Fine needle aspiration biopsy without img gdn; ea addtl 10004 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$208.00
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.
?
What you pay up front if you don't use insurance.
$320.00
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.
$33.48 with Optum vs $516.71 with Independent Living Systems — 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 | $33.48 | ↓ -84% |
| Blue Cross | Medicare Advantage PPO | $40.53 | ↓ -81% |
| Blue Cross | Medicare Advantage HMO | $40.53 | ↓ -81% |
| Value Options | Medicare Advantage | $40.53 | ↓ -81% |
| Wellcare | Medicare Advantage | $40.53 | ↓ -81% |
| Careplus | Medicare Advantage | $40.53 | ↓ -81% |
| Magellan | Medicare Advantage | $40.53 | ↓ -81% |
| Avmed | Medicare Advantage | $40.53 | ↓ -81% |
| Value Options | Managed Medicaid | $40.85 | ↓ -80% |
| Wellcare | Managed Medicaid | $40.85 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $40.85 | ↓ -80% |
| Molina | Managed Medicaid | $40.85 | ↓ -80% |
| Medicaid | Managed Medicaid | $40.85 | ↓ -80% |
| WellMed | Medicare Advantage | $42.56 | ↓ -80% |
| Freedom Health | Medicare Advantage | $42.56 | ↓ -80% |
| Independent Living Systems | Medicare Advantage | $42.56 | ↓ -80% |
| Clear Spring Health | All Products | $43.77 | ↓ -79% |
| United | Medicare Advantage | $45.26 | ↓ -78% |
| Aetna | Medicare Advantage Behavioral Health | $48.64 | ↓ -77% |
| Aetna | Medicare Advantage PCP | $50.26 | ↓ -76% |
| Aetna | Medicare Advantage Specialist | $51.07 | ↓ -75% |
| Avmed | Exchange | $60.13 | ↓ -71% |
| Avmed | Select | $62.44 | ↓ -70% |
| Avmed | Broad | $67.06 | ↓ -68% |
| Aetna | POS First Health | $68.97 | ↓ -67% |
| Cigna | Individual Family Plan Mid-Level | $69.03 | ↓ -67% |
| Cigna | Surefit Mid-Level | $70.35 | ↓ -66% |
| Cigna | All Products Mid-Level | $75.97 | ↓ -63% |
| Cigna | Individual Family Plan Physician | $81.21 | ↓ -61% |
| Aetna | PPO First Health | $81.44 | ↓ -61% |
| Cigna | Surefit Physician | $82.77 | ↓ -60% |
| United | All Products | $87.51 | ↓ -58% |
| Cigna | All Products Physician | $89.38 | ↓ -57% |
| The Legacy Companies | All Products | $208.00 | ↑ +0% |
| Clarity Health | All Products | $208.00 | ↑ +0% |
| Three Rivers | All Products | $208.00 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $240.00 | ↑ +15% |
| National Provider Network | All Products | $272.00 | ↑ +31% |
| Aetna | All Products First Health | $288.00 | ↑ +38% |
| OPTUM | Managed Medicaid | $409.06 | ↑ +97% |
| Carelon BH Strategies | Managed Medicaid | $430.59 | ↑ +107% |
| Molina | Florida Kidcare | $430.59 | ↑ +107% |
| SUNSHINE HEALTH | Managed Medicaid | $430.59 | ↑ +107% |
| AMERIHEALTH | Managed Medicaid | $430.59 | ↑ +107% |
| MOLINA | Florida KidCare | $430.59 | ↑ +107% |
| MOLINA | Managed Medicaid | $452.12 | ↑ +117% |
| AETNA | Managed Medicaid/CHIP | $473.65 | ↑ +128% |
| Independent Living Systems | Managed Medicaid | $516.71 | ↑ +148% |
| Blue Cross | Health Options | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
Visitor-reported prices
Comments
Fine needle aspiration biopsy without img gdn; ea addtl 10004 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $826.15 | $33.48 – $1,682.00 |
| martin north hospital | Stuart | $826.15 | $40.53 – $1,529.00 |
| Baptist Hospital | MIAMI | $339.30 | $90.31 – $469.80 |
| Bethesda Hospital East | BOYNTON BEACH | $339.30 | $147.20 – $522.00 |
| Doctors Hospital | CORAL GABLES | $339.30 | $91.35 – $469.80 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $339.30 | $90.83 – $469.80 |
| Homestead Hospital | HOMESTEAD | $339.30 | $88.74 – $469.80 |
| West Kendall Baptist Hospital | MIAMI | $339.30 | $89.26 – $469.80 |