Consultation/report referred material w/preparation of slides at HCA FLORIDA LAKE MONROE HOSPITAL
1401 WEST SEMINOLE BLVD, SANFORD, FL · HCA Florida Healthcare · · NPI 1285681908
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.
$2.39 with Optimum vs $289.52 with Careworks (Rockport Community) — 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 |
|---|---|---|---|
| Optimum | MGMCR | $2.39 | — |
| Freedom Health | MCR | $2.39 | — |
| Simply | MGMCR | $5.12 | — |
| Oscar | HIX | $5.32 | — |
| Simply Healthcare | HIX | $5.55 | — |
| Molina Healthcare | MGMCR | $6.32 | — |
| Humana | HMO | $6.65 | — |
| Humana | PPO | $6.65 | — |
| Evolutions | TieredNetwork | $7.65 | — |
| AvMed | HMOFI | $7.98 | — |
| Sunshine State Health Plan | QHP | $8.48 | — |
| AvMed | ASOEO | $9.31 | — |
| Aetna | ASA | $9.97 | — |
| Molina Healthcare | HIX | $10.64 | — |
| United | OptionsPPO | $11.11 | — |
| Florida Health Care Plan | COMM | $12.54 | — |
| United | GlobalBenefitPlan | $14.96 | — |
| AvMed | HIXOON | $16.63 | — |
| Prime Health Sheriff | WORKERSCOMP | $16.63 | — |
| Prime Health Sheriff | COMM | $16.63 | — |
| Plotkin Health | COMM | $16.63 | — |
| Three Rivers Provider Network | WorkersComp | $24.94 | — |
| Multiplan | PRIMARYPPO | $24.94 | — |
| Multiplan | Primary | $25.93 | — |
| PPO Next | COMM | $28.26 | — |
| Multiplan | COMPLEMENTARYPPO | $28.26 | — |
| PPO Next | PPO | $28.26 | — |
| Multiplan | Complementary | $28.26 | — |
| NovaNet | COMM | $29.93 | — |
| United | AllPayerAppendix | $49.76 | — |
| CorVel Corporation | WORKERSCOMP | $275.04 | — |
| Prime Health | WC | $280.83 | — |
| Careworks (Rockport Community) | WORKERSCOMP | $289.52 | — |
| Aetna | QHP | not published by hospital | — |
| Aetna | HMO | not published by hospital | — |
| Aetna | PPO | not published by hospital | — |
Visitor-reported prices
Comments
Consultation/report referred material w/preparation of slides at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $247.40 | $51.70 – $90.82 |
| Adventhealth Lake Wales | Lake Wales | $156.18 | $54.42 – $120.81 |
| Adventhealth Palm Coast Parkway | Palm Coast | $184.29 | $51.70 – $116.23 |
| Adventhealth Tampa | Tampa | $691.67 | $54.42 – $120.81 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $513.39 | $51.70 – $118.88 |
| Adventhealth Port Charlotte | Port Charlotte | $368.07 | $54.42 – $99.37 |
| cleveland clinic florida weston hospital | Weston | $511.55 | $38.59 – $787.00 |
| martin north hospital | Stuart | $511.55 | $49.47 – $787.00 |