How many shoppable procedure prices are published for Adventhealth Palm Coast?

Adventhealth Palm Coast in Palm Coast, FL currently has 103 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Adventhealth Palm Coast's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Adventhealth Palm Coast's median negotiated commercial rate is 1.1× the regionally adjusted fair BaseRate benchmark.

What is Adventhealth Palm Coast's CMS Care Compare overall star rating?

CMS Care Compare assigns Adventhealth Palm Coast an overall hospital quality rating of 5 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Church 99 Beds · urban

Adventhealth Palm Coast

60 Memorial Medical Pkwy, Palm Coast, FL 32164 · 103 Priced Procedures · 72% Patient Recommendation

CMS Overall Rating 5 / 5 Stars

Above Fair Market · Negotiate

1.14×vs. Fair Market Price

Typical commercial prices here are +14% above the fair benchmark (1.14×) even after accounting for local nurse/doctor wages and patient complexity.

4/100 · Quarantined

4/100Self-Pay Cash Beats Insurance 0% of the Time

File Completeness20

Price Logic0

Peer Alignment0

Clean Billing0

Real Cash Discount0

High Quality · Fair Price

4-Star CMS clinical quality rating paired with 1.14× fair market pricing.

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

Adventhealth Palm Coast prices shoppable and inpatient services (1.4× to 1.1× Medicare, divergence 0.79×) in alignment with regional hospital peers (1.14× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#85 of 165 in FL · 50th State Percentile#1,820 of 3,385 in U.S. · 53rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 1.00× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 0% of shoppable procedures (25/100 Cash Honesty)
5-Star CMS clinical rating with 72% patient recommendation (74/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (44.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
Commercial insurance median sits at 1.04× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 1.34×) jump +29% above the median procedure ratio (Q50 1.04×)
Unnegotiated chargemaster list prices average 17.3× Medicare (14¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

1.4× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.79× Divergence

1.1× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+29% Upper Tail

Q25 1.00× · Q50 1.04× · Q75 1.34×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

1.4× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.8× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

1.5× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

2.0× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.8× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.6× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

0% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

5 CMS · 74/100Fair

Procedure Prices at Adventhealth Palm Coast

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 103 published procedures.

Sort:

Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$48,059	$30,775	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$26,902	$19,432	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$15,872	$19,087	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$10,873	$8,223	unverified
Rabies immune globulin HCPCS Code: `90375`	$9,246	$9,246	$322	28.7×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$6,566	$6,109	1.1×
Breast lump removal CPT Code: `19120`	—	$4,252	$3,875	1.1×
Inguinal hernia repair CPT Code: `49505`	—	$3,888	$3,629	1.1×
Bunion correction surgery CPT Code: `28296`	—	$3,554	$3,446	1.0×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,300	$1,256	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$1,222	$1,222	$17,936	0.1×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$1,010	$981	1.0×
Upper endoscopy with biopsy CPT Code: `43239`	$4,533	$985	$987	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$747	$747	$123	6.1×
Injection procedure for pain management HCPCS Code: `G0260`	—	$767	$855	0.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$5,376	$778	$511	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$9,387	$632	$448	unverified
Office visit, established patient (20-29 min) CPT Code: `99213`	$590	$590	$87	6.8×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,420	$593	$583	1.0×
New patient office visit (30-44 min) CPT Code: `99203`	$556	$556	$110	5.1×
MRI, brain (no contrast) CPT Code: `70551`	$4,395	$510	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$5,579	$510	$338	unverified
MRI, knee or other leg joint CPT Code: `73721`	$7,173	$510	$369	unverified
Blood transfusion CPT Code: `36430`	$1,932	$479	$498	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$397	$397	$201	2.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,919	$417	$258	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$8,194	$418	$303	unverified
CT scan, head (with contrast) CPT Code: `70460`	$3,774	$391	$242	unverified
Speech therapy (language evaluation) CPT Code: `92507`	$273	$273	$86	3.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$245	$245	$40	6.1×
Neurobehavioral status check CPT Code: `96116`	—	$235	$231	1.0×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,561	$259	$272	1.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$208	$208	$38	5.5×
CT scan, head (no contrast) CPT Code: `70450`	$3,463	$219	$160	unverified
CT scan, sinuses CPT Code: `70486`	$3,162	$219	$166	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$3,818	$219	$167	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$4,620	$219	$169	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$4,241	$219	$168	unverified
CT scan, pelvis CPT Code: `72192`	$3,810	$219	$163	unverified
Ultrasound, thyroid and neck CPT Code: `76536`	$1,493	$233	$132	unverified
Ultrasound, abdomen (complete) CPT Code: `76700`	$2,404	$233	$134	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,763	$233	$126	unverified
Ultrasound, pelvis CPT Code: `76856`	$1,544	$233	$130	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$184	$184	$38	4.8×
Physical therapy (gait training) CPT Code: `97116`	$148	$148	$33	4.5×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$145	$145	$35	4.1×
Physical therapy (manual therapy) CPT Code: `97140`	$139	$139	$34	4.1×
X-ray, lower back CPT Code: `72110`	$1,520	$157	$112	1.4×
Psychological testing evaluation CPT Code: `96136`	—	$145	$128	1.1×
Speech therapy (group session) CPT Code: `92508`	$108	$108	$27	4.0×
Orthotic fitting and training CPT Code: `97760`	$107	$107	$51	2.1×
X-ray, shoulder CPT Code: `73030`	$882	$99	$92	1.1×
X-ray, foot CPT Code: `73630`	$764	$99	$92	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$828	$99	$93	1.1×
X-ray, hand CPT Code: `73130`	$782	$99	$93	1.1×
X-ray, ankle CPT Code: `73610`	$828	$99	$93	1.1×
X-ray, pelvis CPT Code: `72170`	$810	$117	$110	1.1×
X-ray, chest (single view) CPT Code: `71045`	$675	$96	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$1,275	$96	$93	1.0×
X-ray, hip CPT Code: `73502`	$782	$96	$93	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$507	$120	$148	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$452	$93	$123	0.8×
Pneumococcal vaccine HCPCS Code: `90732`	$577	$577	$140	4.1×
Culture, blood CPT Code: `87040`	$348	$348	$11	31.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$282	$282	$56	5.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$97	$97	$25	3.9×
Drug screening test HCPCS Code: `G0480`	—	$119	$116	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$78	$78	$38	2.1×
Blood antibody screen CPT Code: `86850`	$184	$57	$46	1.2×
Flu vaccine injection HCPCS Code: `G0008`	$404	$51	$48	1.1×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$51	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	—	$51	$49	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$733	$64	$64	1.0×
Hospital observation (per hour) HCPCS Code: `G0378`	$59	$59	$86	0.7×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$28	$27	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$584	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$327	$14	$14	1.0×
Blood test, vitamin D CPT Code: `82306`	$112	$31	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$200	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$63	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$133	$5	$5	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$189	$16	$16	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$219	$14	$14	1.0×
Blood test, magnesium CPT Code: `83735`	$168	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$110	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$283	$19	$19	1.0×
Blood test, sodium CPT Code: `84295`	$104	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$141	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$355	$8	$8	1.0×
Hepatitis C antibody test CPT Code: `86803`	$96	$15	$15	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	—	$20	$20	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$156	$17	$18	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$162	$4	$5	0.8×
Blood test, hemoglobin CPT Code: `85018`	$93	$2	$3	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$14	$35	0.4×
Blood test, basic metabolic panel CPT Code: `80048`	$333	$9	$9	unverified
Blood test, liver function panel CPT Code: `80076`	$227	$9	$9	unverified
Blood test, amylase CPT Code: `82150`	$324	$7	$7	unverified
Blood test, glucose (blood sugar) CPT Code: `82947`	$93	$4	$4	unverified
Blood test, average blood sugar (A1c) CPT Code: `83036`	$165	$10	$10	unverified
Blood test, lipase CPT Code: `83690`	$239	$7	$7	unverified
Blood test, clotting time (PTT) CPT Code: `85730`	$197	$6	$6	unverified
Culture, bacterial CPT Code: `87070`	$434	$9	$9	unverified

Showing top 25 high-impact procedures of 103 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 44.0%

Audit a Bill or Quote at Adventhealth Palm Coast (Zero PHI Required)

CMS CCN: 100118

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $48,059

1. Amount on Your Bill or Quote ($) Pre-filled with Adventhealth Palm Coast’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $50,750 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $50,750

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (44.0% of gross = $50,750).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Adventhealth Palm Coast's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$84,567 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($115,342) is $84,567 above the denoised Fair BaseRate ($30,775) and 4.9× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: cbsa_nonprofit_median

Illustrative National Nonprofit Peer Median (44.0% of gross — request this hospital's exact FAP Look-Back AGB percentage)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Hospital-specific AGB look-back percentages are published in each facility’s written Financial Assistance Policy (FAP). This figure reflects the national nonprofit peer median benchmark.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall4/5 Stars (4/5)

Safety Composite74/100

Would Recommend72%

Rated 9 or 10 (HCAHPS)74%

Median ER Wait157 min

Left ER Before Seen0%

30-Day Mortality vs U.S.same

Unplanned Readmissionbetter

Hip/Knee Complication Rate4.2%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Adventhealth Palm Coast. Prior administrative notices do not necessarily reflect current compliance status.

2025-06-04·administrative_or_closure
Closure Notice
Recorded
2025-02-28·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,469 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Median Household Income$72,923U.S. Census ACS

Local Uninsured Share10.8%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 4/100 · Quarantined CMS CCN 100118

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 100118) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-10

Validated Rate Rows0 (CMS v2024)

File Integrity DigestVerified · CCN 100118

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy