Sigmoidoscopy w/plcmt stent at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$778.05
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.
$1,197.00
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.
$116.43 with Wellcare vs $13,683.46 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 |
|---|---|---|---|
| Wellcare | Managed Medicaid | $116.43 | ↓ -85% |
| AmeriHealth | Managed Medicaid | $116.43 | ↓ -85% |
| Value Options | Managed Medicaid | $116.43 | ↓ -85% |
| Molina | Managed Medicaid | $116.43 | ↓ -85% |
| Medicaid | Managed Medicaid | $116.43 | ↓ -85% |
| Optum | Managed Medicaid | $125.31 | ↓ -84% |
| Blue Cross | Medicare Advantage HMO | $145.93 | ↓ -81% |
| Value Options | Medicare Advantage | $145.93 | ↓ -81% |
| Magellan | Medicare Advantage | $145.93 | ↓ -81% |
| Blue Cross | Medicare Advantage PPO | $145.93 | ↓ -81% |
| Wellcare | Medicare Advantage | $145.93 | ↓ -81% |
| Careplus | Medicare Advantage | $145.93 | ↓ -81% |
| Avmed | Medicare Advantage | $145.93 | ↓ -81% |
| WellMed | Medicare Advantage | $153.23 | ↓ -80% |
| Independent Living Systems | Medicare Advantage | $153.23 | ↓ -80% |
| Freedom Health | Medicare Advantage | $153.23 | ↓ -80% |
| United | Medicare Advantage | $155.62 | ↓ -80% |
| Clear Spring Health | All Products | $157.60 | ↓ -80% |
| Aetna | Medicare Advantage Behavioral Health | $175.12 | ↓ -77% |
| Aetna | Medicare Advantage PCP | $180.95 | ↓ -77% |
| Aetna | Medicare Advantage Specialist | $183.87 | ↓ -76% |
| Avmed | Exchange | $207.77 | ↓ -73% |
| Avmed | Select | $215.76 | ↓ -72% |
| Avmed | Broad | $231.74 | ↓ -70% |
| Aetna | PPO First Health | $247.93 | ↓ -68% |
| United | All Products | $302.40 | ↓ -61% |
| Aetna | POS First Health | $538.65 | ↓ -31% |
| The Legacy Companies | All Products | $778.05 | ↑ +0% |
| Clarity Health | All Products | $778.05 | ↑ +0% |
| Three Rivers | All Products | $778.05 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $897.75 | ↑ +15% |
| National Provider Network | All Products | $1,017.45 | ↑ +31% |
| Aetna | All Products First Health | $1,077.30 | ↑ +38% |
| Cigna | All Products Mid-Level | $1,197.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $1,197.00 | ↑ +54% |
| Cigna | All Products Physician | $1,197.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $1,197.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $1,197.00 | ↑ +54% |
| Cigna | Surefit Physician | $1,197.00 | ↑ +54% |
| OPTUM | Managed Medicaid | $1,275.65 | ↑ +64% |
| AMERIHEALTH | Managed Medicaid | $1,342.79 | ↑ +73% |
| SUNSHINE HEALTH | Managed Medicaid | $1,342.79 | ↑ +73% |
| Carelon BH Strategies | Managed Medicaid | $1,342.79 | ↑ +73% |
| MOLINA | Florida KidCare | $1,342.79 | ↑ +73% |
| Molina | Florida Kidcare | $1,342.79 | ↑ +73% |
| MOLINA | Managed Medicaid | $1,409.93 | ↑ +81% |
| AETNA | Managed Medicaid/CHIP | $1,477.07 | ↑ +90% |
| Independent Living Systems | Managed Medicaid | $1,611.35 | ↑ +107% |
| HUMANA | Medicare Advantage HMO | $5,975.31 | ↑ +668% |
| Careplus | MEDICARE ADVANTAGE | $5,975.31 | ↑ +668% |
| Freedom Health | MEDICARE ADVANTAGE | $5,975.31 | ↑ +668% |
| UNITED | MEDICARE ADVANTAGE | $5,975.31 | ↑ +668% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $5,975.31 | ↑ +668% |
| BLUE CROSS | Medicare Advantage PPO | $5,975.31 | ↑ +668% |
| BLUE CROSS | Medicare Advantage HMO | $5,975.31 | ↑ +668% |
| AVMED | MEDICARE ADVANTAGE | $6,214.32 | ↑ +699% |
| Independent Living Systems | MEDICARE ADVANTAGE | $6,274.08 | ↑ +706% |
| Wellcare | MEDICARE ADVANTAGE | $6,339.71 | ↑ +715% |
| WellMed | MEDICARE ADVANTAGE | $6,339.71 | ↑ +715% |
| AETNA | MEDICARE ADVANTAGE | $6,339.71 | ↑ +715% |
| DEVOTED HEALTH | Medicare Advantage HMO | $6,973.68 | ↑ +796% |
| AVMED | EXCHANGE | $9,381.24 | ↑ +1106% |
| AVMED | Select | $10,516.55 | ↑ +1252% |
| AVMED | BROAD | $13,683.46 | ↑ +1659% |
| Value Options | All Products | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| Blue Cross | Health Options | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
Visitor-reported prices
Comments
Sigmoidoscopy w/plcmt stent at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $22,248.85 | $116.43 – $29,094.65 |
| martin north hospital | Stuart | $778.05 | $116.43 – $6,973.68 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $6,022.73 – $10,580.98 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $6,022.73 – $13,540.99 |
| Adventhealth Tampa | Tampa | not published | $6,339.71 – $14,074.16 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $1,851.20 – $1,890.17 |
| Adventhealth Port Charlotte | Port Charlotte | not published | $6,339.71 – $11,576.31 |
| Boca Raton Regional Hospital | BOCA RATON | not published | not published |