Lead capillary at HCA FLORIDA NORTH FLORIDA HOSPITAL
12311 W NEWBERRY RD, NEWBERRY, FL · HCA Florida Healthcare · · NPI 1174579155
not published by hospital
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.
not published by hospital
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.
$0.65 with AvMed vs $15.14 with Simply Healthcare — 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 | HIX | $0.65 | — |
| United | OptionsPPO | $0.81 | — |
| Simply | MGMCR | $0.83 | — |
| Molina Healthcare | MGMCR | $1.03 | — |
| Humana | HMO | $1.08 | — |
| Humana | PPO | $1.08 | — |
| Evolutions | TieredNetwork | $1.24 | — |
| AvMed | HMOFI | $1.35 | — |
| Sunshine State Health Plan | QHP | $1.38 | — |
| Aetna | ASA | $1.62 | — |
| AvMed | ASOEO | $1.62 | — |
| Molina Healthcare | HIX | $1.73 | — |
| United | GlobalBenefitPlan | $2.43 | — |
| AvMed | HIXOON | $2.71 | — |
| Prime Health Sheriff | WORKERSCOMP | $2.71 | — |
| Plotkin Health | COMM | $2.71 | — |
| Prime Health Sheriff | COMM | $2.71 | — |
| Corizon PHS | Prison | $3.25 | — |
| Multiplan | Primary | $4.22 | — |
| Evernorth | BHCOMM | $4.33 | — |
| Evolutions Healthcare | TRADITIONALPPO | $4.60 | — |
| PPO Next | COMM | $4.60 | — |
| PPO Next | PPO | $4.60 | — |
| Multiplan | Complementary | $4.60 | — |
| NovaNet | COMM | $4.87 | — |
| Beacon Health Options | MCR | $5.41 | — |
| CorVel Corporation | WORKERSCOMP | $8.11 | — |
| Prime Health | WC | $8.28 | — |
| Careworks (Rockport Community) | WORKERSCOMP | $8.54 | — |
| Hospice of North Central FL | MCD | $10.90 | — |
| Hospice of North Central FL | FEDERAL | $10.90 | — |
| Hospice of North Central FL | MCR | $10.90 | — |
| Humana | TRICARE | $10.98 | — |
| United | VACCN | $12.11 | — |
| Humana | MGMCRHMO | $12.11 | — |
| Humana | MGMCRPPO | $12.11 | — |
| United Behavioral Health | VACCN | $12.11 | — |
| United | AllPayerAppendix | $12.11 | — |
| NDMS Definitive Care | MGMCR | $12.11 | — |
| Wellmed | MGMCR | $12.11 | — |
| United | MCR | $12.35 | — |
| BCBS | MCRPPO | $12.35 | — |
| BCBS | MCRHMO | $12.35 | — |
| Capital Health Plan | MCRHMO | $12.35 | — |
| Aetna | MCR | $12.41 | — |
| WellCare | MCR | $12.72 | — |
| Sunshine State | MCR | $12.72 | — |
| American Health Plan | MCR | $12.84 | — |
| Align Senior Care | MGMCR | $12.96 | — |
| Cigna Healthspring | MCR | $12.96 | — |
| Florida Complete Care | MCR | $12.96 | — |
| Gold Kidney of Florida | MCR | $13.20 | — |
| Clear Spring Health | MCR | $13.32 | — |
| Centurion | GVT | $13.32 | — |
| Ultimate Health Plan | MCR | $13.93 | — |
| Longevity Health Plan | MCR | $14.53 | — |
| Oscar | HIX | $14.77 | — |
| Simply Healthcare | HIX | $15.14 | — |
| Aetna | PPO | not published by hospital | — |
| Aetna | QHP | not published by hospital | — |
| Aetna | HMO | not published by hospital | — |
Visitor-reported prices
Comments
Lead capillary at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $70.10 | $11.50 – $20.21 |
| Adventhealth Lake Wales | Lake Wales | $84.11 | $12.11 – $26.88 |
| Adventhealth Palm Coast Parkway | Palm Coast | $70.10 | $11.50 – $25.87 |
| Adventhealth Tampa | Tampa | $186.92 | $12.11 – $26.88 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $40.25 | $11.50 – $26.45 |
| Adventhealth Port Charlotte | Port Charlotte | $89.86 | $12.11 – $22.11 |
| cleveland clinic florida weston hospital | Weston | $68.90 | $5.25 – $18.67 |
| martin north hospital | Stuart | $68.90 | $5.09 – $35.00 |