Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$260.00
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.
$400.00
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.
$20.97 with OPTUM vs $723.00 with BLUE CROSS — 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 | $20.97 | ↓ -92% |
| Medicaid | Managed Medicaid | $22.07 | ↓ -92% |
| AMERIHEALTH | Managed Medicaid | $22.07 | ↓ -92% |
| Wellcare | Managed Medicaid | $22.07 | ↓ -92% |
| SUNSHINE HEALTH | Managed Medicaid | $22.07 | ↓ -92% |
| Carelon BH Strategies | Managed Medicaid | $22.07 | ↓ -92% |
| MOLINA | Florida KidCare | $22.07 | ↓ -92% |
| Molina | Florida Kidcare | $22.07 | ↓ -92% |
| MOLINA | Managed Medicaid | $23.17 | ↓ -91% |
| AETNA | Managed Medicaid/CHIP | $24.28 | ↓ -91% |
| Independent Living Systems | Managed Medicaid | $26.48 | ↓ -90% |
| Careplus | MEDICARE ADVANTAGE | $66.46 | ↓ -74% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $66.46 | ↓ -74% |
| BLUE CROSS | Medicare Advantage PPO | $66.46 | ↓ -74% |
| UNITED | MEDICARE ADVANTAGE | $66.46 | ↓ -74% |
| BLUE CROSS | Medicare Advantage HMO | $66.46 | ↓ -74% |
| HUMANA | Medicare Advantage HMO | $66.46 | ↓ -74% |
| Freedom Health | MEDICARE ADVANTAGE | $66.46 | ↓ -74% |
| AETNA | MEDICARE ADVANTAGE | $66.62 | ↓ -74% |
| Wellcare | MEDICARE ADVANTAGE | $66.62 | ↓ -74% |
| WellMed | MEDICARE ADVANTAGE | $66.62 | ↓ -74% |
| AVMED | MEDICARE ADVANTAGE | $69.12 | ↓ -73% |
| Independent Living Systems | MEDICARE ADVANTAGE | $69.78 | ↓ -73% |
| Clear Spring Health | ALL PRODUCTS | $71.95 | ↓ -72% |
| DEVOTED HEALTH | Medicare Advantage HMO | $73.28 | ↓ -72% |
| CIGNA | Individual Family Plan | $92.36 | ↓ -64% |
| AVMED | EXCHANGE | $96.00 | ↓ -63% |
| AVMED | Select | $96.00 | ↓ -63% |
| CIGNA | SUREFIT | $111.83 | ↓ -57% |
| CIGNA | ALL PRODUCTS | $116.93 | ↓ -55% |
| AVMED | BROAD | $124.00 | ↓ -52% |
| AETNA | QHP | $146.00 | ↓ -44% |
| UNITED | NHP | $168.00 | ↓ -35% |
| BMI | ALL PRODUCTS | $200.00 | ↓ -23% |
| UNITED | ALL PRODUCTS | $213.00 | ↓ -18% |
| UNITED | International | $213.00 | ↓ -18% |
| AETNA | ALL PRODUCTS | $235.00 | ↓ -10% |
| MAGELLAN | ALL PRODUCTS | $240.00 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $260.00 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $260.00 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $300.00 | ↑ +15% |
| MULTIPLAN | ALL PRODUCTS | $320.00 | ↑ +23% |
| AETNA | All Products First Health | $320.00 | ↑ +23% |
| BLUE CROSS | BSL | $394.00 | ↑ +52% |
| BLUE CROSS | HMO | $394.00 | ↑ +52% |
| BLUE CROSS | NWBI | $458.00 | ↑ +76% |
| BLUE CROSS | NWB | $458.00 | ↑ +76% |
| BLUE CROSS | PPO | $656.00 | ↑ +152% |
| BLUE CROSS | PHS | $723.00 | ↑ +178% |
| Consociate Health | Transplant | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $146.42 | $46.35 – $81.43 |
| Adventhealth Lake Wales | Lake Wales | $297.69 | $48.79 – $108.31 |
| Adventhealth Palm Coast Parkway | Palm Coast | $110.07 | not published |
| Adventhealth Tampa | Tampa | $314.28 | $48.79 – $108.31 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $178.70 | $46.35 – $106.58 |
| Adventhealth Port Charlotte | Port Charlotte | $414.84 | not published |
| cleveland clinic florida weston hospital | Weston | $260.00 | $20.97 – $340.00 |
| martin north hospital | Stuart | $260.00 | $22.07 – $200.00 |