healthcosts.net
Shoulder Arthroscopy (Rotator Cuff Repair) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$4,053.40
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.
$6,236.00
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.
$720.99 with Optum vs $16,420.98 with AVMED — 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 | $720.99 | ↓ -82% |
| Value Options | Managed Medicaid | $829.04 | ↓ -80% |
| Medicaid | Managed Medicaid | $829.04 | ↓ -80% |
| Molina | Managed Medicaid | $829.04 | ↓ -80% |
| Wellcare | Managed Medicaid | $829.04 | ↓ -80% |
| AmeriHealth | Managed Medicaid | $829.04 | ↓ -80% |
| Blue Cross | Health Options | $1,014.12 | ↓ -75% |
| Blue Cross | Network Blue | $1,039.06 | ↓ -74% |
| Blue Cross | Traditional (PPS) | $1,064.00 | ↓ -74% |
| Blue Cross | Perferred Patient Care | $1,064.00 | ↓ -74% |
| Avmed | Medicare Advantage | $1,068.69 | ↓ -74% |
| Value Options | Medicare Advantage | $1,068.69 | ↓ -74% |
| Magellan | Medicare Advantage | $1,068.69 | ↓ -74% |
| Careplus | Medicare Advantage | $1,068.69 | ↓ -74% |
| Wellcare | Medicare Advantage | $1,068.69 | ↓ -74% |
| Blue Cross | Medicare Advantage PPO | $1,068.69 | ↓ -74% |
| Blue Cross | Medicare Advantage HMO | $1,068.69 | ↓ -74% |
| Independent Living Systems | Medicare Advantage | $1,122.12 | ↓ -72% |
| Freedom Health | Medicare Advantage | $1,122.12 | ↓ -72% |
| WellMed | Medicare Advantage | $1,122.12 | ↓ -72% |
| United | Medicare Advantage | $1,124.86 | ↓ -72% |
| Clear Spring Health | All Products | $1,154.19 | ↓ -72% |
| Aetna | Medicare Advantage Behavioral Health | $1,282.43 | ↓ -68% |
| Aetna | Medicare Advantage PCP | $1,325.18 | ↓ -67% |
| Aetna | Medicare Advantage Specialist | $1,346.55 | ↓ -67% |
| Avmed | Exchange | $1,497.13 | ↓ -63% |
| Avmed | Select | $1,554.71 | ↓ -62% |
| Avmed | Broad | $1,669.88 | ↓ -59% |
| Aetna | PPO First Health | $1,671.43 | ↓ -59% |
| United | All Products | $2,179.02 | ↓ -46% |
| Aetna | POS First Health | $2,806.20 | ↓ -31% |
| OPTUM | Managed Medicaid | $3,407.88 | ↓ -16% |
| MOLINA | Florida KidCare | $3,587.24 | ↓ -12% |
| AMERIHEALTH | Managed Medicaid | $3,587.24 | ↓ -12% |
| Molina | Florida Kidcare | $3,587.24 | ↓ -12% |
| SUNSHINE HEALTH | Managed Medicaid | $3,587.24 | ↓ -12% |
| Carelon BH Strategies | Managed Medicaid | $3,587.24 | ↓ -12% |
| MOLINA | Managed Medicaid | $3,766.60 | ↓ -7% |
| AETNA | Managed Medicaid/CHIP | $3,945.96 | ↓ -3% |
| Clarity Health | All Products | $4,053.40 | ↑ +0% |
| Three Rivers | All Products | $4,053.40 | ↑ +0% |
| The Legacy Companies | All Products | $4,053.40 | ↑ +0% |
| Independent Living Systems | Managed Medicaid | $4,304.69 | ↑ +6% |
| Consociate Health | ALL PRODUCTS | $4,677.00 | ↑ +15% |
| National Provider Network | All Products | $5,300.60 | ↑ +31% |
| Aetna | All Products First Health | $5,612.40 | ↑ +38% |
| Cigna | Individual Family Plan Mid-Level | $6,236.00 | ↑ +54% |
| Cigna | Surefit Physician | $6,236.00 | ↑ +54% |
| Cigna | All Products Physician | $6,236.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $6,236.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $6,236.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $6,236.00 | ↑ +54% |
| UNITED | MEDICARE ADVANTAGE | $7,170.73 | ↑ +77% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $7,170.73 | ↑ +77% |
| Careplus | MEDICARE ADVANTAGE | $7,170.73 | ↑ +77% |
| Freedom Health | MEDICARE ADVANTAGE | $7,170.73 | ↑ +77% |
| BLUE CROSS | Medicare Advantage HMO | $7,170.73 | ↑ +77% |
| HUMANA | Medicare Advantage HMO | $7,170.73 | ↑ +77% |
| BLUE CROSS | Medicare Advantage PPO | $7,170.73 | ↑ +77% |
| AVMED | MEDICARE ADVANTAGE | $7,457.56 | ↑ +84% |
| Independent Living Systems | MEDICARE ADVANTAGE | $7,529.27 | ↑ +86% |
| Wellcare | MEDICARE ADVANTAGE | $7,577.51 | ↑ +87% |
| AETNA | MEDICARE ADVANTAGE | $7,577.51 | ↑ +87% |
| WellMed | MEDICARE ADVANTAGE | $7,577.51 | ↑ +87% |
| DEVOTED HEALTH | Medicare Advantage HMO | $8,335.26 | ↑ +106% |
| AVMED | EXCHANGE | $11,258.05 | ↑ +178% |
| AVMED | Select | $12,620.49 | ↑ +211% |
| UNITED | ALL PRODUCTS | $12,702.00 | ↑ +213% |
| AVMED | BROAD | $16,420.98 | ↑ +305% |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
Visitor-reported prices
Comments
Shoulder Arthroscopy (Rotator Cuff Repair) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $4,053.40 | $720.99 – $8,335.26 |
| martin north hospital | Stuart | $4,053.40 | $829.04 – $8,335.26 |
| Bethesda Hospital East | BOYNTON BEACH | not published | not published |
| Boca Raton Regional Hospital | BOCA RATON | not published | not published |
| Doctors Hospital | CORAL GABLES | not published | not published |
| Baptist Health Hospital Doral | SOUTH MIAMI | not published | not published |
| Fishermens Community Hospital | MARATHON | not published | not published |
| Homestead Hospital | HOMESTEAD | not published | not published |