healthcosts.net
Upper Endoscopy (EGD, diagnostic) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$3,504.15
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.
$5,391.00
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.
$118.03 with Optum vs $7,322.00 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 | $118.03 | ↓ -97% |
| Avmed | Medicare Advantage | $118.07 | ↓ -97% |
| Value Options | Medicare Advantage | $118.07 | ↓ -97% |
| Magellan | Medicare Advantage | $118.07 | ↓ -97% |
| Careplus | Medicare Advantage | $118.07 | ↓ -97% |
| Wellcare | Medicare Advantage | $118.07 | ↓ -97% |
| Blue Cross | Medicare Advantage PPO | $118.07 | ↓ -97% |
| Blue Cross | Medicare Advantage HMO | $118.07 | ↓ -97% |
| Independent Living Systems | Medicare Advantage | $123.97 | ↓ -96% |
| Freedom Health | Medicare Advantage | $123.97 | ↓ -96% |
| WellMed | Medicare Advantage | $123.97 | ↓ -96% |
| United | Medicare Advantage | $124.71 | ↓ -96% |
| Clear Spring Health | All Products | $127.52 | ↓ -96% |
| Blue Cross | Health Options | $138.13 | ↓ -96% |
| Blue Cross | Network Blue | $141.53 | ↓ -96% |
| Aetna | Medicare Advantage Behavioral Health | $141.68 | ↓ -96% |
| Blue Cross | Traditional (PPS) | $144.92 | ↓ -96% |
| Blue Cross | Perferred Patient Care | $144.92 | ↓ -96% |
| Aetna | Medicare Advantage PCP | $146.41 | ↓ -96% |
| Aetna | Medicare Advantage Specialist | $148.77 | ↓ -96% |
| Clear Spring Health | ALL PRODUCTS | $154.72 | ↓ -96% |
| Avmed | Exchange | $165.63 | ↓ -95% |
| Avmed | Select | $172.00 | ↓ -95% |
| Avmed | Broad | $184.74 | ↓ -95% |
| Aetna | POS First Health | $196.20 | ↓ -94% |
| Value Options | Managed Medicaid | $218.05 | ↓ -94% |
| Medicaid | Managed Medicaid | $218.05 | ↓ -94% |
| Molina | Managed Medicaid | $218.05 | ↓ -94% |
| Wellcare | Managed Medicaid | $218.05 | ↓ -94% |
| AmeriHealth | Managed Medicaid | $218.05 | ↓ -94% |
| United | All Products | $241.07 | ↓ -93% |
| Aetna | PPO First Health | $405.80 | ↓ -88% |
| Cigna | Individual Family Plan Mid-Level | $410.00 | ↓ -88% |
| Cigna | Surefit Mid-Level | $417.85 | ↓ -88% |
| Cigna | All Products Mid-Level | $451.23 | ↓ -87% |
| Cigna | Individual Family Plan Physician | $482.35 | ↓ -86% |
| Cigna | Surefit Physician | $491.58 | ↓ -86% |
| Cigna | All Products Physician | $530.85 | ↓ -85% |
| Clarity Health | All Products | $543.40 | ↓ -84% |
| Three Rivers | All Products | $543.40 | ↓ -84% |
| The Legacy Companies | All Products | $543.40 | ↓ -84% |
| OPTUM | Managed Medicaid | $616.53 | ↓ -82% |
| Consociate Health | ALL PRODUCTS | $627.00 | ↓ -82% |
| MOLINA | Florida KidCare | $648.98 | ↓ -81% |
| AMERIHEALTH | Managed Medicaid | $648.98 | ↓ -81% |
| Molina | Florida Kidcare | $648.98 | ↓ -81% |
| SUNSHINE HEALTH | Managed Medicaid | $648.98 | ↓ -81% |
| Carelon BH Strategies | Managed Medicaid | $648.98 | ↓ -81% |
| MOLINA | Managed Medicaid | $681.43 | ↓ -81% |
| National Provider Network | All Products | $710.60 | ↓ -80% |
| AETNA | Managed Medicaid/CHIP | $713.88 | ↓ -80% |
| Aetna | All Products First Health | $752.40 | ↓ -79% |
| Independent Living Systems | Managed Medicaid | $778.78 | ↓ -78% |
| UNITED | MEDICARE ADVANTAGE | $941.10 | ↓ -73% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $941.10 | ↓ -73% |
| Careplus | MEDICARE ADVANTAGE | $941.10 | ↓ -73% |
| Freedom Health | MEDICARE ADVANTAGE | $941.10 | ↓ -73% |
| BLUE CROSS | Medicare Advantage HMO | $941.10 | ↓ -73% |
| HUMANA | Medicare Advantage HMO | $941.10 | ↓ -73% |
| BLUE CROSS | Medicare Advantage PPO | $941.10 | ↓ -73% |
| Wellcare | MEDICARE ADVANTAGE | $947.15 | ↓ -73% |
| AETNA | MEDICARE ADVANTAGE | $947.15 | ↓ -73% |
| WellMed | MEDICARE ADVANTAGE | $947.15 | ↓ -73% |
| AVMED | MEDICARE ADVANTAGE | $978.75 | ↓ -72% |
| Independent Living Systems | MEDICARE ADVANTAGE | $988.16 | ↓ -72% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,041.86 | ↓ -70% |
| AETNA | QHP | $1,261.49 | ↓ -64% |
| CIGNA | Individual Family Plan | $1,385.49 | ↓ -60% |
| AVMED | EXCHANGE | $1,477.53 | ↓ -58% |
| AVMED | Select | $1,656.34 | ↓ -53% |
| CIGNA | SUREFIT | $1,671.21 | ↓ -52% |
| CIGNA | ALL PRODUCTS | $1,714.34 | ↓ -51% |
| AETNA | ALL PRODUCTS | $1,919.20 | ↓ -45% |
| AVMED | BROAD | $2,155.13 | ↓ -38% |
| UNITED | NHP | $2,297.00 | ↓ -34% |
| UNITED | International | $2,307.00 | ↓ -34% |
| BMI | ALL PRODUCTS | $2,695.50 | ↓ -23% |
| UNITED | ALL PRODUCTS | $2,728.00 | ↓ -22% |
| MAGELLAN | ALL PRODUCTS | $3,234.60 | ↓ -8% |
| The Legacy Companies | ALL PRODUCTS | $3,504.15 | ↑ +0% |
| Clarity Health | ALL PRODUCTS | $3,504.15 | ↑ +0% |
| BLUE CROSS | HMO | $3,899.00 | ↑ +11% |
| BLUE CROSS | BSL | $3,899.00 | ↑ +11% |
| MULTIPLAN | ALL PRODUCTS | $4,312.80 | ↑ +23% |
| AETNA | All Products First Health | $4,312.80 | ↑ +23% |
| BLUE CROSS | NWBI | $5,154.00 | ↑ +47% |
| BLUE CROSS | NWB | $5,154.00 | ↑ +47% |
| BLUE CROSS | PHS | $7,322.00 | ↑ +109% |
| BLUE CROSS | PPO | $7,322.00 | ↑ +109% |
| 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 | — |
| 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
Upper Endoscopy (EGD, diagnostic) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $3,504.15 | $118.03 – $4,582.35 |
| martin north hospital | Stuart | $3,504.15 | $115.49 – $2,695.50 |
| Baptist Hospital | MIAMI | not published | not published |
| 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 |