Knee arthroscopy dx at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$12,126.40
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.
$18,656.00
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.
$199.23 with Optum vs $14,924.80 with MULTIPLAN — 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 | $199.23 | ↓ -98% |
| Blue Cross | Health Options | $384.46 | ↓ -97% |
| Blue Cross | Network Blue | $393.91 | ↓ -97% |
| Blue Cross | Perferred Patient Care | $403.37 | ↓ -97% |
| Blue Cross | Traditional (PPS) | $403.37 | ↓ -97% |
| Magellan | Medicare Advantage | $432.31 | ↓ -96% |
| Value Options | Medicare Advantage | $432.31 | ↓ -96% |
| Avmed | Medicare Advantage | $432.31 | ↓ -96% |
| Blue Cross | Medicare Advantage HMO | $432.31 | ↓ -96% |
| Wellcare | Medicare Advantage | $432.31 | ↓ -96% |
| Careplus | Medicare Advantage | $432.31 | ↓ -96% |
| Blue Cross | Medicare Advantage PPO | $432.31 | ↓ -96% |
| Value Options | Managed Medicaid | $433.03 | ↓ -96% |
| AmeriHealth | Managed Medicaid | $433.03 | ↓ -96% |
| Molina | Managed Medicaid | $433.03 | ↓ -96% |
| Wellcare | Managed Medicaid | $433.03 | ↓ -96% |
| Medicaid | Managed Medicaid | $433.03 | ↓ -96% |
| United | Medicare Advantage | $437.47 | ↓ -96% |
| WellMed | Medicare Advantage | $453.93 | ↓ -96% |
| Freedom Health | Medicare Advantage | $453.93 | ↓ -96% |
| Independent Living Systems | Medicare Advantage | $453.93 | ↓ -96% |
| Clear Spring Health | All Products | $466.89 | ↓ -96% |
| Aetna | Medicare Advantage Behavioral Health | $518.77 | ↓ -96% |
| Clear Spring Health | ALL PRODUCTS | $528.38 | ↓ -96% |
| Aetna | Medicare Advantage PCP | $536.06 | ↓ -96% |
| Aetna | Medicare Advantage Specialist | $544.71 | ↓ -96% |
| Avmed | Exchange | $576.42 | ↓ -95% |
| Avmed | Select | $598.59 | ↓ -95% |
| Avmed | Broad | $642.93 | ↓ -95% |
| Aetna | POS First Health | $650.08 | ↓ -95% |
| United | All Products | $838.96 | ↓ -93% |
| Cigna | Individual Family Plan Mid-Level | $846.47 | ↓ -93% |
| Cigna | Surefit Mid-Level | $862.69 | ↓ -93% |
| Aetna | PPO First Health | $892.45 | ↓ -93% |
| Cigna | All Products Mid-Level | $931.59 | ↓ -92% |
| Cigna | Individual Family Plan Physician | $995.90 | ↓ -92% |
| Cigna | Surefit Physician | $1,014.93 | ↓ -92% |
| Cigna | All Products Physician | $1,096.10 | ↓ -91% |
| OPTUM | Managed Medicaid | $1,311.27 | ↓ -89% |
| AMERIHEALTH | Managed Medicaid | $1,380.28 | ↓ -89% |
| Molina | Florida Kidcare | $1,380.28 | ↓ -89% |
| SUNSHINE HEALTH | Managed Medicaid | $1,380.28 | ↓ -89% |
| Carelon BH Strategies | Managed Medicaid | $1,380.28 | ↓ -89% |
| MOLINA | Florida KidCare | $1,380.28 | ↓ -89% |
| MOLINA | Managed Medicaid | $1,449.29 | ↓ -88% |
| Three Rivers | All Products | $1,484.60 | ↓ -88% |
| Clarity Health | All Products | $1,484.60 | ↓ -88% |
| The Legacy Companies | All Products | $1,484.60 | ↓ -88% |
| AETNA | Managed Medicaid/CHIP | $1,518.31 | ↓ -87% |
| Independent Living Systems | Managed Medicaid | $1,656.34 | ↓ -86% |
| Consociate Health | ALL PRODUCTS | $1,713.00 | ↓ -86% |
| National Provider Network | All Products | $1,941.40 | ↓ -84% |
| Aetna | All Products First Health | $2,055.60 | ↓ -83% |
| BLUE CROSS | Medicare Advantage HMO | $3,256.87 | ↓ -73% |
| Freedom Health | MEDICARE ADVANTAGE | $3,256.87 | ↓ -73% |
| UNITED | MEDICARE ADVANTAGE | $3,256.87 | ↓ -73% |
| HUMANA | Medicare Advantage HMO | $3,256.87 | ↓ -73% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $3,256.87 | ↓ -73% |
| BLUE CROSS | Medicare Advantage PPO | $3,256.87 | ↓ -73% |
| Careplus | MEDICARE ADVANTAGE | $3,256.87 | ↓ -73% |
| AVMED | MEDICARE ADVANTAGE | $3,387.15 | ↓ -72% |
| AETNA | MEDICARE ADVANTAGE | $3,416.88 | ↓ -72% |
| Wellcare | MEDICARE ADVANTAGE | $3,416.88 | ↓ -72% |
| WellMed | MEDICARE ADVANTAGE | $3,416.88 | ↓ -72% |
| Independent Living Systems | MEDICARE ADVANTAGE | $3,419.72 | ↓ -72% |
| DEVOTED HEALTH | Medicare Advantage HMO | $3,758.57 | ↓ -69% |
| CIGNA | Individual Family Plan | $4,794.59 | ↓ -60% |
| AVMED | EXCHANGE | $5,113.29 | ↓ -58% |
| AVMED | Select | $5,732.10 | ↓ -53% |
| CIGNA | SUREFIT | $5,783.36 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $5,932.61 | ↓ -51% |
| AVMED | BROAD | $7,458.24 | ↓ -38% |
| AETNA | QHP | $8,015.00 | ↓ -34% |
| BMI | ALL PRODUCTS | $9,328.00 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $11,193.60 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $12,126.40 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $12,126.40 | ↑ +0% |
| AETNA | ALL PRODUCTS | $12,985.00 | ↑ +7% |
| AETNA | All Products First Health | $14,924.80 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $14,924.80 | ↑ +23% |
| Consociate Health | Transplant | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
Visitor-reported prices
Comments
Knee arthroscopy dx at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $1,484.60 | $199.23 – $3,758.57 |
| martin north hospital | Stuart | $1,484.60 | $321.43 – $3,758.57 |
| AdventHealth Orlando | Orlando | $12,781.00 | $3,416.88 – $9,054.74 |
| Adventhealth Carrollwood | Tampa | $31,045.79 | $614.00 – $7,585.48 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,246.04 – $5,702.77 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $3,246.04 – $7,298.12 |
| Adventhealth Tampa | Tampa | not published | $614.00 – $7,585.48 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $3,246.04 – $7,464.18 |