CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: HCA Florida Highlands Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $6,973
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.23x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at HCA Florida Highlands Hospital is $6,973. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is unavailable. Compared to the federal Medicare reimbursement reference rate of $5,675.87, this hospital’s rate is 1.23x the Medicare baseline. Located in 3600 S Highlands Ave, Sebring, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$6,973

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$5,675.87

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $5,675.87 (100%)
Insurance Median: $6,973 (123%)
Ins. Median: $6,973 (123% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $5,675.87 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
American Health Plan $1,275 - $6,973 22%
Florida Complete Care $1,275 - $6,710 22%
Avmed $1,582 - $13,970 28%
Humana $4,630 - $10,494 82%
United $6,000 - $12,685 106%
Wellmed $6,381 112%
Blue Cross Blue Shield $6,644 - $33,142 117%
Sunshine State $6,644 - $7,236 117%
Cigna $6,710 - $19,361 118%
Devoted Health $6,710 118%
Longevity Health Plan $6,710 118%
Aetna $6,743 - $39,295 119%
Freedom Health $6,841 121%
Prominence Healthfirst $6,841 121%
Molina $6,973 123%
Centurion $7,236 127%
Ndms Definitive Care $8,223 145%
Oscar $10,231 180%
Simply Healthcare $46,905 826%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3600 S Highlands Ave, Sebring, FL 33870
  • CMS Rating: ★★★☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals