Hopd mntl hlt, grp at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$72.15
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.
$111.00
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.
$25.97 with AETNA vs $183.42 with Independent Living Systems — 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 |
|---|---|---|---|
| AETNA | QHP | $25.97 | ↓ -64% |
| CIGNA | Individual Family Plan | $28.53 | ↓ -60% |
| HUMANA | Medicare Advantage HMO | $29.90 | ↓ -59% |
| Freedom Health | MEDICARE ADVANTAGE | $29.90 | ↓ -59% |
| UNITED | MEDICARE ADVANTAGE | $29.90 | ↓ -59% |
| BLUE CROSS | Medicare Advantage HMO | $29.90 | ↓ -59% |
| BLUE CROSS | Medicare Advantage PPO | $29.90 | ↓ -59% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $29.90 | ↓ -59% |
| Careplus | MEDICARE ADVANTAGE | $29.90 | ↓ -59% |
| AVMED | MEDICARE ADVANTAGE | $31.10 | ↓ -57% |
| Independent Living Systems | MEDICARE ADVANTAGE | $31.40 | ↓ -56% |
| CIGNA | SUREFIT | $34.41 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $35.30 | ↓ -51% |
| WellMed | MEDICARE ADVANTAGE | $39.13 | ↓ -46% |
| AETNA | MEDICARE ADVANTAGE | $39.13 | ↓ -46% |
| Wellcare | MEDICARE ADVANTAGE | $39.13 | ↓ -46% |
| AETNA | ALL PRODUCTS | $39.52 | ↓ -45% |
| DEVOTED HEALTH | Medicare Advantage HMO | $43.04 | ↓ -40% |
| AVMED | EXCHANGE | $46.95 | ↓ -35% |
| AVMED | Select | $52.63 | ↓ -27% |
| BMI | ALL PRODUCTS | $55.50 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $66.60 | ↓ -8% |
| AVMED | BROAD | $68.48 | ↓ -5% |
| The Legacy Companies | ALL PRODUCTS | $72.15 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $72.15 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $83.25 | ↑ +15% |
| MULTIPLAN | ALL PRODUCTS | $88.80 | ↑ +23% |
| AETNA | All Products First Health | $88.80 | ↑ +23% |
| OPTUM | Managed Medicaid | $145.21 | ↑ +101% |
| MOLINA | Florida KidCare | $152.85 | ↑ +112% |
| AMERIHEALTH | Managed Medicaid | $152.85 | ↑ +112% |
| Carelon BH Strategies | Managed Medicaid | $152.85 | ↑ +112% |
| Medicaid | Managed Medicaid | $152.85 | ↑ +112% |
| Molina | Florida Kidcare | $152.85 | ↑ +112% |
| SUNSHINE HEALTH | Managed Medicaid | $152.85 | ↑ +112% |
| Wellcare | Managed Medicaid | $152.85 | ↑ +112% |
| MOLINA | Managed Medicaid | $160.49 | ↑ +122% |
| AETNA | Managed Medicaid/CHIP | $168.14 | ↑ +133% |
| Independent Living Systems | Managed Medicaid | $183.42 | ↑ +154% |
| BLUE CROSS | NWBI | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| Clear Spring Health | ALL PRODUCTS | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
Visitor-reported prices
Comments
Hopd mntl hlt, grp at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $72.15 | $28.75 – $152.85 |
| martin north hospital | Stuart | $72.15 | $29.90 – $183.42 |