04 | ↓ -82% |
| AVMED | MEDICARE ADVANTAGE | $19.80 | ↓ -82% |
| Independent Living Systems | MEDICARE ADVANTAGE | $19.99 | ↓ -81% |
| DEVOTED HEALTH | Medicare Advantage HMO | $20.94 | ↓ -81% |
| CIGNA | Individual Family Plan | $35.18 | ↓ -67% |
| AETNA | QHP | $38.84 | ↓ -64% |
| AVMED | EXCHANGE | $39.84 | ↓ -63% |
| AVMED | Select | $39.84 | ↓ -63% |
| CIGNA | SUREFIT | $42.59 | ↓ -61% |
| CIGNA | ALL PRODUCTS | $44.53 | ↓ -59% |
| AVMED | BROAD | $51.46 | ↓ -52% |
| AETNA | ALL PRODUCTS | $59.10 | ↓ -45% |
| BMI | ALL PRODUCTS | $83.00 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $99.60 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $107.90 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $107.90 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $124.50 | ↑ +15% |
| MULTIPLAN | ALL PRODUCTS | $132.80 | ↑ +23% |
| AETNA | All Products First Health | $132.80 | ↑ +23% |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Clear Spring Health | ALL PRODUCTS | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
Visitor-reported prices
Comments
Factor ix at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $68.40 | $18.09 – $31.78 |
| Adventhealth Lake Wales | Lake Wales | $59.98 | $19.04 – $42.27 |
| Adventhealth Palm Coast Parkway | Palm Coast | $69.85 | $18.09 – $40.67 |
| Adventhealth Tampa | Tampa | $94.52 | $19.04 – $42.27 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $61.91 | $18.09 – $41.59 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $386.00 | $15.23 – $181.37 |
| Adventhealth Port Charlotte | Port Charlotte | $119.70 | $19.04 – $34.77 |
| cleveland clinic florida weston hospital | Weston | $109.85 | $12.26 – $141.10 |