Mnt subs tx for change dx at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$128.70
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.
$198.00
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.
$6.16 with Aetna vs $198.00 with Cigna — 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 |
|---|---|---|---|
| Aetna | PPO First Health | $6.16 | ↓ -95% |
| Aetna | POS First Health | $21.59 | ↓ -83% |
| Blue Cross | Medicare Advantage PPO | $22.51 | ↓ -83% |
| Value Options | Medicare Advantage | $22.51 | ↓ -83% |
| Careplus | Medicare Advantage | $22.51 | ↓ -83% |
| Wellcare | Medicare Advantage | $22.51 | ↓ -83% |
| Avmed | Medicare Advantage | $22.51 | ↓ -83% |
| Magellan | Medicare Advantage | $22.51 | ↓ -83% |
| Blue Cross | Medicare Advantage HMO | $22.51 | ↓ -83% |
| Freedom Health | Medicare Advantage | $23.64 | ↓ -82% |
| Independent Living Systems | Medicare Advantage | $23.64 | ↓ -82% |
| WellMed | Medicare Advantage | $23.64 | ↓ -82% |
| Clear Spring Health | All Products | $24.31 | ↓ -81% |
| Blue Cross | Health Options | $24.83 | ↓ -81% |
| Blue Cross | Network Blue | $25.44 | ↓ -80% |
| Blue Cross | Perferred Patient Care | $26.05 | ↓ -80% |
| Blue Cross | Traditional (PPS) | $26.05 | ↓ -80% |
| United | Medicare Advantage | $26.75 | ↓ -79% |
| Aetna | Medicare Advantage Behavioral Health | $27.01 | ↓ -79% |
| Aetna | Medicare Advantage PCP | $27.91 | ↓ -78% |
| Aetna | Medicare Advantage Specialist | $28.36 | ↓ -78% |
| AETNA | NAP | $29.84 | ↓ -77% |
| WellMed | MEDICARE ADVANTAGE | $29.84 | ↓ -77% |
| Wellcare | MEDICARE ADVANTAGE | $29.84 | ↓ -77% |
| AETNA | QHP | $29.84 | ↓ -77% |
| AETNA | MEDICARE ADVANTAGE | $29.84 | ↓ -77% |
| Clear Spring Health | ALL PRODUCTS | $32.23 | ↓ -75% |
| DEVOTED HEALTH | Medicare Advantage HMO | $32.82 | ↓ -74% |
| Careplus | MEDICARE ADVANTAGE | $34.61 | ↓ -73% |
| BLUE CROSS | Medicare Advantage HMO | $34.61 | ↓ -73% |
| BLUE CROSS | Medicare Advantage PPO | $34.61 | ↓ -73% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $34.61 | ↓ -73% |
| UNITED | MEDICARE ADVANTAGE | $34.61 | ↓ -73% |
| Freedom Health | MEDICARE ADVANTAGE | $34.61 | ↓ -73% |
| HUMANA | Medicare Advantage HMO | $34.61 | ↓ -73% |
| Avmed | Exchange | $35.36 | ↓ -73% |
| AVMED | MEDICARE ADVANTAGE | $35.99 | ↓ -72% |
| Independent Living Systems | MEDICARE ADVANTAGE | $36.34 | ↓ -72% |
| Avmed | Select | $36.72 | ↓ -71% |
| Avmed | Broad | $39.44 | ↓ -69% |
| United | All Products | $47.28 | ↓ -63% |
| CIGNA | Individual Family Plan | $48.85 | ↓ -62% |
| CIGNA | SUREFIT | $59.15 | ↓ -54% |
| CIGNA | ALL PRODUCTS | $61.84 | ↓ -52% |
| AETNA | ALL PRODUCTS | $70.72 | ↓ -45% |
| The Legacy Companies | All Products | $128.70 | ↑ +0% |
| Clarity Health | All Products | $128.70 | ↑ +0% |
| Three Rivers | All Products | $128.70 | ↑ +0% |
| OPTUM | Managed Medicaid | $136.93 | ↑ +6% |
| Medicaid | Managed Medicaid | $144.14 | ↑ +12% |
| Wellcare | Managed Medicaid | $144.14 | ↑ +12% |
| SUNSHINE HEALTH | Managed Medicaid | $144.14 | ↑ +12% |
| MOLINA | Florida KidCare | $144.14 | ↑ +12% |
| Molina | Florida Kidcare | $144.14 | ↑ +12% |
| Carelon BH Strategies | Managed Medicaid | $144.14 | ↑ +12% |
| AMERIHEALTH | Managed Medicaid | $144.14 | ↑ +12% |
| Consociate Health | ALL PRODUCTS | $148.50 | ↑ +15% |
| MOLINA | Managed Medicaid | $151.35 | ↑ +18% |
| AETNA | Managed Medicaid/CHIP | $158.55 | ↑ +23% |
| National Provider Network | All Products | $168.30 | ↑ +31% |
| Independent Living Systems | Managed Medicaid | $172.97 | ↑ +34% |
| Aetna | All Products First Health | $178.20 | ↑ +38% |
| Cigna | Surefit Mid-Level | $198.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $198.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $198.00 | ↑ +54% |
| Cigna | All Products Physician | $198.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $198.00 | ↑ +54% |
| Cigna | Surefit Physician | $198.00 | ↑ +54% |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products PCP | 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 | — |
| AmeriHealth | Managed Medicaid | not published by hospital | — |
| Optum | Managed Medicaid | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Value Options | Managed Medicaid | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Mnt subs tx for change dx at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $128.70 | $22.51 – $198.00 |
| martin north hospital | Stuart | $128.70 | $20.76 – $198.00 |
| Boca Raton Regional Hospital | BOCA RATON | $66.30 | $27.38 – $102.00 |
| Ascension St. Vincent's Riverside (St. Vincent's Medical Center, Inc.) | Jacksonville | $58.74 | $75.58 – $75.58 |
| HCA FLORIDA CAPITAL HOSPITAL | TALLAHASSEE | $159.05 | $26.50 – $45.05 |
| HCA FLORIDA AVENTURA HOSPITAL | HIALEAH | $161.00 | $27.69 – $40.56 |
| HCA FLORIDA FORT WALTON-DESTIN HOSPITAL | NAVARRE | $99.00 | $25.97 – $32.00 |
| HCA FLORIDA HIGHLANDS HOSPITAL | Sebring | $144.00 | $26.50 – $31.80 |