Ghs simple repair 12.6 - 20.0 cm - 12005 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$974.35
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.
$1,499.00
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.
$64.56 with Optum vs $4,542.00 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 | $64.56 | ↓ -93% |
| Blue Cross | Health Options | $99.92 | ↓ -90% |
| United | Medicare Advantage | $100.90 | ↓ -90% |
| Avmed | Medicare Advantage | $102.11 | ↓ -90% |
| Wellcare | Medicare Advantage | $102.11 | ↓ -90% |
| Value Options | Medicare Advantage | $102.11 | ↓ -90% |
| Magellan | Medicare Advantage | $102.11 | ↓ -90% |
| Careplus | Medicare Advantage | $102.11 | ↓ -90% |
| Blue Cross | Medicare Advantage PPO | $102.11 | ↓ -90% |
| Blue Cross | Medicare Advantage HMO | $102.11 | ↓ -90% |
| Blue Cross | Network Blue | $102.38 | ↓ -89% |
| Blue Cross | Traditional (PPS) | $104.84 | ↓ -89% |
| Blue Cross | Perferred Patient Care | $104.84 | ↓ -89% |
| Independent Living Systems | Medicare Advantage | $105.95 | ↓ -89% |
| WellMed | Medicare Advantage | $107.22 | ↓ -89% |
| Freedom Health | Medicare Advantage | $107.22 | ↓ -89% |
| Clear Spring Health | All Products | $110.28 | ↓ -89% |
| OPTUM | Managed Medicaid | $115.89 | ↓ -88% |
| Molina | Florida Kidcare | $121.99 | ↓ -87% |
| Wellcare | Managed Medicaid | $121.99 | ↓ -87% |
| AMERIHEALTH | Managed Medicaid | $121.99 | ↓ -87% |
| Carelon BH Strategies | Managed Medicaid | $121.99 | ↓ -87% |
| MOLINA | Florida KidCare | $121.99 | ↓ -87% |
| Medicaid | Managed Medicaid | $121.99 | ↓ -87% |
| SUNSHINE HEALTH | Managed Medicaid | $121.99 | ↓ -87% |
| Aetna | Medicare Advantage Behavioral Health | $122.53 | ↓ -87% |
| Clear Spring Health | ALL PRODUCTS | $125.50 | ↓ -87% |
| Aetna | Medicare Advantage PCP | $126.62 | ↓ -87% |
| MOLINA | Managed Medicaid | $128.09 | ↓ -87% |
| Aetna | Medicare Advantage Specialist | $128.66 | ↓ -87% |
| AETNA | Managed Medicaid/CHIP | $134.19 | ↓ -86% |
| AmeriHealth | Managed Medicaid | $135.58 | ↓ -86% |
| Value Options | Managed Medicaid | $135.58 | ↓ -86% |
| Molina | Managed Medicaid | $135.58 | ↓ -86% |
| Avmed | Exchange | $135.76 | ↓ -86% |
| Avmed | Select | $140.98 | ↓ -86% |
| Independent Living Systems | Managed Medicaid | $146.39 | ↓ -85% |
| Aetna | POS First Health | $150.62 | ↓ -85% |
| Avmed | Broad | $151.42 | ↓ -84% |
| United | All Products | $197.59 | ↓ -80% |
| Cigna | Individual Family Plan Mid-Level | $217.67 | ↓ -78% |
| Cigna | Surefit Mid-Level | $221.84 | ↓ -77% |
| Cigna | All Products Mid-Level | $239.56 | ↓ -75% |
| Aetna | PPO First Health | $253.60 | ↓ -74% |
| Cigna | Individual Family Plan Physician | $256.08 | ↓ -74% |
| Cigna | Surefit Physician | $260.98 | ↓ -73% |
| Cigna | All Products Physician | $281.83 | ↓ -71% |
| CIGNA | Individual Family Plan | $385.24 | ↓ -60% |
| UNITED | MEDICARE ADVANTAGE | $401.04 | ↓ -59% |
| Freedom Health | MEDICARE ADVANTAGE | $401.04 | ↓ -59% |
| BLUE CROSS | Medicare Advantage HMO | $401.04 | ↓ -59% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $401.04 | ↓ -59% |
| Careplus | MEDICARE ADVANTAGE | $401.04 | ↓ -59% |
| HUMANA | Medicare Advantage HMO | $401.04 | ↓ -59% |
| BLUE CROSS | Medicare Advantage PPO | $401.04 | ↓ -59% |
| AVMED | MEDICARE ADVANTAGE | $417.08 | ↓ -57% |
| Independent Living Systems | MEDICARE ADVANTAGE | $421.09 | ↓ -57% |
| WellMed | MEDICARE ADVANTAGE | $424.52 | ↓ -56% |
| AETNA | MEDICARE ADVANTAGE | $424.52 | ↓ -56% |
| Wellcare | MEDICARE ADVANTAGE | $424.52 | ↓ -56% |
| CIGNA | SUREFIT | $464.69 | ↓ -52% |
| DEVOTED HEALTH | Medicare Advantage HMO | $466.97 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $476.68 | ↓ -51% |
| AETNA | QHP | $554.00 | ↓ -43% |
| Three Rivers | All Products | $563.55 | ↓ -42% |
| Clarity Health | All Products | $563.55 | ↓ -42% |
| The Legacy Companies | All Products | $563.55 | ↓ -42% |
| AVMED | EXCHANGE | $629.63 | ↓ -35% |
| Consociate Health | ALL PRODUCTS | $650.25 | ↓ -33% |
| AVMED | Select | $705.83 | ↓ -28% |
| National Provider Network | All Products | $736.95 | ↓ -24% |
| BMI | ALL PRODUCTS | $749.50 | ↓ -23% |
| Aetna | All Products First Health | $780.30 | ↓ -20% |
| UNITED | NHP | $850.00 | ↓ -13% |
| MAGELLAN | ALL PRODUCTS | $899.40 | ↓ -8% |
| AVMED | BROAD | $918.38 | ↓ -6% |
| The Legacy Companies | ALL PRODUCTS | $974.35 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $974.35 | ↑ +0% |
| UNITED | ALL PRODUCTS | $1,151.00 | ↑ +18% |
| UNITED | International | $1,151.00 | ↑ +18% |
| MULTIPLAN | ALL PRODUCTS | $1,199.20 | ↑ +23% |
| AETNA | All Products First Health | $1,199.20 | ↑ +23% |
| BLUE CROSS | BSL | $2,467.00 | ↑ +153% |
| BLUE CROSS | HMO | $2,467.00 | ↑ +153% |
| BLUE CROSS | NWB | $3,264.00 | ↑ +235% |
| BLUE CROSS | NWBI | $3,264.00 | ↑ +235% |
| BLUE CROSS | PHS | $4,027.00 | ↑ +313% |
| BLUE CROSS | PPO | $4,027.00 | ↑ +313% |
| AETNA | ALL PRODUCTS | $4,542.00 | ↑ +366% |
| Magellan | Summit | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 12.6 - 20.0 cm - 12005 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $1,225.93 | $403.29 – $708.52 |
| Adventhealth Lake Wales | Lake Wales | $1,225.93 | $424.52 – $942.42 |
| Adventhealth Palm Coast Parkway | Palm Coast | $1,225.93 | $403.29 – $906.72 |
| Adventhealth Tampa | Tampa | $2,827.66 | $424.52 – $942.42 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $926.37 | $403.29 – $927.35 |
| Adventhealth Port Charlotte | Port Charlotte | $2,092.66 | $424.52 – $775.16 |
| cleveland clinic florida weston hospital | Weston | $974.35 | $64.56 – $1,274.15 |
| martin north hospital | Stuart | $974.35 | $83.54 – $749.50 |