Ghs moderate sedation, > 5 yr, 30 min, other at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$474.50
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.
$730.00
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.
$13.94 with OPTUM vs $660.00 with Cigna — 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 | $13.94 | ↓ -97% |
| AMERIHEALTH | Managed Medicaid | $14.67 | ↓ -97% |
| Molina | Florida Kidcare | $14.67 | ↓ -97% |
| MOLINA | Florida KidCare | $14.67 | ↓ -97% |
| Wellcare | Managed Medicaid | $14.67 | ↓ -97% |
| SUNSHINE HEALTH | Managed Medicaid | $14.67 | ↓ -97% |
| Carelon BH Strategies | Managed Medicaid | $14.67 | ↓ -97% |
| Medicaid | Managed Medicaid | $14.67 | ↓ -97% |
| MOLINA | Managed Medicaid | $15.40 | ↓ -97% |
| AETNA | Managed Medicaid/CHIP | $16.14 | ↓ -97% |
| Independent Living Systems | Managed Medicaid | $17.60 | ↓ -96% |
| Molina | Managed Medicaid | $56.17 | ↓ -88% |
| Value Options | Managed Medicaid | $56.17 | ↓ -88% |
| AmeriHealth | Managed Medicaid | $56.17 | ↓ -88% |
| Optum | Managed Medicaid | $57.60 | ↓ -88% |
| United | Medicare Advantage | $75.12 | ↓ -84% |
| Blue Cross | Medicare Advantage PPO | $76.78 | ↓ -84% |
| Wellcare | Medicare Advantage | $76.78 | ↓ -84% |
| Value Options | Medicare Advantage | $76.78 | ↓ -84% |
| Careplus | Medicare Advantage | $76.78 | ↓ -84% |
| Magellan | Medicare Advantage | $76.78 | ↓ -84% |
| Avmed | Medicare Advantage | $76.78 | ↓ -84% |
| Blue Cross | Medicare Advantage HMO | $76.78 | ↓ -84% |
| Independent Living Systems | Medicare Advantage | $78.88 | ↓ -83% |
| Freedom Health | Medicare Advantage | $80.62 | ↓ -83% |
| WellMed | Medicare Advantage | $80.62 | ↓ -83% |
| Clear Spring Health | All Products | $82.92 | ↓ -83% |
| Aetna | Medicare Advantage Behavioral Health | $92.14 | ↓ -81% |
| Aetna | Medicare Advantage PCP | $95.21 | ↓ -80% |
| Aetna | Medicare Advantage Specialist | $96.74 | ↓ -80% |
| Avmed | Exchange | $101.70 | ↓ -79% |
| Clear Spring Health | ALL PRODUCTS | $104.20 | ↓ -78% |
| Avmed | Select | $105.61 | ↓ -78% |
| Avmed | Broad | $113.43 | ↓ -76% |
| Aetna | PPO First Health | $121.54 | ↓ -74% |
| United | All Products | $135.99 | ↓ -71% |
| AETNA | QHP | $170.82 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $171.55 | ↓ -64% |
| AVMED | EXCHANGE | $175.20 | ↓ -63% |
| AVMED | Select | $175.20 | ↓ -63% |
| CIGNA | Individual Family Plan | $187.61 | ↓ -60% |
| AVMED | BROAD | $226.30 | ↓ -52% |
| CIGNA | SUREFIT | $226.30 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $232.14 | ↓ -51% |
| AETNA | ALL PRODUCTS | $259.88 | ↓ -45% |
| Aetna | POS First Health | $297.00 | ↓ -37% |
| BMI | ALL PRODUCTS | $365.00 | ↓ -23% |
| The Legacy Companies | All Products | $429.00 | ↓ -10% |
| Three Rivers | All Products | $429.00 | ↓ -10% |
| Clarity Health | All Products | $429.00 | ↓ -10% |
| MAGELLAN | ALL PRODUCTS | $438.00 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $474.50 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $474.50 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $495.00 | ↑ +4% |
| National Provider Network | All Products | $561.00 | ↑ +18% |
| AETNA | All Products First Health | $584.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $584.00 | ↑ +23% |
| Aetna | All Products First Health | $594.00 | ↑ +25% |
| Cigna | Surefit Mid-Level | $660.00 | ↑ +39% |
| Cigna | All Products Mid-Level | $660.00 | ↑ +39% |
| Cigna | All Products Physician | $660.00 | ↑ +39% |
| Cigna | Individual Family Plan Physician | $660.00 | ↑ +39% |
| Cigna | Individual Family Plan Mid-Level | $660.00 | ↑ +39% |
| Cigna | Surefit Physician | $660.00 | ↑ +39% |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
| BLUE CROSS | Medicare Advantage PPO | not published by hospital | — |
| BLUE CROSS | Medicare Advantage HMO | not published by hospital | — |
| WellMed | MEDICARE ADVANTAGE | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Blue Cross | Health Options | not published by hospital | — |
| AVMED | MEDICARE ADVANTAGE | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Wellcare | MEDICARE ADVANTAGE | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| DEVOTED HEALTH | Medicare Advantage HMO | not published by hospital | — |
| Freedom Health | MEDICARE ADVANTAGE | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| Careplus | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Ghs moderate sedation, > 5 yr, 30 min, other at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $286.81 | not published |
| Adventhealth Lake Wales | Lake Wales | $1,270.66 | not published |
| Adventhealth Palm Coast Parkway | Palm Coast | $348.43 | not published |
| Adventhealth Tampa | Tampa | $1,444.33 | not published |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $221.63 | not published |
| Adventhealth Port Charlotte | Port Charlotte | $543.14 | not published |
| cleveland clinic florida weston hospital | Weston | $474.50 | $13.94 – $660.00 |
| martin north hospital | Stuart | $474.50 | $14.67 – $660.00 |