Ghs simple repair 7.6 - 12.5 cm - 12004 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$484.25
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.
$745.00
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.
$37.35 with Optum vs $4,027.00 with BLUE CROSS — 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 | $37.35 | ↓ -92% |
| Blue Cross | Health Options | $74.85 | ↓ -85% |
| Blue Cross | Network Blue | $76.69 | ↓ -84% |
| United | Medicare Advantage | $77.78 | ↓ -84% |
| Blue Cross | Traditional (PPS) | $78.53 | ↓ -84% |
| Blue Cross | Perferred Patient Care | $78.53 | ↓ -84% |
| Blue Cross | Medicare Advantage PPO | $81.64 | ↓ -83% |
| Wellcare | Medicare Advantage | $81.64 | ↓ -83% |
| Value Options | Medicare Advantage | $81.64 | ↓ -83% |
| Careplus | Medicare Advantage | $81.64 | ↓ -83% |
| Avmed | Medicare Advantage | $81.64 | ↓ -83% |
| Magellan | Medicare Advantage | $81.64 | ↓ -83% |
| Blue Cross | Medicare Advantage HMO | $81.64 | ↓ -83% |
| Independent Living Systems | Medicare Advantage | $81.67 | ↓ -83% |
| Freedom Health | Medicare Advantage | $85.72 | ↓ -82% |
| WellMed | Medicare Advantage | $85.72 | ↓ -82% |
| Clear Spring Health | All Products | $88.17 | ↓ -82% |
| Aetna | Medicare Advantage Behavioral Health | $97.97 | ↓ -80% |
| Clear Spring Health | ALL PRODUCTS | $98.83 | ↓ -80% |
| Aetna | Medicare Advantage PCP | $101.23 | ↓ -79% |
| Wellcare | Managed Medicaid | $101.87 | ↓ -79% |
| AmeriHealth | Managed Medicaid | $101.87 | ↓ -79% |
| Molina | Managed Medicaid | $101.87 | ↓ -79% |
| Value Options | Managed Medicaid | $101.87 | ↓ -79% |
| Medicaid | Managed Medicaid | $101.87 | ↓ -79% |
| Aetna | Medicare Advantage Specialist | $102.87 | ↓ -79% |
| Avmed | Exchange | $104.82 | ↓ -78% |
| Avmed | Select | $108.85 | ↓ -78% |
| Aetna | POS First Health | $115.48 | ↓ -76% |
| OPTUM | Managed Medicaid | $115.89 | ↓ -76% |
| Avmed | Broad | $116.91 | ↓ -76% |
| Molina | Florida Kidcare | $121.99 | ↓ -75% |
| Carelon BH Strategies | Managed Medicaid | $121.99 | ↓ -75% |
| AMERIHEALTH | Managed Medicaid | $121.99 | ↓ -75% |
| MOLINA | Florida KidCare | $121.99 | ↓ -75% |
| SUNSHINE HEALTH | Managed Medicaid | $121.99 | ↓ -75% |
| MOLINA | Managed Medicaid | $128.09 | ↓ -74% |
| AETNA | Managed Medicaid/CHIP | $134.19 | ↓ -72% |
| Cigna | Individual Family Plan Mid-Level | $143.34 | ↓ -70% |
| Cigna | Surefit Mid-Level | $146.07 | ↓ -70% |
| Independent Living Systems | Managed Medicaid | $146.39 | ↓ -70% |
| United | All Products | $152.56 | ↓ -68% |
| Cigna | All Products Mid-Level | $157.77 | ↓ -67% |
| Cigna | Individual Family Plan Physician | $168.64 | ↓ -65% |
| Cigna | Surefit Physician | $171.87 | ↓ -65% |
| AETNA | QHP | $174.33 | ↓ -64% |
| Cigna | All Products Physician | $185.61 | ↓ -62% |
| CIGNA | Individual Family Plan | $191.47 | ↓ -60% |
| Aetna | PPO First Health | $194.52 | ↓ -60% |
| UNITED | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| HUMANA | Medicare Advantage HMO | $199.45 | ↓ -59% |
| Careplus | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| BLUE CROSS | Medicare Advantage PPO | $199.45 | ↓ -59% |
| Freedom Health | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| BLUE CROSS | Medicare Advantage HMO | $199.45 | ↓ -59% |
| AVMED | MEDICARE ADVANTAGE | $207.43 | ↓ -57% |
| Independent Living Systems | MEDICARE ADVANTAGE | $209.42 | ↓ -57% |
| WellMed | MEDICARE ADVANTAGE | $209.52 | ↓ -57% |
| AETNA | MEDICARE ADVANTAGE | $209.52 | ↓ -57% |
| Wellcare | MEDICARE ADVANTAGE | $209.52 | ↓ -57% |
| DEVOTED HEALTH | Medicare Advantage HMO | $230.47 | ↓ -52% |
| CIGNA | SUREFIT | $230.95 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $236.91 | ↓ -51% |
| AETNA | ALL PRODUCTS | $265.22 | ↓ -45% |
| AVMED | EXCHANGE | $313.14 | ↓ -35% |
| AVMED | Select | $351.03 | ↓ -28% |
| BMI | ALL PRODUCTS | $372.50 | ↓ -23% |
| Three Rivers | All Products | $412.10 | ↓ -15% |
| Clarity Health | All Products | $412.10 | ↓ -15% |
| The Legacy Companies | All Products | $412.10 | ↓ -15% |
| MAGELLAN | ALL PRODUCTS | $447.00 | ↓ -8% |
| AVMED | BROAD | $456.74 | ↓ -6% |
| Consociate Health | ALL PRODUCTS | $475.50 | ↓ -2% |
| Clarity Health | ALL PRODUCTS | $484.25 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $484.25 | ↑ +0% |
| National Provider Network | All Products | $538.90 | ↑ +11% |
| Aetna | All Products First Health | $570.60 | ↑ +18% |
| MULTIPLAN | ALL PRODUCTS | $596.00 | ↑ +23% |
| AETNA | All Products First Health | $596.00 | ↑ +23% |
| UNITED | NHP | $850.00 | ↑ +76% |
| UNITED | ALL PRODUCTS | $1,151.00 | ↑ +138% |
| UNITED | International | $1,151.00 | ↑ +138% |
| BLUE CROSS | BSL | $2,467.00 | ↑ +409% |
| BLUE CROSS | HMO | $2,467.00 | ↑ +409% |
| BLUE CROSS | NWB | $3,264.00 | ↑ +574% |
| BLUE CROSS | NWBI | $3,264.00 | ↑ +574% |
| BLUE CROSS | PHS | $4,027.00 | ↑ +732% |
| BLUE CROSS | PPO | $4,027.00 | ↑ +732% |
| Magellan | Pinnacle | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 7.6 - 12.5 cm - 12004 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $636.93 | $199.04 – $349.69 |
| Adventhealth Lake Wales | Lake Wales | $636.93 | $209.52 – $465.13 |
| Adventhealth Palm Coast Parkway | Palm Coast | $636.93 | $199.04 – $447.51 |
| Adventhealth Tampa | Tampa | $2,198.18 | $209.52 – $465.13 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $720.14 | $199.04 – $457.69 |
| Adventhealth Port Charlotte | Port Charlotte | $1,230.98 | $209.52 – $382.58 |
| cleveland clinic florida weston hospital | Weston | $484.25 | $37.35 – $633.25 |
| martin north hospital | Stuart | $484.25 | $62.58 – $475.50 |