healthcosts.net
Skin Biopsy at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$484.25
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.
$745.00
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.
$24.24 with Optum vs $4,545.00 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 |
|---|---|---|---|
| Optum | Managed Medicaid | $24.24 | ↓ -95% |
| Avmed | Medicare Advantage | $31.93 | ↓ -93% |
| Value Options | Medicare Advantage | $31.93 | ↓ -93% |
| Magellan | Medicare Advantage | $31.93 | ↓ -93% |
| Careplus | Medicare Advantage | $31.93 | ↓ -93% |
| Wellcare | Medicare Advantage | $31.93 | ↓ -93% |
| Blue Cross | Medicare Advantage PPO | $31.93 | ↓ -93% |
| Blue Cross | Medicare Advantage HMO | $31.93 | ↓ -93% |
| Independent Living Systems | Medicare Advantage | $33.53 | ↓ -93% |
| Freedom Health | Medicare Advantage | $33.53 | ↓ -93% |
| WellMed | Medicare Advantage | $33.53 | ↓ -93% |
| Clear Spring Health | All Products | $34.48 | ↓ -93% |
| United | Medicare Advantage | $37.70 | ↓ -92% |
| Aetna | Medicare Advantage Behavioral Health | $38.32 | ↓ -92% |
| Aetna | Medicare Advantage PCP | $39.59 | ↓ -92% |
| Aetna | Medicare Advantage Specialist | $40.23 | ↓ -92% |
| Clear Spring Health | ALL PRODUCTS | $43.50 | ↓ -91% |
| Avmed | Exchange | $50.77 | ↓ -90% |
| Avmed | Select | $52.72 | ↓ -89% |
| Avmed | Broad | $56.62 | ↓ -88% |
| Aetna | POS First Health | $62.51 | ↓ -87% |
| United | All Products | $73.89 | ↓ -85% |
| Value Options | Managed Medicaid | $75.58 | ↓ -84% |
| Medicaid | Managed Medicaid | $75.58 | ↓ -84% |
| Molina | Managed Medicaid | $75.58 | ↓ -84% |
| Wellcare | Managed Medicaid | $75.58 | ↓ -84% |
| AmeriHealth | Managed Medicaid | $75.58 | ↓ -84% |
| Cigna | Individual Family Plan Mid-Level | $108.93 | ↓ -78% |
| Cigna | Surefit Mid-Level | $111.02 | ↓ -77% |
| Cigna | All Products Mid-Level | $119.91 | ↓ -75% |
| Cigna | Individual Family Plan Physician | $128.16 | ↓ -74% |
| Cigna | Surefit Physician | $130.62 | ↓ -73% |
| Cigna | All Products Physician | $141.06 | ↓ -71% |
| Aetna | PPO First Health | $148.84 | ↓ -69% |
| AETNA | QHP | $174.33 | ↓ -64% |
| Clarity Health | All Products | $188.50 | ↓ -61% |
| Three Rivers | All Products | $188.50 | ↓ -61% |
| The Legacy Companies | All Products | $188.50 | ↓ -61% |
| CIGNA | Individual Family Plan | $191.47 | ↓ -60% |
| UNITED | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| Careplus | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| Freedom Health | MEDICARE ADVANTAGE | $199.45 | ↓ -59% |
| BLUE CROSS | Medicare Advantage HMO | $199.45 | ↓ -59% |
| HUMANA | Medicare Advantage HMO | $199.45 | ↓ -59% |
| BLUE CROSS | Medicare Advantage PPO | $199.45 | ↓ -59% |
| AVMED | MEDICARE ADVANTAGE | $207.43 | ↓ -57% |
| Independent Living Systems | MEDICARE ADVANTAGE | $209.42 | ↓ -57% |
| Consociate Health | ALL PRODUCTS | $217.50 | ↓ -55% |
| CIGNA | SUREFIT | $230.95 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $236.91 | ↓ -51% |
| National Provider Network | All Products | $246.50 | ↓ -49% |
| OPTUM | Managed Medicaid | $254.67 | ↓ -47% |
| Aetna | All Products First Health | $261.00 | ↓ -46% |
| AETNA | ALL PRODUCTS | $265.22 | ↓ -45% |
| MOLINA | Florida KidCare | $268.07 | ↓ -45% |
| AMERIHEALTH | Managed Medicaid | $268.07 | ↓ -45% |
| Molina | Florida Kidcare | $268.07 | ↓ -45% |
| SUNSHINE HEALTH | Managed Medicaid | $268.07 | ↓ -45% |
| Carelon BH Strategies | Managed Medicaid | $268.07 | ↓ -45% |
| MOLINA | Managed Medicaid | $281.47 | ↓ -42% |
| AETNA | Managed Medicaid/CHIP | $294.88 | ↓ -39% |
| AVMED | EXCHANGE | $313.14 | ↓ -35% |
| Independent Living Systems | Managed Medicaid | $321.68 | ↓ -34% |
| AVMED | Select | $351.03 | ↓ -28% |
| BMI | ALL PRODUCTS | $372.50 | ↓ -23% |
| Wellcare | MEDICARE ADVANTAGE | $424.52 | ↓ -12% |
| AETNA | MEDICARE ADVANTAGE | $424.52 | ↓ -12% |
| WellMed | MEDICARE ADVANTAGE | $424.52 | ↓ -12% |
| MAGELLAN | ALL PRODUCTS | $447.00 | ↓ -8% |
| AVMED | BROAD | $456.74 | ↓ -6% |
| DEVOTED HEALTH | Medicare Advantage HMO | $466.97 | ↓ -4% |
| The Legacy Companies | ALL PRODUCTS | $484.25 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $484.25 | ↑ +0% |
| MULTIPLAN | ALL PRODUCTS | $596.00 | ↑ +23% |
| AETNA | All Products First Health | $596.00 | ↑ +23% |
| BLUE CROSS | HMO | $2,784.00 | ↑ +475% |
| BLUE CROSS | BSL | $2,784.00 | ↑ +475% |
| BLUE CROSS | NWBI | $3,679.00 | ↑ +660% |
| BLUE CROSS | NWB | $3,679.00 | ↑ +660% |
| BLUE CROSS | PHS | $4,545.00 | ↑ +839% |
| BLUE CROSS | PPO | $4,545.00 | ↑ +839% |
| Magellan | Pinnacle | not published by hospital | — |
| Aetna | Medical Rental | not published by hospital | — |
| Aetna | All Products Behavioral Health | not published by hospital | — |
| Blue Cross | Network Blue | not published by hospital | — |
| Magellan | Summit | not published by hospital | — |
| UNITED | ALL PRODUCTS | not published by hospital | — |
| Aetna | All Products Anesthesia | not published by hospital | — |
| Blue Cross | Perferred Patient Care | not published by hospital | — |
| UNITED | NHP | not published by hospital | — |
| UNITED | International | not published by hospital | — |
| Blue Cross | Health Options | not published by hospital | — |
| Aetna | All Products PCP | not published by hospital | — |
| Aetna | All Products Specialist | not published by hospital | — |
| Blue Cross | Traditional (PPS) | not published by hospital | — |
| HUMANA | Managed Medicaid | not published by hospital | — |
| AETNA | NAP | not published by hospital | — |
| Value Options | All Products | not published by hospital | — |
| Consociate Health | Transplant | not published by hospital | — |
Visitor-reported prices
Comments
Skin Biopsy at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $484.25 | $24.24 – $633.25 |
| martin north hospital | Stuart | $484.25 | $31.93 – $466.97 |
| Baptist Hospital | MIAMI | $665.60 | $173.17 – $921.60 |
| Bethesda Hospital East | BOYNTON BEACH | $665.60 | $205.82 – $921.60 |
| Boca Raton Regional Hospital | BOCA RATON | $568.10 | $314.64 – $591.00 |
| Doctors Hospital | CORAL GABLES | $665.60 | $179.20 – $921.60 |
| Baptist Health Hospital Doral | SOUTH MIAMI | $665.60 | $178.18 – $921.60 |
| Homestead Hospital | HOMESTEAD | $665.60 | $167.89 – $921.60 |