Biopsy abdominal mass at Adventhealth Sebring
4200 Sun N Lake Blvd, Sebring, FL · AdventHealth · · NPI 1083692594
$4,840.89
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.
$4,840.89
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.
$1,767.85 with Humana vs $3,919.62 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 | $1,767.85 | ↓ -63% |
| Bcbs | Medicare Managed Care Plan | $1,776.47 | ↓ -63% |
| Aetna | Medicare Managed Care Plan | $1,793.72 | ↓ -63% |
| Simply Healthcare | Medicare Managed Care Plan | $1,828.21 | ↓ -62% |
| Unitedhealthcare | Medicare Managed Care Plan | $1,843.73 | ↓ -62% |
| Devoted Health | Medicare Managed Care Plan | $1,845.46 | ↓ -62% |
| Sunshine Health | Ambetter Exchange | $3,828.90 | ↓ -21% |
| Oscar | Exchange | $3,919.62 | ↓ -19% |
Visitor-reported prices
Comments
Biopsy abdominal mass at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| HCA FLORIDA HIGHLANDS HOSPITAL | Sebring | not published | $1,524.78 – $1,524.78 |
| Adventhealth Daytona Beach | Daytona Beach | $2,498.75 | $1,638.49 – $2,878.57 |
| Adventhealth Palm Coast Parkway | Palm Coast | $3,585.25 | $1,638.49 – $3,683.85 |
| Adventhealth Tampa | Tampa | $5,146.37 | $401.00 – $3,828.90 |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $2,174.81 | $1,638.49 – $3,767.67 |
| Adventhealth Port Charlotte | Port Charlotte | $5,638.11 | $1,724.73 – $3,149.35 |
| cleveland clinic florida weston hospital | Weston | $6,055.40 | $74.44 – $7,918.60 |
| martin north hospital | Stuart | $6,055.40 | $66.60 – $4,658.00 |