Open periprosthetic breast capsule 19370 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$2,622.75
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.
$4,035.00
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.
$388.57 with Optum vs $8,802.20 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 | $388.57 | ↓ -85% |
| Value Options | Managed Medicaid | $522.14 | ↓ -80% |
| Wellcare | Managed Medicaid | $522.14 | ↓ -80% |
| Medicaid | Managed Medicaid | $522.14 | ↓ -80% |
| Molina | Managed Medicaid | $522.14 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $522.14 | ↓ -80% |
| Blue Cross | Health Options | $653.08 | ↓ -75% |
| Value Options | Medicare Advantage | $667.96 | ↓ -75% |
| Blue Cross | Medicare Advantage PPO | $667.96 | ↓ -75% |
| Wellcare | Medicare Advantage | $667.96 | ↓ -75% |
| Blue Cross | Medicare Advantage HMO | $667.96 | ↓ -75% |
| Magellan | Medicare Advantage | $667.96 | ↓ -75% |
| Avmed | Medicare Advantage | $667.96 | ↓ -75% |
| Careplus | Medicare Advantage | $667.96 | ↓ -75% |
| Blue Cross | Network Blue | $669.14 | ↓ -74% |
| Blue Cross | Traditional (PPS) | $685.20 | ↓ -74% |
| Blue Cross | Perferred Patient Care | $685.20 | ↓ -74% |
| Independent Living Systems | Medicare Advantage | $701.36 | ↓ -73% |
| WellMed | Medicare Advantage | $701.36 | ↓ -73% |
| Freedom Health | Medicare Advantage | $701.36 | ↓ -73% |
| United | Medicare Advantage | $703.21 | ↓ -73% |
| Clear Spring Health | All Products | $721.40 | ↓ -72% |
| Aetna | Medicare Advantage Behavioral Health | $801.55 | ↓ -69% |
| Aetna | Medicare Advantage PCP | $828.27 | ↓ -68% |
| Aetna | Medicare Advantage Specialist | $841.63 | ↓ -68% |
| Avmed | Exchange | $932.46 | ↓ -64% |
| Avmed | Select | $968.33 | ↓ -63% |
| Avmed | Broad | $1,040.06 | ↓ -60% |
| Aetna | PPO First Health | $1,084.22 | ↓ -59% |
| United | All Products | $1,357.17 | ↓ -48% |
| Aetna | POS First Health | $1,815.75 | ↓ -31% |
| OPTUM | Managed Medicaid | $2,132.55 | ↓ -19% |
| AMERIHEALTH | Managed Medicaid | $2,244.79 | ↓ -14% |
| MOLINA | Florida KidCare | $2,244.79 | ↓ -14% |
| Molina | Florida Kidcare | $2,244.79 | ↓ -14% |
| SUNSHINE HEALTH | Managed Medicaid | $2,244.79 | ↓ -14% |
| Carelon BH Strategies | Managed Medicaid | $2,244.79 | ↓ -14% |
| MOLINA | Managed Medicaid | $2,357.03 | ↓ -10% |
| AETNA | Managed Medicaid/CHIP | $2,469.27 | ↓ -6% |
| The Legacy Companies | All Products | $2,622.75 | ↑ +0% |
| Clarity Health | All Products | $2,622.75 | ↑ +0% |
| Three Rivers | All Products | $2,622.75 | ↑ +0% |
| Independent Living Systems | Managed Medicaid | $2,693.75 | ↑ +3% |
| Consociate Health | ALL PRODUCTS | $3,026.25 | ↑ +15% |
| National Provider Network | All Products | $3,429.75 | ↑ +31% |
| Aetna | All Products First Health | $3,631.50 | ↑ +38% |
| BLUE CROSS | Medicare Advantage HMO | $3,843.75 | ↑ +47% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $3,843.75 | ↑ +47% |
| BLUE CROSS | Medicare Advantage PPO | $3,843.75 | ↑ +47% |
| Careplus | MEDICARE ADVANTAGE | $3,843.75 | ↑ +47% |
| Freedom Health | MEDICARE ADVANTAGE | $3,843.75 | ↑ +47% |
| UNITED | MEDICARE ADVANTAGE | $3,843.75 | ↑ +47% |
| HUMANA | Medicare Advantage HMO | $3,843.75 | ↑ +47% |
| AVMED | MEDICARE ADVANTAGE | $3,997.50 | ↑ +52% |
| Cigna | All Products Physician | $4,035.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $4,035.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $4,035.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $4,035.00 | ↑ +54% |
| Cigna | Surefit Physician | $4,035.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $4,035.00 | ↑ +54% |
| Independent Living Systems | MEDICARE ADVANTAGE | $4,035.94 | ↑ +54% |
| WellMed | MEDICARE ADVANTAGE | $4,088.81 | ↑ +56% |
| AETNA | MEDICARE ADVANTAGE | $4,088.81 | ↑ +56% |
| Wellcare | MEDICARE ADVANTAGE | $4,088.81 | ↑ +56% |
| DEVOTED HEALTH | Medicare Advantage HMO | $4,497.69 | ↑ +71% |
| AVMED | EXCHANGE | $6,034.69 | ↑ +130% |
| AVMED | Select | $6,765.01 | ↑ +158% |
| AVMED | BROAD | $8,802.20 | ↑ +236% |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
Visitor-reported prices
Comments
Open periprosthetic breast capsule 19370 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $2,622.75 | $388.57 – $4,497.69 |
| martin north hospital | Stuart | $2,622.75 | $522.14 – $4,497.69 |
| Baptist Hospital | MIAMI | $20,610.85 | $173.17 – $14,268.60 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,884.37 – $6,824.22 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $3,884.37 – $8,733.28 |
| Adventhealth Tampa | Tampa | not published | $758.00 – $9,077.15 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $3,884.37 – $8,932.00 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $3,106.13 – $3,171.52 |