Interrog evl pm/ldls pm ip at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$174.20
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.
$268.00
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.
$21.15 with OPTUM vs $1,880.00 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 | $21.15 | ↓ -88% |
| Medicaid | Managed Medicaid | $22.26 | ↓ -87% |
| Molina | Florida Kidcare | $22.26 | ↓ -87% |
| AMERIHEALTH | Managed Medicaid | $22.26 | ↓ -87% |
| SUNSHINE HEALTH | Managed Medicaid | $22.26 | ↓ -87% |
| Wellcare | Managed Medicaid | $22.26 | ↓ -87% |
| Carelon BH Strategies | Managed Medicaid | $22.26 | ↓ -87% |
| MOLINA | Florida KidCare | $22.26 | ↓ -87% |
| MOLINA | Managed Medicaid | $23.37 | ↓ -87% |
| AETNA | Managed Medicaid/CHIP | $24.49 | ↓ -86% |
| Independent Living Systems | Managed Medicaid | $26.71 | ↓ -85% |
| Optum | Managed Medicaid | $31.73 | ↓ -82% |
| Blue Cross | Health Options | $34.52 | ↓ -80% |
| Blue Cross | Network Blue | $35.37 | ↓ -80% |
| Blue Cross | Traditional (PPS) | $36.22 | ↓ -79% |
| Blue Cross | Perferred Patient Care | $36.22 | ↓ -79% |
| Freedom Health | MEDICARE ADVANTAGE | $37.43 | ↓ -79% |
| BLUE CROSS | Medicare Advantage HMO | $37.43 | ↓ -79% |
| BLUE CROSS | Medicare Advantage PPO | $37.43 | ↓ -79% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $37.43 | ↓ -79% |
| HUMANA | Medicare Advantage HMO | $37.43 | ↓ -79% |
| Careplus | MEDICARE ADVANTAGE | $37.43 | ↓ -79% |
| UNITED | MEDICARE ADVANTAGE | $37.43 | ↓ -79% |
| AVMED | MEDICARE ADVANTAGE | $38.93 | ↓ -78% |
| AETNA | MEDICARE ADVANTAGE | $38.97 | ↓ -78% |
| WellMed | MEDICARE ADVANTAGE | $38.97 | ↓ -78% |
| Wellcare | MEDICARE ADVANTAGE | $38.97 | ↓ -78% |
| Independent Living Systems | MEDICARE ADVANTAGE | $39.30 | ↓ -77% |
| Molina | Managed Medicaid | $41.60 | ↓ -76% |
| AmeriHealth | Managed Medicaid | $41.60 | ↓ -76% |
| Value Options | Managed Medicaid | $41.60 | ↓ -76% |
| DEVOTED HEALTH | Medicare Advantage HMO | $42.87 | ↓ -75% |
| United | Medicare Advantage | $54.12 | ↓ -69% |
| Wellcare | Medicare Advantage | $56.80 | ↓ -67% |
| Value Options | Medicare Advantage | $56.80 | ↓ -67% |
| Magellan | Medicare Advantage | $56.80 | ↓ -67% |
| Blue Cross | Medicare Advantage HMO | $56.80 | ↓ -67% |
| Blue Cross | Medicare Advantage PPO | $56.80 | ↓ -67% |
| Avmed | Medicare Advantage | $56.80 | ↓ -67% |
| Careplus | Medicare Advantage | $56.80 | ↓ -67% |
| Independent Living Systems | Medicare Advantage | $56.83 | ↓ -67% |
| AVMED | EXCHANGE | $58.77 | ↓ -66% |
| Freedom Health | Medicare Advantage | $59.64 | ↓ -66% |
| WellMed | Medicare Advantage | $59.64 | ↓ -66% |
| Clear Spring Health | All Products | $61.34 | ↓ -65% |
| AETNA | QHP | $62.71 | ↓ -64% |
| AVMED | Select | $65.88 | ↓ -62% |
| Aetna | PPO First Health | $65.95 | ↓ -62% |
| Aetna | Medicare Advantage Behavioral Health | $68.16 | ↓ -61% |
| CIGNA | Individual Family Plan | $68.88 | ↓ -60% |
| Aetna | Medicare Advantage PCP | $70.43 | ↓ -60% |
| Aetna | Medicare Advantage Specialist | $71.57 | ↓ -59% |
| Avmed | Exchange | $73.26 | ↓ -58% |
| Avmed | Select | $76.07 | ↓ -56% |
| Aetna | POS First Health | $77.40 | ↓ -56% |
| Clear Spring Health | ALL PRODUCTS | $80.67 | ↓ -54% |
| Avmed | Broad | $81.71 | ↓ -53% |
| CIGNA | SUREFIT | $83.08 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $85.22 | ↓ -51% |
| AVMED | BROAD | $85.72 | ↓ -51% |
| AETNA | ALL PRODUCTS | $95.41 | ↓ -45% |
| United | All Products | $97.96 | ↓ -44% |
| The Legacy Companies | All Products | $111.80 | ↓ -36% |
| Clarity Health | All Products | $111.80 | ↓ -36% |
| Three Rivers | All Products | $111.80 | ↓ -36% |
| Consociate Health | ALL PRODUCTS | $129.00 | ↓ -26% |
| BMI | ALL PRODUCTS | $134.00 | ↓ -23% |
| National Provider Network | All Products | $146.20 | ↓ -16% |
| Aetna | All Products First Health | $154.80 | ↓ -11% |
| MAGELLAN | ALL PRODUCTS | $160.80 | ↓ -8% |
| Cigna | Surefit Physician | $172.00 | ↓ -1% |
| Cigna | All Products Mid-Level | $172.00 | ↓ -1% |
| Cigna | Surefit Mid-Level | $172.00 | ↓ -1% |
| Cigna | Individual Family Plan Physician | $172.00 | ↓ -1% |
| Cigna | All Products Physician | $172.00 | ↓ -1% |
| Cigna | Individual Family Plan Mid-Level | $172.00 | ↓ -1% |
| The Legacy Companies | ALL PRODUCTS | $174.20 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $174.20 | ↑ +0% |
| AETNA | All Products First Health | $214.40 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $214.40 | ↑ +23% |
| UNITED | NHP | $1,105.00 | ↑ +534% |
| UNITED | International | $1,428.00 | ↑ +720% |
| UNITED | ALL PRODUCTS | $1,428.00 | ↑ +720% |
| BLUE CROSS | HMO | $1,474.00 | ↑ +746% |
| BLUE CROSS | BSL | $1,474.00 | ↑ +746% |
| BLUE CROSS | NWB | $1,780.00 | ↑ +922% |
| BLUE CROSS | NWBI | $1,780.00 | ↑ +922% |
| BLUE CROSS | PPO | $1,880.00 | ↑ +979% |
| BLUE CROSS | PHS | $1,880.00 | ↑ +979% |
| Magellan | Summit | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | Medical Rental | 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 PCP | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
Visitor-reported prices
Comments
Interrog evl pm/ldls pm ip at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $110.17 | not published |
| Adventhealth Palm Coast Parkway | Palm Coast | $110.52 | $37.03 – $83.24 |
| Adventhealth Tampa | Tampa | $461.09 | not published |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $87.46 | not published |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $131.00 | $28.50 – $29.10 |
| Adventhealth Port Charlotte | Port Charlotte | $461.09 | not published |
| cleveland clinic florida weston hospital | Weston | $286.00 | $14.21 – $227.80 |
| martin north hospital | Stuart | $286.00 | $16.15 – $172.00 |