Coombs direct 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.
$1.64 with Freedom Health vs $28.34 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 |
|---|---|---|---|
| Freedom Health | MCR | $1.64 | — |
| Optimum | MGMCR | $1.64 | — |
| Simply | MGMCR | $3.50 | — |
| Molina Healthcare | MGMCR | $4.32 | — |
| Humana | PPO | $4.55 | — |
| Humana | HMO | $4.55 | — |
| Evolutions | TieredNetwork | $5.23 | — |
| Wellmed | MGMCR | $5.39 | — |
| United | AllPayerAppendix | $5.39 | — |
| Humana | MGMCRHMO | $5.39 | — |
| United | VACCN | $5.39 | — |
| Devoted Health | MCR | $5.39 | — |
| NDMS Definitive Care | MGMCR | $5.39 | — |
| AvMed | HMOFI | $5.46 | — |
| United | MCR | $5.50 | — |
| FL Health Care Plan | MCR | $5.50 | — |
| BCBS | MCRPPO | $5.50 | — |
| BCBS | MCRHMO | $5.50 | — |
| Aetna | MCR | $5.52 | — |
| Sunshine State | MCR | $5.66 | — |
| WellCare | MCR | $5.66 | — |
| American Health Plan | MCR | $5.71 | — |
| AvMed | MGMCR | $5.71 | — |
| Florida Complete Care | MCR | $5.77 | — |
| Align Senior Care | MGMCR | $5.77 | — |
| Cigna Healthspring | MCR | $5.77 | — |
| Sunshine State Health Plan | QHP | $5.80 | — |
| Gold Kidney of Florida | MCR | $5.88 | — |
| Seminole County Sheriffs Office | MGMCR | $5.93 | — |
| Centurion | GVT | $5.93 | — |
| Clear Spring Health | MCR | $5.93 | — |
| CarePlus | MGMCR | $6.14 | — |
| Ultimate Health Plan | MCR | $6.20 | — |
| AvMed | ASOEO | $6.37 | — |
| Longevity Health Plan | MCR | $6.47 | — |
| Aetna | ASA | $6.83 | — |
| Molina Healthcare | HIX | $7.28 | — |
| United | OptionsPPO | $7.60 | — |
| Solis Health Plan | MCR | $7.82 | — |
| Oscar | HIX | $7.82 | — |
| Simply Healthcare | HIX | $8.41 | — |
| Florida Health Care Plan | COMM | $8.58 | — |
| United | GlobalBenefitPlan | $10.24 | — |
| Prime Health Sheriff | WORKERSCOMP | $11.38 | — |
| Plotkin Health | COMM | $11.38 | — |
| AvMed | HIXOON | $11.38 | — |
| Prime Health Sheriff | COMM | $11.38 | — |
| Multiplan | PRIMARYPPO | $17.06 | — |
| Three Rivers Provider Network | WorkersComp | $17.06 | — |
| Multiplan | Primary | $17.75 | — |
| Multiplan | COMPLEMENTARYPPO | $19.34 | — |
| PPO Next | PPO | $19.34 | — |
| PPO Next | COMM | $19.34 | — |
| Multiplan | Complementary | $19.34 | — |
| NovaNet | COMM | $20.48 | — |
| Humana | MGMCRPPO | $21.56 | — |
| CorVel Corporation | WORKERSCOMP | $26.92 | — |
| Prime Health | WC | $27.49 | — |
| Careworks (Rockport Community) | WORKERSCOMP | $28.34 | — |
| Aetna | PPO | not published by hospital | — |
| Aetna | QHP | not published by hospital | — |
| Aetna | HMO | not published by hospital | — |
Visitor-reported prices
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Coombs direct at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Daytona Beach | Daytona Beach | $259.96 | $58.52 – $102.82 |
| Adventhealth Lake Wales | Lake Wales | $224.58 | $61.60 – $136.76 |
| Adventhealth Palm Coast Parkway | Palm Coast | $248.45 | $58.52 – $131.58 |
| Adventhealth Tampa | Tampa | $224.12 | $61.60 – $136.76 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $58.27 | $58.52 – $134.57 |
| Adventhealth Port Charlotte | Port Charlotte | $411.14 | $61.60 – $112.49 |
| cleveland clinic florida weston hospital | Weston | $112.45 | $2.08 – $166.00 |
| martin north hospital | Stuart | $112.45 | $2.19 – $67.76 |