Observation direct referral from physician office for admission at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$1,992.25
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.
$3,065.00
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.
$615.42 with BLUE CROSS vs $5,963.00 with UNITED — 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 |
|---|---|---|---|
| BLUE CROSS | Medicare Advantage PPO | $615.42 | ↓ -69% |
| HUMANA | Medicare Advantage HMO | $615.42 | ↓ -69% |
| Careplus | MEDICARE ADVANTAGE | $615.42 | ↓ -69% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $615.42 | ↓ -69% |
| UNITED | MEDICARE ADVANTAGE | $615.42 | ↓ -69% |
| BLUE CROSS | Medicare Advantage HMO | $615.42 | ↓ -69% |
| Freedom Health | MEDICARE ADVANTAGE | $615.42 | ↓ -69% |
| WellMed | MEDICARE ADVANTAGE | $621.90 | ↓ -69% |
| AETNA | MEDICARE ADVANTAGE | $621.90 | ↓ -69% |
| Wellcare | MEDICARE ADVANTAGE | $621.90 | ↓ -69% |
| AVMED | MEDICARE ADVANTAGE | $640.03 | ↓ -68% |
| Independent Living Systems | MEDICARE ADVANTAGE | $646.19 | ↓ -68% |
| DEVOTED HEALTH | Medicare Advantage HMO | $684.09 | ↓ -66% |
| CIGNA | Individual Family Plan | $787.71 | ↓ -60% |
| CIGNA | SUREFIT | $950.15 | ↓ -52% |
| AVMED | EXCHANGE | $966.21 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $974.67 | ↓ -51% |
| AVMED | Select | $1,083.13 | ↓ -46% |
| AVMED | BROAD | $1,409.31 | ↓ -29% |
| BMI | ALL PRODUCTS | $1,532.50 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $1,839.00 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $1,992.25 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $1,992.25 | ↑ +0% |
| AETNA | NAP | $2,108.72 | ↑ +6% |
| AETNA | QHP | $2,149.00 | ↑ +8% |
| Consociate Health | ALL PRODUCTS | $2,298.75 | ↑ +15% |
| AETNA | All Products First Health | $2,452.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $2,452.00 | ↑ +23% |
| BLUE CROSS | HMO | $2,890.00 | ↑ +45% |
| BLUE CROSS | BSL | $2,890.00 | ↑ +45% |
| BLUE CROSS | NWBI | $3,143.00 | ↑ +58% |
| BLUE CROSS | NWB | $3,143.00 | ↑ +58% |
| BLUE CROSS | PHS | $3,351.00 | ↑ +68% |
| BLUE CROSS | PPO | $3,351.00 | ↑ +68% |
| AETNA | ALL PRODUCTS | $3,483.00 | ↑ +75% |
| UNITED | NHP | $4,606.00 | ↑ +131% |
| UNITED | International | $5,963.00 | ↑ +199% |
| UNITED | ALL PRODUCTS | $5,963.00 | ↑ +199% |
| MOLINA | Florida KidCare | not published by hospital | — |
| MOLINA | Managed Medicaid | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| OPTUM | Managed Medicaid | not published by hospital | — |
| SUNSHINE HEALTH | Managed Medicaid | not published by hospital | — |
| Clear Spring Health | ALL PRODUCTS | not published by hospital | — |
| Carelon BH Strategies | Managed Medicaid | not published by hospital | — |
| Wellcare | Managed Medicaid | not published by hospital | — |
| AMERIHEALTH | Managed Medicaid | not published by hospital | — |
| Independent Living Systems | Managed Medicaid | not published by hospital | — |
| AETNA | Managed Medicaid/CHIP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| Medicaid | Managed Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $1,422.23 | $590.81 – $1,037.95 |
| Adventhealth Lake Wales | Lake Wales | $1,967.40 | $621.90 – $1,380.62 |
| Adventhealth Palm Coast Parkway | Palm Coast | $1,387.46 | $590.81 – $1,328.32 |
| Adventhealth Tampa | Tampa | $2,142.76 | $621.90 – $1,380.62 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $247.65 | $590.81 – $1,358.54 |
| Adventhealth Port Charlotte | Port Charlotte | $1,237.66 | $621.90 – $1,135.59 |
| cleveland clinic florida weston hospital | Weston | $1,992.25 | $615.42 – $3,933.00 |
| martin north hospital | Stuart | $1,992.25 | $615.42 – $2,298.75 |