Established Patient Office Visit (level 4) at HCA FLORIDA HIGHLANDS HOSPITAL
3600 S Highlands Ave, Sebring, FL · HCA Florida Healthcare · · NPI 1598282246
$1,138.00
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.
$1,138.00
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.
$78.52 with Aetna vs $512.10 with United — 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 |
|---|---|---|---|
| Aetna | MCR | $78.52 | ↓ -93% |
| BCBS | MCRHMO | $83.07 | ↓ -93% |
| Prime Health | WORKERSCOMP | $86.33 | ↓ -92% |
| Freedom Health | MGMCR | $97.87 | ↓ -91% |
| BCBS | BSL | $154.77 | ↓ -86% |
| BCBS | SBN | $154.77 | ↓ -86% |
| BCBS | MBN | $154.77 | ↓ -86% |
| Aetna | QHP | $198.01 | ↓ -83% |
| BCBS | HMO | $215.08 | ↓ -81% |
| Molina | MCR | $216.22 | ↓ -81% |
| Aetna | HMO | $221.91 | ↓ -81% |
| BCBS | PPO | $228.74 | ↓ -80% |
| BCBS | NWB | $228.74 | ↓ -80% |
| BCBS | PHS | $274.26 | ↓ -76% |
| Aetna | PPO | $277.67 | ↓ -76% |
| Cigna | NewBusinessNBN | $299.29 | ↓ -74% |
| Aetna | ASA | $341.40 | ↓ -70% |
| Office of Sheiff Highland Co | GVT | $398.30 | ↓ -65% |
| Cigna | HMO | $399.44 | ↓ -65% |
| Cigna | PPO | $399.44 | ↓ -65% |
| Humana | HMO | $421.06 | ↓ -63% |
| Humana | PPO | $455.20 | ↓ -60% |
| United PPO | OptionsPPO | $500.72 | ↓ -56% |
| United | GlobalBenefitPlanAppendix | $512.10 | ↓ -55% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other Florida hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Sebring | Sebring | $1,231.87 | not published |
| Adventhealth Daytona Beach | Daytona Beach | $428.75 | not published |
| Adventhealth Lake Wales | Lake Wales | $650.55 | not published |
| Adventhealth Palm Coast Parkway | Palm Coast | $747.19 | not published |
| Adventhealth Tampa | Tampa | $639.64 | not published |
| AdventHealth New Smyrna Beach | New Smyrna Beach | $524.29 | not published |
| Adventhealth Port Charlotte | Port Charlotte | $984.78 | not published |
| cleveland clinic florida weston hospital | Weston | $499.20 | $39.31 – $384.00 |