Ins mark abd/pel for right perq at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$928.20
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.
$1,428.00
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.
$111.82 with Optum vs $3,145.16 with AVMED — 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 | $111.82 | ↓ -88% |
| Wellcare | Medicare Advantage | $169.27 | ↓ -82% |
| Careplus | Medicare Advantage | $169.27 | ↓ -82% |
| Blue Cross | Medicare Advantage PPO | $169.27 | ↓ -82% |
| Avmed | Medicare Advantage | $169.27 | ↓ -82% |
| Blue Cross | Medicare Advantage HMO | $169.27 | ↓ -82% |
| Magellan | Medicare Advantage | $169.27 | ↓ -82% |
| Value Options | Medicare Advantage | $169.27 | ↓ -82% |
| Freedom Health | Medicare Advantage | $177.73 | ↓ -81% |
| WellMed | Medicare Advantage | $177.73 | ↓ -81% |
| Independent Living Systems | Medicare Advantage | $177.73 | ↓ -81% |
| Blue Cross | Health Options | $178.66 | ↓ -81% |
| Clear Spring Health | All Products | $182.81 | ↓ -80% |
| Blue Cross | Network Blue | $183.05 | ↓ -80% |
| United | Medicare Advantage | $187.24 | ↓ -80% |
| Blue Cross | Traditional (PPS) | $187.45 | ↓ -80% |
| Blue Cross | Perferred Patient Care | $187.45 | ↓ -80% |
| Aetna | Medicare Advantage Behavioral Health | $203.12 | ↓ -78% |
| Aetna | Medicare Advantage PCP | $209.89 | ↓ -77% |
| Aetna | Medicare Advantage Specialist | $213.28 | ↓ -77% |
| Avmed | Exchange | $246.61 | ↓ -73% |
| Avmed | Select | $256.10 | ↓ -72% |
| Avmed | Broad | $275.07 | ↓ -70% |
| Aetna | POS First Health | $288.03 | ↓ -69% |
| United | All Products | $358.93 | ↓ -61% |
| Wellcare | Managed Medicaid | $362.56 | ↓ -61% |
| Value Options | Managed Medicaid | $362.56 | ↓ -61% |
| Medicaid | Managed Medicaid | $362.56 | ↓ -61% |
| Molina | Managed Medicaid | $362.56 | ↓ -61% |
| AmeriHealth | Managed Medicaid | $362.56 | ↓ -61% |
| OPTUM | Managed Medicaid | $635.48 | ↓ -32% |
| MOLINA | Florida KidCare | $668.93 | ↓ -28% |
| AMERIHEALTH | Managed Medicaid | $668.93 | ↓ -28% |
| Carelon BH Strategies | Managed Medicaid | $668.93 | ↓ -28% |
| Molina | Florida Kidcare | $668.93 | ↓ -28% |
| SUNSHINE HEALTH | Managed Medicaid | $668.93 | ↓ -28% |
| MOLINA | Managed Medicaid | $702.38 | ↓ -24% |
| Cigna | Individual Family Plan Mid-Level | $706.29 | ↓ -24% |
| Cigna | Surefit Mid-Level | $719.81 | ↓ -22% |
| Aetna | PPO First Health | $725.42 | ↓ -22% |
| AETNA | Managed Medicaid/CHIP | $735.82 | ↓ -21% |
| Cigna | All Products Mid-Level | $777.30 | ↓ -16% |
| Independent Living Systems | Managed Medicaid | $802.72 | ↓ -14% |
| Cigna | Individual Family Plan Physician | $830.92 | ↓ -10% |
| Cigna | Surefit Physician | $846.81 | ↓ -9% |
| Cigna | All Products Physician | $914.47 | ↓ -1% |
| Three Rivers | All Products | $928.20 | ↑ +0% |
| The Legacy Companies | All Products | $928.20 | ↑ +0% |
| Clarity Health | All Products | $928.20 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $1,071.00 | ↑ +15% |
| National Provider Network | All Products | $1,213.80 | ↑ +31% |
| Aetna | All Products First Health | $1,285.20 | ↑ +38% |
| Freedom Health | MEDICARE ADVANTAGE | $1,373.43 | ↑ +48% |
| HUMANA | Medicare Advantage HMO | $1,373.43 | ↑ +48% |
| BLUE CROSS | Medicare Advantage PPO | $1,373.43 | ↑ +48% |
| BLUE CROSS | Medicare Advantage HMO | $1,373.43 | ↑ +48% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $1,373.43 | ↑ +48% |
| UNITED | MEDICARE ADVANTAGE | $1,373.43 | ↑ +48% |
| Careplus | MEDICARE ADVANTAGE | $1,373.43 | ↑ +48% |
| AVMED | MEDICARE ADVANTAGE | $1,428.37 | ↑ +54% |
| Independent Living Systems | MEDICARE ADVANTAGE | $1,442.10 | ↑ +55% |
| Wellcare | MEDICARE ADVANTAGE | $1,445.42 | ↑ +56% |
| AETNA | MEDICARE ADVANTAGE | $1,445.42 | ↑ +56% |
| WellMed | MEDICARE ADVANTAGE | $1,445.42 | ↑ +56% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,589.96 | ↑ +71% |
| AVMED | EXCHANGE | $2,156.29 | ↑ +132% |
| AVMED | Select | $2,417.24 | ↑ +160% |
| AVMED | BROAD | $3,145.16 | ↑ +239% |
| 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 Anesthesia | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
Visitor-reported prices
Comments
Ins mark abd/pel for right perq at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $3,761.43 | $1,373.15 – $2,412.40 |
| Adventhealth Palm Coast Parkway | Palm Coast | $2,477.24 | not published |
| Adventhealth Tampa | Tampa | $451.26 | $1,445.42 – $3,208.83 |
| cleveland clinic florida weston hospital | Weston | $5,114.20 | $111.82 – $6,687.80 |
| martin north hospital | Stuart | $5,114.20 | $149.37 – $3,934.00 |
| Baptist Hospital | MIAMI | $4,835.35 | $173.17 – $6,695.10 |
| Bethesda Hospital East | BOYNTON BEACH | $4,835.35 | $670.86 – $6,695.10 |
| Boca Raton Regional Hospital | BOCA RATON | $4,436.90 | $1,419.46 – $4,707.00 |