Repair of mitral valve w/bypass 33425 at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$12,989.60
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.
$19,984.00
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.
$1,547.50 with Optum vs $19,984.00 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 |
|---|---|---|---|
| Optum | Managed Medicaid | $1,547.50 | ↓ -88% |
| AmeriHealth | Managed Medicaid | $2,052.04 | ↓ -84% |
| Wellcare | Managed Medicaid | $2,052.04 | ↓ -84% |
| Value Options | Managed Medicaid | $2,052.04 | ↓ -84% |
| Medicaid | Managed Medicaid | $2,052.04 | ↓ -84% |
| Molina | Managed Medicaid | $2,052.04 | ↓ -84% |
| Blue Cross | Health Options | $2,701.24 | ↓ -79% |
| Blue Cross | Network Blue | $2,767.66 | ↓ -79% |
| Blue Cross | Traditional (PPS) | $2,834.08 | ↓ -78% |
| Blue Cross | Perferred Patient Care | $2,834.08 | ↓ -78% |
| United | Medicare Advantage | $2,893.13 | ↓ -78% |
| Careplus | Medicare Advantage | $2,894.57 | ↓ -78% |
| Magellan | Medicare Advantage | $2,894.57 | ↓ -78% |
| Value Options | Medicare Advantage | $2,894.57 | ↓ -78% |
| Wellcare | Medicare Advantage | $2,894.57 | ↓ -78% |
| Blue Cross | Medicare Advantage HMO | $2,894.57 | ↓ -78% |
| Blue Cross | Medicare Advantage PPO | $2,894.57 | ↓ -78% |
| Avmed | Medicare Advantage | $2,894.57 | ↓ -78% |
| Independent Living Systems | Medicare Advantage | $3,037.79 | ↓ -77% |
| Freedom Health | Medicare Advantage | $3,039.30 | ↓ -77% |
| WellMed | Medicare Advantage | $3,039.30 | ↓ -77% |
| Clear Spring Health | All Products | $3,126.14 | ↓ -76% |
| Aetna | Medicare Advantage Behavioral Health | $3,473.48 | ↓ -73% |
| Aetna | Medicare Advantage PCP | $3,589.27 | ↓ -72% |
| Aetna | Medicare Advantage Specialist | $3,647.16 | ↓ -72% |
| Avmed | Exchange | $3,869.79 | ↓ -70% |
| Avmed | Select | $4,018.63 | ↓ -69% |
| Avmed | Broad | $4,316.30 | ↓ -67% |
| Aetna | PPO First Health | $4,537.01 | ↓ -65% |
| United | All Products | $5,632.33 | ↓ -57% |
| OPTUM | Managed Medicaid | $7,099.16 | ↓ -45% |
| MOLINA | Florida KidCare | $7,472.80 | ↓ -42% |
| Carelon BH Strategies | Managed Medicaid | $7,472.80 | ↓ -42% |
| SUNSHINE HEALTH | Managed Medicaid | $7,472.80 | ↓ -42% |
| AMERIHEALTH | Managed Medicaid | $7,472.80 | ↓ -42% |
| Molina | Florida Kidcare | $7,472.80 | ↓ -42% |
| MOLINA | Managed Medicaid | $7,846.44 | ↓ -40% |
| AETNA | Managed Medicaid/CHIP | $8,220.08 | ↓ -37% |
| Independent Living Systems | Managed Medicaid | $8,967.36 | ↓ -31% |
| Aetna | POS First Health | $8,992.80 | ↓ -31% |
| The Legacy Companies | All Products | $12,989.60 | ↑ +0% |
| Three Rivers | All Products | $12,989.60 | ↑ +0% |
| Clarity Health | All Products | $12,989.60 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $14,988.00 | ↑ +15% |
| National Provider Network | All Products | $16,986.40 | ↑ +31% |
| Aetna | All Products First Health | $17,985.60 | ↑ +38% |
| Cigna | Surefit Mid-Level | $19,984.00 | ↑ +54% |
| Cigna | Surefit Physician | $19,984.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $19,984.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $19,984.00 | ↑ +54% |
| Cigna | All Products Physician | $19,984.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $19,984.00 | ↑ +54% |
| Value Options | All Products | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
Visitor-reported prices
Comments
Repair of mitral valve w/bypass 33425 at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $12,989.60 | $1,547.50 – $19,984.00 |
| martin north hospital | Stuart | $12,989.60 | $2,052.04 – $19,984.00 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $497.36 – $507.83 |
| HCA FLORIDA BRANDON HOSPITAL | TAMPA | not published | $504.90 – $515.53 |
| HCA FLORIDA JFK HOSPITAL | PALM BEACH GARDENS | not published | $522.22 – $533.21 |
| HCA FLORIDA KENDALL HOSPITAL | DORAL | not published | $542.30 – $553.71 |
| HCA FLORIDA CAPITAL HOSPITAL | TALLAHASSEE | not published | $462.73 – $487.08 |
| HCA FLORIDA CITRUS HOSPITAL | Inverness | not published | $469.80 – $479.69 |