Sigmoidoscopy w/us guide bx at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$852.15
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.
$1,311.00
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.
$128.68 with Molina vs $2,710.30 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 |
|---|---|---|---|
| Molina | Managed Medicaid | $128.68 | ↓ -85% |
| Medicaid | Managed Medicaid | $128.68 | ↓ -85% |
| Value Options | Managed Medicaid | $128.68 | ↓ -85% |
| AmeriHealth | Managed Medicaid | $128.68 | ↓ -85% |
| Wellcare | Managed Medicaid | $128.68 | ↓ -85% |
| Careplus | Medicare Advantage | $162.71 | ↓ -81% |
| Magellan | Medicare Advantage | $162.71 | ↓ -81% |
| Value Options | Medicare Advantage | $162.71 | ↓ -81% |
| Wellcare | Medicare Advantage | $162.71 | ↓ -81% |
| Blue Cross | Medicare Advantage HMO | $162.71 | ↓ -81% |
| Blue Cross | Medicare Advantage PPO | $162.71 | ↓ -81% |
| Avmed | Medicare Advantage | $162.71 | ↓ -81% |
| Optum | Managed Medicaid | $163.07 | ↓ -81% |
| WellMed | Medicare Advantage | $170.85 | ↓ -80% |
| Freedom Health | Medicare Advantage | $170.85 | ↓ -80% |
| Independent Living Systems | Medicare Advantage | $170.85 | ↓ -80% |
| United | Medicare Advantage | $172.63 | ↓ -80% |
| Clear Spring Health | All Products | $175.73 | ↓ -79% |
| Aetna | Medicare Advantage Behavioral Health | $195.25 | ↓ -77% |
| Aetna | Medicare Advantage PCP | $201.76 | ↓ -76% |
| Aetna | Medicare Advantage Specialist | $205.01 | ↓ -76% |
| Blue Cross | Health Options | $226.86 | ↓ -73% |
| Avmed | Exchange | $231.28 | ↓ -73% |
| Blue Cross | Network Blue | $232.44 | ↓ -73% |
| Blue Cross | Perferred Patient Care | $238.02 | ↓ -72% |
| Blue Cross | Traditional (PPS) | $238.02 | ↓ -72% |
| Avmed | Select | $240.18 | ↓ -72% |
| Avmed | Broad | $257.97 | ↓ -70% |
| Aetna | PPO First Health | $271.06 | ↓ -68% |
| United | All Products | $336.62 | ↓ -60% |
| Aetna | POS First Health | $589.95 | ↓ -31% |
| OPTUM | Managed Medicaid | $605.04 | ↓ -29% |
| Molina | Florida Kidcare | $636.88 | ↓ -25% |
| Carelon BH Strategies | Managed Medicaid | $636.88 | ↓ -25% |
| AMERIHEALTH | Managed Medicaid | $636.88 | ↓ -25% |
| SUNSHINE HEALTH | Managed Medicaid | $636.88 | ↓ -25% |
| MOLINA | Florida KidCare | $636.88 | ↓ -25% |
| MOLINA | Managed Medicaid | $668.72 | ↓ -22% |
| AETNA | Managed Medicaid/CHIP | $700.57 | ↓ -18% |
| Independent Living Systems | Managed Medicaid | $764.26 | ↓ -10% |
| The Legacy Companies | All Products | $852.15 | ↑ +0% |
| Clarity Health | All Products | $852.15 | ↑ +0% |
| Three Rivers | All Products | $852.15 | ↑ +0% |
| Consociate Health | ALL PRODUCTS | $983.25 | ↑ +15% |
| National Provider Network | All Products | $1,114.35 | ↑ +31% |
| Aetna | All Products First Health | $1,179.90 | ↑ +38% |
| BLUE CROSS | Medicare Advantage HMO | $1,183.54 | ↑ +39% |
| BLUE CROSS | Medicare Advantage PPO | $1,183.54 | ↑ +39% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $1,183.54 | ↑ +39% |
| Careplus | MEDICARE ADVANTAGE | $1,183.54 | ↑ +39% |
| Freedom Health | MEDICARE ADVANTAGE | $1,183.54 | ↑ +39% |
| UNITED | MEDICARE ADVANTAGE | $1,183.54 | ↑ +39% |
| HUMANA | Medicare Advantage HMO | $1,183.54 | ↑ +39% |
| AVMED | MEDICARE ADVANTAGE | $1,230.88 | ↑ +44% |
| Independent Living Systems | MEDICARE ADVANTAGE | $1,242.71 | ↑ +46% |
| WellMed | MEDICARE ADVANTAGE | $1,249.63 | ↑ +47% |
| AETNA | MEDICARE ADVANTAGE | $1,249.63 | ↑ +47% |
| Wellcare | MEDICARE ADVANTAGE | $1,249.63 | ↑ +47% |
| Cigna | Surefit Physician | $1,311.00 | ↑ +54% |
| Cigna | Individual Family Plan Physician | $1,311.00 | ↑ +54% |
| Cigna | Surefit Mid-Level | $1,311.00 | ↑ +54% |
| Cigna | All Products Mid-Level | $1,311.00 | ↑ +54% |
| Cigna | All Products Physician | $1,311.00 | ↑ +54% |
| Cigna | Individual Family Plan Mid-Level | $1,311.00 | ↑ +54% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,374.59 | ↑ +61% |
| AVMED | EXCHANGE | $1,858.15 | ↑ +118% |
| AVMED | Select | $2,083.02 | ↑ +144% |
| AVMED | BROAD | $2,710.30 | ↑ +218% |
| Aetna | All Products Specialist | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
Visitor-reported prices
Comments
Sigmoidoscopy w/us guide bx at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $4,407.00 | $128.68 – $5,763.00 |
| martin north hospital | Stuart | $852.15 | $128.68 – $1,374.59 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $1,187.15 – $2,085.63 |
| Adventhealth Lake Wales | Lake Wales | not published | $1,249.63 – $2,774.17 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $1,187.15 – $2,669.08 |
| Adventhealth Tampa | Tampa | not published | $401.00 – $2,774.17 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | not published | $1,187.15 – $2,729.81 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | not published | $1,851.20 – $1,890.17 |