Ankle arthroscopy/surgery at Adventhealth Sebring
4200 Sun N Lake Blvd, Sebring, FL · AdventHealth · · NPI 1083692594
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.
$3,502.30 with Humana vs $7,765.20 with Oscar — 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 | Medicare Managed Care Plan | $3,502.30 | — |
| Bcbs | Medicare Managed Care Plan | $3,519.39 | — |
| Aetna | Medicare Managed Care Plan | $3,553.56 | — |
| Simply Healthcare | Medicare Managed Care Plan | $3,621.89 | — |
| Unitedhealthcare | Medicare Managed Care Plan | $3,652.65 | — |
| Devoted Health | Medicare Managed Care Plan | $3,656.06 | — |
| Sunshine Health | Ambetter Exchange | $7,585.48 | — |
| Oscar | Exchange | $7,765.20 | — |
Visitor-reported prices
Comments
Ankle arthroscopy/surgery at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA HIGHLANDS HOSPITAL | Sebring | not published | $5,430.75 – $5,430.75 |
| cleveland clinic florida weston hospital | Weston | $2,428.40 | $436.35 – $3,758.57 |
| martin north hospital | Stuart | $2,428.40 | $436.35 – $3,758.57 |
| AdventHealth Orlando | Orlando | $13,055.00 | $3,416.88 – $9,054.74 |
| Adventhealth Carrollwood | Tampa | $31,045.79 | $614.00 – $7,585.48 |
| Adventhealth Daytona Beach | Daytona Beach | not published | $3,246.04 – $5,702.77 |
| Adventhealth Palm Coast Parkway | Palm Coast | not published | $3,246.04 – $7,298.12 |
| Adventhealth Tampa | Tampa | not published | $614.00 – $7,585.48 |