CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: HCA Florida Lake City Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 392
Insurance Median: $7,030
Cash Discount Price: Unavailable
vs. Medicare Baseline: 1.24x Medicare

The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at HCA Florida Lake City Hospital is $7,030. 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 1.24x the Medicare baseline. Located in 340 Nw Commerce Dr, Lake City, FL.

Cash / Self-Pay

Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median

$7,030

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: $7,030 (124%)

Ins. Median: $7,030 (124% 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.

Billing Status

Remaining Deductible ($)

Your Coinsurance 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
Clear Spring Health	$1,050	18%
Align Senior Care	$1,275 - $7,574	22%
American Health Plan	$1,275 - $6,981	22%
Florida Complete Care	$1,275 - $7,574	22%
Avmed	$1,636 - $16,299	29%
Molina Healthcare	$2,201 - $13,318	39%
Sunshine State Health Plan	$2,336 - $11,680	41%
Humana	$4,954 - $6,935	87%
United	$5,063 - $12,353	89%
Hospice Of North Central Fl	$5,927	104%
Wellmed	$6,454	114%
Oscar	$6,458	114%
Blue Cross Blue Shield	$6,652 - $35,887	117%
Ultimate Health Plan	$6,718	118%
Aetna	$6,750 - $40,808	119%
Simply	$6,915	122%
Cigna	$6,981 - $34,839	123%
Sunshine State	$7,080	125%
Wellcare	$7,080	125%
Gold Kidney Of Florida	$7,179	126%
Centurion	$7,244	128%
Longevity Health Plan	$7,376	130%
Ndms Definitive Care	$8,232	145%
Evolutions	$12,635	223%
Simply Healthcare	$25,970	458%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $X.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify MS-DRG Code matches exactly: 392.

Insurance In-Network Protection Plan

Contact your insurance company to confirm HCA Florida Lake City Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for MS-DRG code 392.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.