healthcosts.net
Upper Endoscopy (EGD, with biopsy) at indian river hospital
1000 36th Street, Vero Beach, FL · Cleveland Clinic · · NPI 1376512988
$683.80
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.
$1,052.00
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.
$132.00 with Avmed 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 |
|---|---|---|---|
| Avmed | Medicare Advantage | $132.00 | ↓ -81% |
| Value Options | Medicare Advantage | $132.00 | ↓ -81% |
| Magellan | Medicare Advantage | $132.00 | ↓ -81% |
| Careplus | Medicare Advantage | $132.00 | ↓ -81% |
| Wellcare | Medicare Advantage | $132.00 | ↓ -81% |
| Blue Cross | Medicare Advantage PPO | $132.00 | ↓ -81% |
| Blue Cross | Medicare Advantage HMO | $132.00 | ↓ -81% |
| Optum | Managed Medicaid | $132.82 | ↓ -81% |
| Independent Living Systems | Medicare Advantage | $138.60 | ↓ -80% |
| Freedom Health | Medicare Advantage | $138.60 | ↓ -80% |
| WellMed | Medicare Advantage | $138.60 | ↓ -80% |
| United | Medicare Advantage | $139.75 | ↓ -80% |
| Clear Spring Health | All Products | $142.56 | ↓ -79% |
| Aetna | Medicare Advantage Behavioral Health | $158.40 | ↓ -77% |
| Blue Cross | Health Options | $162.63 | ↓ -76% |
| Aetna | Medicare Advantage PCP | $163.68 | ↓ -76% |
| Aetna | Medicare Advantage Specialist | $166.32 | ↓ -76% |
| Blue Cross | Network Blue | $166.63 | ↓ -76% |
| Blue Cross | Traditional (PPS) | $170.63 | ↓ -75% |
| Blue Cross | Perferred Patient Care | $170.63 | ↓ -75% |
| Avmed | Exchange | $187.29 | ↓ -73% |
| Avmed | Select | $194.49 | ↓ -72% |
| Avmed | Broad | $208.90 | ↓ -69% |
| Aetna | POS First Health | $222.08 | ↓ -68% |
| United | All Products | $272.59 | ↓ -60% |
| Value Options | Managed Medicaid | $281.88 | ↓ -59% |
| Medicaid | Managed Medicaid | $281.88 | ↓ -59% |
| Molina | Managed Medicaid | $281.88 | ↓ -59% |
| Wellcare | Managed Medicaid | $281.88 | ↓ -59% |
| AmeriHealth | Managed Medicaid | $281.88 | ↓ -59% |
| Cigna | Individual Family Plan Mid-Level | $522.13 | ↓ -24% |
| Cigna | Surefit Mid-Level | $532.12 | ↓ -22% |
| Aetna | PPO First Health | $541.40 | ↓ -21% |
| Cigna | All Products Mid-Level | $574.63 | ↓ -16% |
| Cigna | Individual Family Plan Physician | $614.26 | ↓ -10% |
| OPTUM | Managed Medicaid | $616.53 | ↓ -10% |
| Cigna | Surefit Physician | $626.01 | ↓ -8% |
| MOLINA | Florida KidCare | $648.98 | ↓ -5% |
| AMERIHEALTH | Managed Medicaid | $648.98 | ↓ -5% |
| Molina | Florida Kidcare | $648.98 | ↓ -5% |
| SUNSHINE HEALTH | Managed Medicaid | $648.98 | ↓ -5% |
| Carelon BH Strategies | Managed Medicaid | $648.98 | ↓ -5% |
| Cigna | All Products Physician | $676.03 | ↓ -1% |
| MOLINA | Managed Medicaid | $681.43 | ↓ -0% |
| Clarity Health | All Products | $683.80 | ↑ +0% |
| Three Rivers | All Products | $683.80 | ↑ +0% |
| The Legacy Companies | All Products | $683.80 | ↑ +0% |
| AETNA | Managed Medicaid/CHIP | $713.88 | ↑ +4% |
| Independent Living Systems | Managed Medicaid | $778.78 | ↑ +14% |
| Consociate Health | ALL PRODUCTS | $789.00 | ↑ +15% |
| National Provider Network | All Products | $894.20 | ↑ +31% |
| UNITED | MEDICARE ADVANTAGE | $941.10 | ↑ +38% |
| Carelon BH Strategies | MEDICARE ADVANTAGE | $941.10 | ↑ +38% |
| Careplus | MEDICARE ADVANTAGE | $941.10 | ↑ +38% |
| Freedom Health | MEDICARE ADVANTAGE | $941.10 | ↑ +38% |
| BLUE CROSS | Medicare Advantage HMO | $941.10 | ↑ +38% |
| HUMANA | Medicare Advantage HMO | $941.10 | ↑ +38% |
| BLUE CROSS | Medicare Advantage PPO | $941.10 | ↑ +38% |
| Aetna | All Products First Health | $946.80 | ↑ +38% |
| Wellcare | MEDICARE ADVANTAGE | $947.15 | ↑ +39% |
| AETNA | MEDICARE ADVANTAGE | $947.15 | ↑ +39% |
| WellMed | MEDICARE ADVANTAGE | $947.15 | ↑ +39% |
| AVMED | MEDICARE ADVANTAGE | $978.75 | ↑ +43% |
| Independent Living Systems | MEDICARE ADVANTAGE | $988.16 | ↑ +45% |
| DEVOTED HEALTH | Medicare Advantage HMO | $1,041.86 | ↑ +52% |
| AVMED | EXCHANGE | $1,477.53 | ↑ +116% |
| AVMED | Select | $1,656.34 | ↑ +142% |
| AVMED | BROAD | $2,155.13 | ↑ +215% |
| UNITED | NHP | $2,297.00 | ↑ +236% |
| UNITED | ALL PRODUCTS | $2,728.00 | ↑ +299% |
| AETNA | QHP | $2,789.00 | ↑ +308% |
| BLUE CROSS | BSL | $3,899.00 | ↑ +470% |
| AETNA | ALL PRODUCTS | $4,542.00 | ↑ +564% |
| BLUE CROSS | NWB | $5,154.00 | ↑ +654% |
| BLUE CROSS | PPO | $7,322.00 | ↑ +971% |
| 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
Upper Endoscopy (EGD, with biopsy) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic florida weston hospital | Weston | $3,504.15 | $132.00 – $4,582.35 |
| martin north hospital | Stuart | $3,504.15 | $132.00 – $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 |