Pt evaluation high complexity patient/family at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$491.40
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.
$756.00
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.
$126.19 with BLUE CROSS 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 |
|---|---|---|---|
| BLUE CROSS | Medicare Advantage PPO | $126.19 | ↓ -74% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $126.19 | ↓ -74% |
| HUMANA | Medicare Advantage HMO | $126.19 | ↓ -74% |
| Freedom Health | MEDICARE ADVANTAGE | $126.19 | ↓ -74% |
| UNITED | MEDICARE ADVANTAGE | $126.19 | ↓ -74% |
| BLUE CROSS | Medicare Advantage HMO | $126.19 | ↓ -74% |
| Careplus | MEDICARE ADVANTAGE | $126.19 | ↓ -74% |
| WellMed | MEDICARE ADVANTAGE | $126.43 | ↓ -74% |
| AETNA | MEDICARE ADVANTAGE | $126.43 | ↓ -74% |
| Wellcare | MEDICARE ADVANTAGE | $126.43 | ↓ -74% |
| AVMED | MEDICARE ADVANTAGE | $131.24 | ↓ -73% |
| Independent Living Systems | MEDICARE ADVANTAGE | $132.50 | ↓ -73% |
| Clear Spring Health | ALL PRODUCTS | $136.54 | ↓ -72% |
| DEVOTED HEALTH | Medicare Advantage HMO | $139.07 | ↓ -72% |
| AETNA | QHP | $146.00 | ↓ -70% |
| OPTUM | Managed Medicaid | $148.98 | ↓ -70% |
| Medicaid | Managed Medicaid | $156.82 | ↓ -68% |
| Wellcare | Managed Medicaid | $156.82 | ↓ -68% |
| SUNSHINE HEALTH | Managed Medicaid | $156.82 | ↓ -68% |
| Carelon BH Strategies | Managed Medicaid | $156.82 | ↓ -68% |
| AMERIHEALTH | Managed Medicaid | $156.82 | ↓ -68% |
| MOLINA | Florida KidCare | $156.82 | ↓ -68% |
| Molina | Florida Kidcare | $156.82 | ↓ -68% |
| MOLINA | Managed Medicaid | $164.66 | ↓ -66% |
| UNITED | NHP | $168.00 | ↓ -66% |
| AETNA | Managed Medicaid/CHIP | $172.50 | ↓ -65% |
| AVMED | EXCHANGE | $181.44 | ↓ -63% |
| AVMED | Select | $181.44 | ↓ -63% |
| Independent Living Systems | Managed Medicaid | $188.18 | ↓ -62% |
| CIGNA | Individual Family Plan | $195.32 | ↓ -60% |
| UNITED | ALL PRODUCTS | $213.00 | ↓ -57% |
| UNITED | International | $213.00 | ↓ -57% |
| AVMED | BROAD | $234.36 | ↓ -52% |
| AETNA | ALL PRODUCTS | $235.00 | ↓ -52% |
| CIGNA | SUREFIT | $236.38 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $250.16 | ↓ -49% |
| BMI | ALL PRODUCTS | $378.00 | ↓ -23% |
| BLUE CROSS | HMO | $394.00 | ↓ -20% |
| BLUE CROSS | BSL | $394.00 | ↓ -20% |
| MAGELLAN | ALL PRODUCTS | $453.60 | ↓ -8% |
| BLUE CROSS | NWBI | $458.00 | ↓ -7% |
| BLUE CROSS | NWB | $458.00 | ↓ -7% |
| Clarity Health | ALL PRODUCTS | $491.40 | ↑ +0% |
| The Legacy Companies | ALL PRODUCTS | $491.40 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $567.00 | ↑ +15% |
| AETNA | All Products First Health | $604.80 | ↑ +23% |
| MULTIPLAN | ALL PRODUCTS | $604.80 | ↑ +23% |
| BLUE CROSS | PPO | $656.00 | ↑ +33% |
| BLUE CROSS | PHS | $723.00 | ↑ +47% |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation high complexity patient/family at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $384.35 | $95.26 – $167.35 |
| Adventhealth Lake Wales | Lake Wales | $589.05 | $100.27 – $222.60 |
| Adventhealth Palm Coast Parkway | Palm Coast | $448.92 | not published |
| Adventhealth Tampa | Tampa | $750.11 | $100.27 – $222.60 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $667.18 | $95.26 – $219.04 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $1,109.00 | $67.58 – $101.38 |
| Adventhealth Port Charlotte | Port Charlotte | $845.68 | not published |
| cleveland clinic florida weston hospital | Weston | $491.40 | $68.99 – $642.60 |