healthcosts.net
Lumbar Spinal Fusion (single level) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$6,729.45
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.
$10,353.00
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.
$1,113.94 with Optum vs $42,272.40 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 | $1,113.94 | ↓ -83% |
| Value Options | Managed Medicaid | $1,226.32 | ↓ -82% |
| Medicaid | Managed Medicaid | $1,226.32 | ↓ -82% |
| Molina | Managed Medicaid | $1,226.32 | ↓ -82% |
| Wellcare | Managed Medicaid | $1,226.32 | ↓ -82% |
| AmeriHealth | Managed Medicaid | $1,226.32 | ↓ -82% |
| Blue Cross | Health Options | $1,530.62 | ↓ -77% |
| Blue Cross | Network Blue | $1,568.26 | ↓ -77% |
| Blue Cross | Traditional (PPS) | $1,605.89 | ↓ -76% |
| Blue Cross | Perferred Patient Care | $1,605.89 | ↓ -76% |
| Avmed | Medicare Advantage | $1,660.78 | ↓ -75% |
| Value Options | Medicare Advantage | $1,660.78 | ↓ -75% |
| Magellan | Medicare Advantage | $1,660.78 | ↓ -75% |
| Careplus | Medicare Advantage | $1,660.78 | ↓ -75% |
| Wellcare | Medicare Advantage | $1,660.78 | ↓ -75% |
| Blue Cross | Medicare Advantage PPO | $1,660.78 | ↓ -75% |
| Blue Cross | Medicare Advantage HMO | $1,660.78 | ↓ -75% |
| United | Medicare Advantage | $1,717.83 | ↓ -74% |
| Independent Living Systems | Medicare Advantage | $1,743.82 | ↓ -74% |
| Freedom Health | Medicare Advantage | $1,743.82 | ↓ -74% |
| WellMed | Medicare Advantage | $1,743.82 | ↓ -74% |
| Clear Spring Health | All Products | $1,793.64 | ↓ -73% |
| Aetna | Medicare Advantage Behavioral Health | $1,992.94 | ↓ -70% |
| Aetna | Medicare Advantage PCP | $2,059.37 | ↓ -69% |
| Aetna | Medicare Advantage Specialist | $2,092.58 | ↓ -69% |
| Avmed | Exchange | $2,291.12 | ↓ -66% |
| Avmed | Select | $2,379.24 | ↓ -65% |
| Avmed | Broad | $2,555.48 | ↓ -62% |
| Aetna | PPO First Health | $2,640.00 | ↓ -61% |
| United | All Products | $3,334.64 | ↓ -50% |
| Aetna | POS First Health | $4,658.85 | ↓ -31% |
| OPTUM | Managed Medicaid | $6,141.85 | ↓ -9% |
| MOLINA | Florida KidCare | $6,465.10 | ↓ -4% |
| AMERIHEALTH | Managed Medicaid | $6,465.10 | ↓ -4% |
| Molina | Florida Kidcare | $6,465.10 | ↓ -4% |
| SUNSHINE HEALTH | Managed Medicaid | $6,465.10 | ↓ -4% |
| Carelon BH Strategies | Managed Medicaid | $6,465.10 | ↓ -4% |
| Clarity Health | All Products | $6,729.45 | ↑ +0% |
| Three Rivers | All Products | $6,729.45 | ↑ +0% |
| The Legacy Companies | All Products | $6,729.45 | ↑ +0% |
| MOLINA | Managed Medicaid | $6,788.36 | ↑ +1% |
| AETNA | Managed Medicaid/CHIP | $7,111.61 | ↑ +6% |
| Independent Living Systems | Managed Medicaid | $7,758.12 | ↑ +15% |
| Consociate Health | ALL PRODUCTS | $7,764.75 | ↑ +15% |
| National Provider Network | All Products | $8,800.05 | ↑ +31% |
| Aetna | All Products First Health | $9,317.70 | ↑ +38% |
| Cigna | Individual Family Plan Mid-Level | $10,353.00 | ↑ +54% |
| Cigna | Surefit Physician | $10,353.00 | ↑ +54% |
| Cigna | All Products Physician | $10,353.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $10,353.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $10,353.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $10,353.00 | ↑ +54% |
| Wellcare | MEDICARE ADVANTAGE | $18,310.20 | ↑ +172% |
| AETNA | MEDICARE ADVANTAGE | $18,310.20 | ↑ +172% |
| WellMed | MEDICARE ADVANTAGE | $18,310.20 | ↑ +172% |
| UNITED | MEDICARE ADVANTAGE | $18,459.56 | ↑ +174% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $18,459.56 | ↑ +174% |
| Careplus | MEDICARE ADVANTAGE | $18,459.56 | ↑ +174% |
| Freedom Health | MEDICARE ADVANTAGE | $18,459.56 | ↑ +174% |
| BLUE CROSS | Medicare Advantage HMO | $18,459.56 | ↑ +174% |
| HUMANA | Medicare Advantage HMO | $18,459.56 | ↑ +174% |
| BLUE CROSS | Medicare Advantage PPO | $18,459.56 | ↑ +174% |
| AVMED | MEDICARE ADVANTAGE | $19,197.95 | ↑ +185% |
| Independent Living Systems | MEDICARE ADVANTAGE | $19,382.54 | ↑ +188% |
| DEVOTED HEALTH | Medicare Advantage HMO | $20,141.22 | ↑ +199% |
| AVMED | EXCHANGE | $28,981.52 | ↑ +331% |
| AVMED | Select | $32,488.83 | ↑ +383% |
| AVMED | BROAD | $42,272.40 | ↑ +528% |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
Visitor-reported prices
Comments
Lumbar Spinal Fusion (single level) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $6,729.45 | $1,113.94 – $20,141.22 |
| martin north hospital | Stuart | $6,729.45 | $1,226.32 – $20,141.22 |
| Baptist Hospital | MIAMI | not published | not published |
| Bethesda Hospital East | BOYNTON BEACH | not published | not published |
| Boca Raton Regional Hospital | BOCA RATON | not published | not published |
| Baptist Health Hospital Doral | SOUTH MIAMI | not published | not published |