Oth resp proc, indiv at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$79.95
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.
$123.00
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.
$9.99 with Blue Cross vs $358.00 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 | Health Options | $9.99 | ↓ -88% |
| Blue Cross | Network Blue | $10.23 | ↓ -87% |
| United | Medicare Advantage | $10.26 | ↓ -87% |
| Blue Cross | Perferred Patient Care | $10.48 | ↓ -87% |
| Blue Cross | Traditional (PPS) | $10.48 | ↓ -87% |
| Independent Living Systems | Medicare Advantage | $10.77 | ↓ -87% |
| Blue Cross | Medicare Advantage HMO | $11.83 | ↓ -85% |
| Careplus | Medicare Advantage | $11.83 | ↓ -85% |
| Magellan | Medicare Advantage | $11.83 | ↓ -85% |
| Avmed | Medicare Advantage | $11.83 | ↓ -85% |
| Value Options | Medicare Advantage | $11.83 | ↓ -85% |
| Wellcare | Medicare Advantage | $11.83 | ↓ -85% |
| Blue Cross | Medicare Advantage PPO | $11.83 | ↓ -85% |
| WellMed | Medicare Advantage | $12.42 | ↓ -84% |
| Freedom Health | Medicare Advantage | $12.42 | ↓ -84% |
| Clear Spring Health | All Products | $12.78 | ↓ -84% |
| Avmed | Exchange | $13.73 | ↓ -83% |
| Aetna | Medicare Advantage Behavioral Health | $14.20 | ↓ -82% |
| Avmed | Select | $14.26 | ↓ -82% |
| Aetna | Medicare Advantage PCP | $14.67 | ↓ -82% |
| Aetna | Medicare Advantage Specialist | $14.91 | ↓ -81% |
| Avmed | Broad | $15.31 | ↓ -81% |
| Clear Spring Health | ALL PRODUCTS | $17.36 | ↓ -78% |
| Aetna | PPO First Health | $18.20 | ↓ -77% |
| United | All Products | $18.36 | ↓ -77% |
| OPTUM | Managed Medicaid | $22.83 | ↓ -71% |
| Carelon BH Strategies | Managed Medicaid | $24.03 | ↓ -70% |
| AMERIHEALTH | Managed Medicaid | $24.03 | ↓ -70% |
| Medicaid | Managed Medicaid | $24.03 | ↓ -70% |
| SUNSHINE HEALTH | Managed Medicaid | $24.03 | ↓ -70% |
| Molina | Florida Kidcare | $24.03 | ↓ -70% |
| Wellcare | Managed Medicaid | $24.03 | ↓ -70% |
| MOLINA | Florida KidCare | $24.03 | ↓ -70% |
| Freedom Health | MEDICARE ADVANTAGE | $24.58 | ↓ -69% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $24.58 | ↓ -69% |
| HUMANA | Medicare Advantage HMO | $24.58 | ↓ -69% |
| BLUE CROSS | Medicare Advantage PPO | $24.58 | ↓ -69% |
| UNITED | MEDICARE ADVANTAGE | $24.58 | ↓ -69% |
| BLUE CROSS | Medicare Advantage HMO | $24.58 | ↓ -69% |
| Careplus | MEDICARE ADVANTAGE | $24.58 | ↓ -69% |
| MOLINA | Managed Medicaid | $25.23 | ↓ -68% |
| AVMED | MEDICARE ADVANTAGE | $25.57 | ↓ -68% |
| Independent Living Systems | MEDICARE ADVANTAGE | $25.81 | ↓ -68% |
| AETNA | Managed Medicaid/CHIP | $26.43 | ↓ -67% |
| AETNA | QHP | $28.78 | ↓ -64% |
| Independent Living Systems | Managed Medicaid | $28.84 | ↓ -64% |
| AETNA | MEDICARE ADVANTAGE | $30.20 | ↓ -62% |
| Wellcare | MEDICARE ADVANTAGE | $30.20 | ↓ -62% |
| WellMed | MEDICARE ADVANTAGE | $30.20 | ↓ -62% |
| CIGNA | Individual Family Plan | $31.61 | ↓ -60% |
| DEVOTED HEALTH | Medicare Advantage HMO | $33.22 | ↓ -58% |
| CIGNA | SUREFIT | $38.13 | ↓ -52% |
| AVMED | EXCHANGE | $38.59 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $39.11 | ↓ -51% |
| AVMED | Select | $43.27 | ↓ -46% |
| AETNA | ALL PRODUCTS | $43.79 | ↓ -45% |
| Aetna | POS First Health | $53.55 | ↓ -33% |
| AVMED | BROAD | $56.29 | ↓ -30% |
| BMI | ALL PRODUCTS | $61.50 | ↓ -23% |
| MAGELLAN | ALL PRODUCTS | $73.80 | ↓ -8% |
| Three Rivers | All Products | $77.35 | ↓ -3% |
| Clarity Health | All Products | $77.35 | ↓ -3% |
| The Legacy Companies | All Products | $77.35 | ↓ -3% |
| Clarity Health | ALL PRODUCTS | $79.95 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $79.95 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $89.25 | ↑ +12% |
| MULTIPLAN | ALL PRODUCTS | $98.40 | ↑ +23% |
| AETNA | All Products First Health | $98.40 | ↑ +23% |
| National Provider Network | All Products | $101.15 | ↑ +27% |
| Aetna | All Products First Health | $107.10 | ↑ +34% |
| Cigna | All Products Mid-Level | $119.00 | ↑ +49% |
| Cigna | All Products Physician | $119.00 | ↑ +49% |
| Cigna | Individual Family Plan Mid-Level | $119.00 | ↑ +49% |
| Cigna | Surefit Physician | $119.00 | ↑ +49% |
| Cigna | Surefit Mid-Level | $119.00 | ↑ +49% |
| Cigna | Individual Family Plan Physician | $119.00 | ↑ +49% |
| UNITED | NHP | $275.00 | ↑ +244% |
| UNITED | International | $358.00 | ↑ +348% |
| UNITED | ALL PRODUCTS | $358.00 | ↑ +348% |
| Consociate Health | Transplant | not published by hospital | — |
| BLUE CROSS | PPO | not published by hospital | — |
| BLUE CROSS | NWBI | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| BLUE CROSS | BSL | not published by hospital | — |
| BLUE CROSS | NWB | not published by hospital | — |
| BLUE CROSS | HMO | not published by hospital | — |
| BLUE CROSS | PHS | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Molina | Managed Medicaid | not published by hospital | — |
| Optum | Managed Medicaid | not published by hospital | — |
| AmeriHealth | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Value Options | Managed Medicaid | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
Visitor-reported prices
Comments
Oth resp proc, indiv at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $140.37 | not published |
| Adventhealth Palm Coast Parkway | Palm Coast | $187.81 | not published |
| Adventhealth Tampa | Tampa | $332.56 | not published |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $375.00 | $9.50 – $9.70 |
| Adventhealth Port Charlotte | Port Charlotte | $247.20 | $30.20 – $55.15 |
| cleveland clinic florida weston hospital | Weston | $77.35 | $9.33 – $119.00 |
| martin north hospital | Stuart | $79.95 | $8.35 – $119.00 |
| Bethesda Hospital East | BOYNTON BEACH | $262.60 | $21.76 – $363.60 |