Fna bx w/mr gdn 1st les at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$783.90
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.
$1,206.00
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.
$96.76 with Wellcare vs $1,617.31 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 |
|---|---|---|---|
| Wellcare | Managed Medicaid | $96.76 | ↓ -88% |
| Value Options | Managed Medicaid | $96.76 | ↓ -88% |
| Molina | Managed Medicaid | $96.76 | ↓ -88% |
| AmeriHealth | Managed Medicaid | $96.76 | ↓ -88% |
| Medicaid | Managed Medicaid | $96.76 | ↓ -88% |
| OPTUM | Managed Medicaid | $409.06 | ↓ -48% |
| Carelon BH Strategies | Managed Medicaid | $430.59 | ↓ -45% |
| SUNSHINE HEALTH | Managed Medicaid | $430.59 | ↓ -45% |
| MOLINA | Florida KidCare | $430.59 | ↓ -45% |
| AMERIHEALTH | Managed Medicaid | $430.59 | ↓ -45% |
| Molina | Florida Kidcare | $430.59 | ↓ -45% |
| MOLINA | Managed Medicaid | $452.12 | ↓ -42% |
| AETNA | Managed Medicaid/CHIP | $473.65 | ↓ -40% |
| Independent Living Systems | Managed Medicaid | $516.71 | ↓ -34% |
| Aetna | POS First Health | $542.70 | ↓ -31% |
| Aetna | PPO First Health | $542.70 | ↓ -31% |
| BLUE CROSS | Medicare Advantage HMO | $706.25 | ↓ -10% |
| UNITED | MEDICARE ADVANTAGE | $706.25 | ↓ -10% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $706.25 | ↓ -10% |
| Freedom Health | MEDICARE ADVANTAGE | $706.25 | ↓ -10% |
| Careplus | MEDICARE ADVANTAGE | $706.25 | ↓ -10% |
| HUMANA | Medicare Advantage HMO | $706.25 | ↓ -10% |
| BLUE CROSS | Medicare Advantage PPO | $706.25 | ↓ -10% |
| Magellan | Medicare Advantage | $723.60 | ↓ -8% |
| AVMED | MEDICARE ADVANTAGE | $734.50 | ↓ -6% |
| WellMed | MEDICARE ADVANTAGE | $739.49 | ↓ -6% |
| AETNA | MEDICARE ADVANTAGE | $739.49 | ↓ -6% |
| Wellcare | MEDICARE ADVANTAGE | $739.49 | ↓ -6% |
| Independent Living Systems | MEDICARE ADVANTAGE | $741.56 | ↓ -5% |
| Three Rivers | All Products | $783.90 | ↑ +0% |
| The Legacy Companies | All Products | $783.90 | ↑ +0% |
| Clarity Health | All Products | $783.90 | ↑ +0% |
| United | All Products | $801.63 | ↑ +2% |
| DEVOTED HEALTH | Medicare Advantage HMO | $813.44 | ↑ +4% |
| Consociate Health | ALL PRODUCTS | $904.50 | ↑ +15% |
| National Provider Network | All Products | $1,025.10 | ↑ +31% |
| Aetna | All Products First Health | $1,085.40 | ↑ +38% |
| AVMED | EXCHANGE | $1,108.81 | ↑ +41% |
| Cigna | Individual Family Plan Physician | $1,206.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $1,206.00 | ↑ +54% |
| Cigna | Surefit Physician | $1,206.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $1,206.00 | ↑ +54% |
| Cigna | All Products Physician | $1,206.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $1,206.00 | ↑ +54% |
| AVMED | Select | $1,243.00 | ↑ +59% |
| AVMED | BROAD | $1,617.31 | ↑ +106% |
| Clear Spring Health | All Products | not published by hospital | — |
| Avmed | Select | not published by hospital | — |
| Independent Living Systems | Medicare Advantage | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| Avmed | Medicare Advantage | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Avmed | Exchange | not published by hospital | — |
| Avmed | Broad | not published by hospital | — |
| Aetna | Medicare Advantage Specialist | not published by hospital | — |
| Aetna | Medicare Advantage PCP | not published by hospital | — |
| Aetna | Medicare Advantage Behavioral Health | not published by hospital | — |
| Careplus | Medicare Advantage | not published by hospital | — |
| Optum | Managed Medicaid | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Blue Cross | Health Options | not published by hospital | — |
| Blue Cross | Medicare Advantage HMO | not published by hospital | — |
| Blue Cross | Medicare Advantage PPO | not published by hospital | — |
| United | Medicare Advantage | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Value Options | Medicare Advantage | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Wellcare | Medicare Advantage | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| WellMed | Medicare Advantage | not published by hospital | — |
| Freedom Health | Medicare Advantage | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
Visitor-reported prices
Comments
Fna bx w/mr gdn 1st les at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $2,629.90 | $96.76 – $3,439.10 |
| Baptist Hospital | MIAMI | $1,051.70 | $173.17 – $1,456.20 |
| Bethesda Hospital East | BOYNTON BEACH | $1,051.70 | $425.48 – $1,456.20 |
| Doctors Hospital | CORAL GABLES | $1,051.70 | $283.15 – $1,456.20 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $1,051.70 | $281.53 – $1,456.20 |
| Homestead Hospital | HOMESTEAD | $1,051.70 | $167.89 – $1,456.20 |
| West Kendall Baptist Hospital | MIAMI | $1,051.70 | $276.68 – $1,456.20 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $702.51 – $1,234.20 |