Ins/rpl prph sac/gstr npg/r at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$22,662.25
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.
$34,865.00
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.
$77.76 with Optum vs $49,293.28 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 | $77.76 | ↓ -100% |
| Blue Cross | Health Options | $151.66 | ↓ -99% |
| Blue Cross | Network Blue | $155.39 | ↓ -99% |
| Blue Cross | Traditional (PPS) | $159.12 | ↓ -99% |
| Blue Cross | Perferred Patient Care | $159.12 | ↓ -99% |
| Wellcare | Managed Medicaid | $241.98 | ↓ -99% |
| Medicaid | Managed Medicaid | $241.98 | ↓ -99% |
| AmeriHealth | Managed Medicaid | $241.98 | ↓ -99% |
| Value Options | Managed Medicaid | $241.98 | ↓ -99% |
| Molina | Managed Medicaid | $241.98 | ↓ -99% |
| Aetna | POS First Health | $252.71 | ↓ -99% |
| Magellan | Medicare Advantage | $289.00 | ↓ -99% |
| Avmed | Medicare Advantage | $289.00 | ↓ -99% |
| Value Options | Medicare Advantage | $289.00 | ↓ -99% |
| Blue Cross | Medicare Advantage PPO | $289.00 | ↓ -99% |
| Wellcare | Medicare Advantage | $289.00 | ↓ -99% |
| Careplus | Medicare Advantage | $289.00 | ↓ -99% |
| Blue Cross | Medicare Advantage HMO | $289.00 | ↓ -99% |
| WellMed | Medicare Advantage | $303.45 | ↓ -99% |
| Freedom Health | Medicare Advantage | $303.45 | ↓ -99% |
| Independent Living Systems | Medicare Advantage | $303.45 | ↓ -99% |
| United | Medicare Advantage | $304.40 | ↓ -99% |
| Clear Spring Health | All Products | $312.12 | ↓ -99% |
| Cigna | Individual Family Plan Mid-Level | $344.53 | ↓ -98% |
| Aetna | Medicare Advantage Behavioral Health | $346.80 | ↓ -98% |
| Cigna | Surefit Mid-Level | $351.12 | ↓ -98% |
| Aetna | Medicare Advantage PCP | $358.36 | ↓ -98% |
| Aetna | Medicare Advantage Specialist | $364.14 | ↓ -98% |
| Clear Spring Health | ALL PRODUCTS | $371.41 | ↓ -98% |
| Cigna | All Products Mid-Level | $379.21 | ↓ -98% |
| Cigna | Individual Family Plan Physician | $405.35 | ↓ -98% |
| Avmed | Exchange | $406.17 | ↓ -98% |
| Aetna | PPO First Health | $406.66 | ↓ -98% |
| Cigna | Surefit Physician | $413.10 | ↓ -98% |
| Avmed | Select | $421.79 | ↓ -98% |
| Cigna | All Products Physician | $446.14 | ↓ -98% |
| Avmed | Broad | $453.04 | ↓ -98% |
| United | All Products | $591.17 | ↓ -97% |
| Three Rivers | All Products | $1,458.60 | ↓ -94% |
| Clarity Health | All Products | $1,458.60 | ↓ -94% |
| The Legacy Companies | All Products | $1,458.60 | ↓ -94% |
| Consociate Health | ALL PRODUCTS | $1,683.00 | ↓ -93% |
| National Provider Network | All Products | $1,907.40 | ↓ -92% |
| Aetna | All Products First Health | $2,019.60 | ↓ -91% |
| AETNA | QHP | $2,789.00 | ↓ -88% |
| AETNA | ALL PRODUCTS | $4,542.00 | ↓ -80% |
| CIGNA | Individual Family Plan | $8,960.31 | ↓ -60% |
| CIGNA | SUREFIT | $10,808.15 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $11,087.07 | ↓ -51% |
| OPTUM | Managed Medicaid | $11,520.56 | ↓ -49% |
| Molina | Florida Kidcare | $12,126.91 | ↓ -46% |
| MOLINA | Florida KidCare | $12,126.91 | ↓ -46% |
| Carelon BH Strategies | Managed Medicaid | $12,126.91 | ↓ -46% |
| AMERIHEALTH | Managed Medicaid | $12,126.91 | ↓ -46% |
| SUNSHINE HEALTH | Managed Medicaid | $12,126.91 | ↓ -46% |
| MOLINA | Managed Medicaid | $12,733.26 | ↓ -44% |
| AETNA | Managed Medicaid/CHIP | $13,339.60 | ↓ -41% |
| Independent Living Systems | Managed Medicaid | $14,552.29 | ↓ -36% |
| BMI | ALL PRODUCTS | $17,432.50 | ↓ -23% |
| UNITED | NHP | $19,673.00 | ↓ -13% |
| AETNA | MEDICARE ADVANTAGE | $20,259.13 | ↓ -11% |
| Wellcare | MEDICARE ADVANTAGE | $20,259.13 | ↓ -11% |
| WellMed | MEDICARE ADVANTAGE | $20,259.13 | ↓ -11% |
| MAGELLAN | ALL PRODUCTS | $20,919.00 | ↓ -8% |
| Careplus | MEDICARE ADVANTAGE | $21,525.45 | ↓ -5% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $21,525.45 | ↓ -5% |
| HUMANA | Medicare Advantage HMO | $21,525.45 | ↓ -5% |
| UNITED | MEDICARE ADVANTAGE | $21,525.45 | ↓ -5% |
| BLUE CROSS | Medicare Advantage HMO | $21,525.45 | ↓ -5% |
| BLUE CROSS | Medicare Advantage PPO | $21,525.45 | ↓ -5% |
| Freedom Health | MEDICARE ADVANTAGE | $21,525.45 | ↓ -5% |
| DEVOTED HEALTH | Medicare Advantage HMO | $22,285.04 | ↓ -2% |
| AVMED | MEDICARE ADVANTAGE | $22,386.47 | ↓ -1% |
| Independent Living Systems | MEDICARE ADVANTAGE | $22,601.72 | ↓ -0% |
| Clarity Health | ALL PRODUCTS | $22,662.25 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $22,662.25 | ↑ +0% |
| UNITED | ALL PRODUCTS | $23,350.00 | ↑ +3% |
| UNITED | International | $25,633.00 | ↑ +13% |
| MULTIPLAN | ALL PRODUCTS | $27,892.00 | ↑ +23% |
| AETNA | All Products First Health | $27,892.00 | ↑ +23% |
| AVMED | EXCHANGE | $33,794.96 | ↑ +49% |
| AVMED | Select | $37,884.79 | ↑ +67% |
| AVMED | BROAD | $49,293.28 | ↑ +118% |
| BLUE CROSS | HMO | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rpl prph sac/gstr npg/r at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $22,662.25 | $77.76 – $29,635.25 |
| martin north hospital | Stuart | $22,662.25 | $126.80 – $22,386.47 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $19,246.18 – $33,812.49 |
| Adventhealth Lake Wales | Lake Wales | not published | $20,259.13 – $44,975.27 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $19,246.18 – $43,271.48 |
| Adventhealth Tampa | Tampa | not published | $537.00 – $44,975.27 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $1,588.12 – $1,621.55 |
| Baptist Hospital | MIAMI | not published | not published |