Calculi urinary-sendout at HCA FLORIDA HIGHLANDS HOSPITAL
3600 S Highlands Ave, Sebring, FL · HCA Florida Healthcare · · NPI 1598282246
$12.12
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.
$12.12
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.
$1.04 with Freedom Health vs $69.27 with Prime Health — 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 | MGMCR | $1.04 | ↓ -91% |
| AvMed | HIX | $1.58 | ↓ -87% |
| Molina | MCR | $2.30 | ↓ -81% |
| AvMed | FullyInsured | $2.91 | ↓ -76% |
| AvMed | Engage | $3.15 | ↓ -74% |
| AvMed | Select | $3.15 | ↓ -74% |
| AvMed | Focus | $3.15 | ↓ -74% |
| AvMed | Flex | $3.15 | ↓ -74% |
| AvMed | Empower | $3.15 | ↓ -74% |
| AvMed | ASOEO | $3.39 | ↓ -72% |
| Aetna | ASA | $3.64 | ↓ -70% |
| Office of Sheiff Highland Co | GVT | $4.24 | ↓ -65% |
| Humana | HMO | $4.48 | ↓ -63% |
| Humana | PPO | $4.85 | ↓ -60% |
| United PPO | OptionsPPO | $5.33 | ↓ -56% |
| United | GlobalBenefitPlanAppendix | $5.45 | ↓ -55% |
| AvMed | JacksonFirstNetworkOON | $6.06 | ↓ -50% |
| United | GVT | $12.87 | ↑ +6% |
| United | AllPayerAppendix | $12.87 | ↑ +6% |
| Devoted Health | MCR | $12.87 | ↑ +6% |
| HUMANA | MGMCRHMO | $12.87 | ↑ +6% |
| HUMANA | MGMCRPPO | $12.87 | ↑ +6% |
| NDMS Definitive Care | MGMCR | $12.87 | ↑ +6% |
| Wellmed | MGMCR | $12.87 | ↑ +6% |
| BCBS | MCRHMO | $13.13 | ↑ +8% |
| United | MCR | $13.13 | ↑ +8% |
| BCBS | MCRPPO | $13.13 | ↑ +8% |
| Aetna | MCR | $13.26 | ↑ +9% |
| Prominence HealthFirst | MCRHMO | $13.51 | ↑ +11% |
| Sunshine State | MCR | $13.51 | ↑ +11% |
| American Health Plan | MCR | $13.64 | ↑ +13% |
| Florida Complete Care | MCR | $13.77 | ↑ +14% |
| Cigna Healthspring | MCR | $13.77 | ↑ +14% |
| Sunshine State | MCD | $14.16 | ↑ +17% |
| Centurion | GVT | $14.16 | ↑ +17% |
| Longevity Health Plan | MCR | $15.44 | ↑ +27% |
| AmeriHealth Caritas | MGMCR | $15.44 | ↑ +27% |
| Oscar | HIX | $24.84 | ↑ +105% |
| Simply Healthcare | HIX | $29.09 | ↑ +140% |
| Prime Health | WORKERSCOMP | $69.27 | ↑ +472% |
| Aetna | PPO | not published by hospital | — |
| Aetna | QHP | not published by hospital | — |
| Aetna | HMO | not published by hospital | — |
Visitor-reported prices
Comments
Calculi urinary-sendout at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Sebring | Sebring | not published | $13.19 – $29.25 |
| Adventhealth Tampa | Tampa | $198.65 | $12.87 – $28.57 |
| HCA FLORIDA MEMORIAL HOSPITAL | JACKSONVILLE | $15.00 | $10.30 – $75.49 |
| Adventhealth Port Charlotte | Port Charlotte | $85.70 | $12.87 – $23.50 |
| Baptist Hospital | MIAMI | $57.20 | $4.86 – $79.20 |
| Bethesda Hospital East | BOYNTON BEACH | $57.20 | $6.32 – $79.20 |
| Boca Raton Regional Hospital | BOCA RATON | $23.40 | $12.87 – $23.51 |
| Doctors Hospital | CORAL GABLES | $57.20 | $6.12 – $79.20 |