CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Central Florida Lake Monroe Hospital

Billing Code: 392 (MS-DRG)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 392
  • Insurance Median: $9,036
  • Cash Discount Price: Unavailable
  • vs. Medicare Baseline: 1.59x Medicare
The contracted insurance negotiated median rate for a Digestive disorders treatment (inpatient stay) at Central Florida Lake Monroe Hospital is $9,036. 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 1.59x the Medicare baseline. Located in 1401 W Seminole Blvd, Sanford, FL.
Cash / Self-Pay
Unavailable

Average discount available for prompt cash payment at this facility.

Insurance Median
$9,036

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: $9,036 (159%)
Ins. Median: $9,036 (159% 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
Clear Spring Health $1,050 - $8,658 18%
Align Senior Care $1,275 - $9,246 22%
American Health Plan $1,275 - $8,910 22%
Florida Complete Care $1,275 - $9,246 22%
Molina Healthcare $2,201 - $13,318 39%
Sunshine State Health Plan $2,348 - $11,736 41%
Avmed $2,825 - $16,299 50%
United $4,328 - $10,555 76%
Humana $8,154 - $19,754 144%
Wellmed $8,238 145%
Blue Cross Blue Shield $8,490 - $30,630 150%
Fl Health Care Plan $8,490 150%
Devoted Health $8,574 151%
Ultimate Health Plan $8,574 151%
Aetna $8,616 - $39,504 152%
Freedom Health $8,742 154%
Optimum $8,742 154%
Simply $8,826 156%
Cigna $8,994 - $14,264 158%
Solis Health Plan $8,994 158%
Sunshine State $9,036 159%
Wellcare $9,036 159%
Longevity Health Plan $9,078 160%
Careplus $9,162 - $9,667 161%
Gold Kidney Of Florida $9,162 161%
Centurion $9,246 163%
Seminole County Sheriffs Office $9,246 163%
Ndms Definitive Care $10,507 185%
Oscar $10,581 186%
Florida Health Care Plan $12,492 220%
Evolutions $12,635 223%
Truli For Health $17,408 307%
Simply Healthcare $32,330 570%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 1401 W Seminole Blvd, Sanford, FL 32771
  • CMS Rating: ★★☆☆☆
  • Ownership Type: Proprietary
  • Hospital Type: Acute Care Hospitals