Ortho wrst/hnd w/jnt cstm w/fit&adj at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$201.50
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.
$310.00
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.
$64.79 with CIGNA vs $310.00 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 |
|---|---|---|---|
| CIGNA | ALL PRODUCTS | $64.79 | ↓ -68% |
| CIGNA | SUREFIT | $64.79 | ↓ -68% |
| AETNA | QHP | $72.54 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $72.85 | ↓ -64% |
| AVMED | Select | $74.40 | ↓ -63% |
| AVMED | EXCHANGE | $74.40 | ↓ -63% |
| BLUE CROSS | NWB | $96.10 | ↓ -52% |
| BLUE CROSS | BSL | $96.10 | ↓ -52% |
| BLUE CROSS | NWBI | $96.10 | ↓ -52% |
| AVMED | BROAD | $96.10 | ↓ -52% |
| BLUE CROSS | PHS | $96.10 | ↓ -52% |
| BLUE CROSS | HMO | $96.10 | ↓ -52% |
| BLUE CROSS | PPO | $96.10 | ↓ -52% |
| AETNA | ALL PRODUCTS | $110.36 | ↓ -45% |
| BMI | ALL PRODUCTS | $155.00 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $186.00 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $201.50 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $201.50 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $232.50 | ↑ +15% |
| AETNA | All Products First Health | $248.00 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $248.00 | ↑ +23% |
| CIGNA | Individual Family Plan | $310.00 | ↑ +54% |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| UNITED | MEDICARE ADVANTAGE | not published by hospital | — |
| Freedom Health | MEDICARE ADVANTAGE | not published by hospital | — |
| MOLINA | Florida KidCare | not published by hospital | — |
| MOLINA | Managed Medicaid | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| Independent Living Systems | Managed Medicaid | not published by hospital | — |
| Independent Living Systems | MEDICARE ADVANTAGE | not published by hospital | — |
| Careplus | MEDICARE ADVANTAGE | not published by hospital | — |
| Clear Spring Health | ALL PRODUCTS | not published by hospital | — |
| Medicaid | Managed Medicaid | not published by hospital | — |
| HUMANA | Medicare Advantage HMO | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| WellMed | MEDICARE ADVANTAGE | not published by hospital | — |
| Carelon BH Strategies | Managed Medicaid | not published by hospital | — |
| Carelon BH Strategies | MEDICARE ADVANTAGE | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| AETNA | Managed Medicaid/CHIP | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| AMERIHEALTH | Managed Medicaid | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
| BLUE CROSS | Medicare Advantage PPO | not published by hospital | — |
| BLUE CROSS | Medicare Advantage HMO | not published by hospital | — |
| OPTUM | Managed Medicaid | not published by hospital | — |
| SUNSHINE HEALTH | Managed Medicaid | not published by hospital | — |
| Wellcare | MEDICARE ADVANTAGE | not published by hospital | — |
| Wellcare | Managed Medicaid | not published by hospital | — |
| DEVOTED HEALTH | Medicare Advantage HMO | not published by hospital | — |
| AVMED | MEDICARE ADVANTAGE | not published by hospital | — |
Visitor-reported prices
Comments
Ortho wrst/hnd w/jnt cstm w/fit&adj at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $201.50 | $52.08 – $263.50 |
| martin north hospital | Stuart | $1,772.55 | $14.14 – $840.51 |
| Boca Raton Regional Hospital | BOCA RATON | $2,477.15 | $589.54 – $2,488.58 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $892.17 – $1,338.25 |
| HCA FLORIDA BRANDON HOSPITAL | TAMPA | not published | $1,081.75 – $1,617.05 |
| HCA FLORIDA JFK HOSPITAL | PALM BEACH GARDENS | not published | $1,059.45 – $1,617.05 |
| HCA FLORIDA KENDALL HOSPITAL | DORAL | not published | $1,081.75 – $2,341.94 |
| HCA FLORIDA CAPITAL HOSPITAL | TALLAHASSEE | not published | $1,081.75 – $1,895.86 |