Ot re-evaluation patient/family at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$311.35
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.
$479.00
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.
$87.79 with AETNA 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 |
|---|---|---|---|
| AETNA | MEDICARE ADVANTAGE | $87.79 | ↓ -72% |
| WellMed | MEDICARE ADVANTAGE | $87.79 | ↓ -72% |
| Wellcare | MEDICARE ADVANTAGE | $87.79 | ↓ -72% |
| Freedom Health | MEDICARE ADVANTAGE | $88.55 | ↓ -72% |
| UNITED | MEDICARE ADVANTAGE | $88.55 | ↓ -72% |
| BLUE CROSS | Medicare Advantage HMO | $88.55 | ↓ -72% |
| BLUE CROSS | Medicare Advantage PPO | $88.55 | ↓ -72% |
| HUMANA | Medicare Advantage HMO | $88.55 | ↓ -72% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $88.55 | ↓ -72% |
| Careplus | MEDICARE ADVANTAGE | $88.55 | ↓ -72% |
| AVMED | MEDICARE ADVANTAGE | $92.09 | ↓ -70% |
| Independent Living Systems | MEDICARE ADVANTAGE | $92.98 | ↓ -70% |
| Clear Spring Health | ALL PRODUCTS | $94.81 | ↓ -70% |
| DEVOTED HEALTH | Medicare Advantage HMO | $96.57 | ↓ -69% |
| AVMED | Select | $114.96 | ↓ -63% |
| AVMED | EXCHANGE | $114.96 | ↓ -63% |
| AETNA | QHP | $146.00 | ↓ -53% |
| AVMED | BROAD | $148.49 | ↓ -52% |
| UNITED | NHP | $168.00 | ↓ -46% |
| CIGNA | Individual Family Plan | $195.32 | ↓ -37% |
| UNITED | ALL PRODUCTS | $213.00 | ↓ -32% |
| UNITED | International | $213.00 | ↓ -32% |
| AETNA | ALL PRODUCTS | $235.00 | ↓ -25% |
| CIGNA | SUREFIT | $236.38 | ↓ -24% |
| BMI | ALL PRODUCTS | $239.50 | ↓ -23% |
| OPTUM | Managed Medicaid | $247.93 | ↓ -20% |
| CIGNA | ALL PRODUCTS | $250.16 | ↓ -20% |
| AMERIHEALTH | Managed Medicaid | $260.98 | ↓ -16% |
| Carelon BH Strategies | Managed Medicaid | $260.98 | ↓ -16% |
| Medicaid | Managed Medicaid | $260.98 | ↓ -16% |
| Molina | Florida Kidcare | $260.98 | ↓ -16% |
| MOLINA | Florida KidCare | $260.98 | ↓ -16% |
| SUNSHINE HEALTH | Managed Medicaid | $260.98 | ↓ -16% |
| Wellcare | Managed Medicaid | $260.98 | ↓ -16% |
| MOLINA | Managed Medicaid | $274.03 | ↓ -12% |
| AETNA | Managed Medicaid/CHIP | $287.08 | ↓ -8% |
| MAGELLAN | ALL PRODUCTS | $287.40 | ↓ -8% |
| Clarity Health | ALL PRODUCTS | $311.35 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $311.35 | ↑ +0% |
| Independent Living Systems | Managed Medicaid | $313.18 | ↑ +1% |
| Consociate Health | ALL PRODUCTS | $359.25 | ↑ +15% |
| AETNA | All Products First Health | $383.20 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $383.20 | ↑ +23% |
| BLUE CROSS | HMO | $394.00 | ↑ +27% |
| BLUE CROSS | BSL | $394.00 | ↑ +27% |
| BLUE CROSS | NWBI | $458.00 | ↑ +47% |
| BLUE CROSS | NWB | $458.00 | ↑ +47% |
| BLUE CROSS | PPO | $656.00 | ↑ +111% |
| BLUE CROSS | PHS | $723.00 | ↑ +132% |
| 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 re-evaluation patient/family at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $241.42 | $65.75 – $115.51 |
| Adventhealth Lake Wales | Lake Wales | $444.81 | $69.21 – $153.65 |
| Adventhealth Palm Coast Parkway | Palm Coast | $262.48 | not published |
| Adventhealth Tampa | Tampa | $367.84 | $69.21 – $153.65 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $235.00 | $65.75 – $151.19 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $677.00 | $47.20 – $70.80 |
| Adventhealth Port Charlotte | Port Charlotte | $333.59 | not published |
| cleveland clinic florida weston hospital | Weston | $311.35 | $44.12 – $407.15 |