Inj, spesolimab-sbzo, 1 mg at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
not published by hospital
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.
not published by hospital
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.
$61.43 with Carelon BH Strategies vs $18,253.82 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 |
|---|---|---|---|
| Carelon BH Strategies | MEDICARE ADVANTAGE | $61.43 | — |
| BLUE CROSS | Medicare Advantage HMO | $61.43 | — |
| UNITED | MEDICARE ADVANTAGE | $61.43 | — |
| Careplus | MEDICARE ADVANTAGE | $61.43 | — |
| BLUE CROSS | Medicare Advantage PPO | $61.43 | — |
| HUMANA | Medicare Advantage HMO | $61.43 | — |
| Freedom Health | MEDICARE ADVANTAGE | $61.43 | — |
| AVMED | MEDICARE ADVANTAGE | $63.89 | — |
| Independent Living Systems | MEDICARE ADVANTAGE | $64.50 | — |
| WellMed | MEDICARE ADVANTAGE | $65.72 | — |
| AETNA | MEDICARE ADVANTAGE | $65.72 | — |
| Wellcare | MEDICARE ADVANTAGE | $65.72 | — |
| AETNA | ALL PRODUCTS | $71.70 | — |
| DEVOTED HEALTH | Medicare Advantage HMO | $72.29 | — |
| AVMED | EXCHANGE | $96.45 | — |
| AVMED | Select | $108.12 | — |
| CIGNA | Individual Family Plan | $109.26 | — |
| BLUE CROSS | NWB | $124.89 | — |
| BLUE CROSS | NWBI | $124.89 | — |
| BLUE CROSS | PHS | $124.89 | — |
| BLUE CROSS | PPO | $124.89 | — |
| BLUE CROSS | BSL | $124.89 | — |
| BLUE CROSS | HMO | $124.89 | — |
| CIGNA | SUREFIT | $132.20 | — |
| CIGNA | ALL PRODUCTS | $138.16 | — |
| AVMED | BROAD | $140.67 | — |
| OPTUM | Managed Medicaid | $14,450.94 | — |
| AMERIHEALTH | Managed Medicaid | $15,211.52 | — |
| Molina | Florida Kidcare | $15,211.52 | — |
| MOLINA | Florida KidCare | $15,211.52 | — |
| Wellcare | Managed Medicaid | $15,211.52 | — |
| Carelon BH Strategies | Managed Medicaid | $15,211.52 | — |
| Medicaid | Managed Medicaid | $15,211.52 | — |
| SUNSHINE HEALTH | Managed Medicaid | $15,211.52 | — |
| MOLINA | Managed Medicaid | $15,972.10 | — |
| AETNA | Managed Medicaid/CHIP | $16,732.67 | — |
| Independent Living Systems | Managed Medicaid | $18,253.82 | — |
Visitor-reported prices
Comments
Inj, spesolimab-sbzo, 1 mg at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $130,649.82 | not published |
| Adventhealth Palm Coast Parkway | Palm Coast | $273,155.32 | not published |
| Adventhealth Tampa | Tampa | $420,318.10 | not published |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $240,622.71 | not published |
| Adventhealth Palm Coast | Palm Coast | $273,155.32 | not published |
| Adventhealth Waterman | Tavares | $412,055.72 | not published |
| AdventHealth Orlando | Orlando | $255,588.84 | not published |
| Adventhealth Zephyrhills | Zephyrhills | $792,082.77 | not published |