Dch validity tests 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.
$3.15 with Humana vs $37.46 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 |
|---|---|---|---|
| Humana | TRICARE | $3.15 | — |
| Wellmed | MGMCR | $3.48 | — |
| United | AllPayerAppendix | $3.48 | — |
| Humana | MGMCRHMO | $3.48 | — |
| United | VACCN | $3.48 | — |
| NDMS Definitive Care | MGMCR | $3.48 | — |
| Devoted Health | MCR | $3.48 | — |
| BCBS | MCRHMO | $3.55 | — |
| FL Health Care Plan | MCR | $3.55 | — |
| United | MCR | $3.55 | — |
| BCBS | MCRPPO | $3.55 | — |
| Aetna | MCR | $3.57 | — |
| Sunshine State | MCR | $3.65 | — |
| WellCare | MCR | $3.65 | — |
| American Health Plan | MCR | $3.69 | — |
| AvMed | MGMCR | $3.69 | — |
| Florida Complete Care | MCR | $3.72 | — |
| Cigna Healthspring | MCR | $3.72 | — |
| Align Senior Care | MGMCR | $3.72 | — |
| Gold Kidney of Florida | MCR | $3.79 | — |
| Seminole County Sheriffs Office | MGMCR | $3.83 | — |
| Centurion | GVT | $3.83 | — |
| Clear Spring Health | MCR | $3.83 | — |
| CarePlus | MGMCR | $3.97 | — |
| Ultimate Health Plan | MCR | $4.00 | — |
| Longevity Health Plan | MCR | $4.18 | — |
| Oscar | HIX | $5.05 | — |
| Solis Health Plan | MCR | $5.05 | — |
| Simply Healthcare | HIX | $5.43 | — |
| Humana | MGMCRPPO | $13.92 | — |
| CorVel Corporation | WORKERSCOMP | $35.59 | — |
| Prime Health | WC | $36.34 | — |
| Careworks (Rockport Community) | WORKERSCOMP | $37.46 | — |
| Aetna | QHP | not published by hospital | — |
| Aetna | PPO | not published by hospital | — |
| Aetna | HMO | not published by hospital | — |
Visitor-reported prices
Comments
Dch validity tests at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Palm Coast Parkway | Palm Coast | $60.18 | $3.31 – $7.43 |
| Adventhealth Tampa | Tampa | $61.78 | $3.48 – $7.73 |
| Adventhealth Port Charlotte | Port Charlotte | $25.85 | $3.48 – $6.35 |
| cleveland clinic florida weston hospital | Weston | $25.35 | $1.43 – $31.45 |
| martin north hospital | Stuart | $51.35 | $1.50 – $18.50 |
| indian river hospital | Vero Beach | $25.35 | $1.43 – $29.60 |
| Ascension St. Vincent's Southside (St. Luke's-St. Vincent's HealthCare, Inc.) | Jacksonville | $4.90 | $3.06 – $8.70 |
| Ascension Sacred Heart Pensacola (Sacred Heart Health System, Inc.) | Pensacola | $8.20 | $3.48 – $12.76 |