How many shoppable procedure prices are published for Central Florida Lake Monroe Hospital?

Central Florida Lake Monroe Hospital in Sanford, FL currently has 127 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Central Florida Lake Monroe Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Central Florida Lake Monroe Hospital's median negotiated commercial rate is 1.4× the regionally adjusted fair BaseRate benchmark.

What is Central Florida Lake Monroe Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns Central Florida Lake Monroe Hospital an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 199 Beds · urban Updated: 2026-09-01

Central Florida Lake Monroe Hospital

1401 W Seminole Blvd, Sanford, FL 32771 · 127 Priced Procedures · 54% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Above Fair Market · Negotiate

1.40×vs. Fair Market Price

Typical commercial prices here are +40% above the fair benchmark (1.40×) even after accounting for local nurse/doctor wages and patient complexity.

69/100 · Caution

69/100Self-Pay Cash Beats Insurance 6% of the Time

File Completeness100

Price Logic86

Peer Alignment48

Clean Billing90

Real Cash Discount6

High Price · Lower Safety

1-Star CMS clinical quality rating paired with 1.40× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +143% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Central Florida Lake Monroe Hospital prices routine shoppable procedures at 3.6× Medicare (median 1.05× Fair BaseRate) while upper-quartile commercial rates jump +143% to 2.55× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#123 of 165 in FL · 73rd State Percentile#2,444 of 3,385 in U.S. · 72nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.97× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 6% of shoppable procedures (25/100 Cash Honesty)
2-Star CMS clinical rating with 54% patient recommendation (53/100 safety score)
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.6× markup over Medicare rates
Commercial insurance median sits at 1.05× Fair BaseRate (3.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.55×) jump +143% above the median procedure ratio (Q50 1.05×)
Consolidated metro market (HHI 2,354) limits in-network hospital competition (Moderately Concentrated (1,500–2,500))

Front-Door ShoppableElective / Imaging

3.6× Medicare

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

Back-Door Captive & ER0.31× Divergence

1.1× Medicare

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

Quantile Tail Spread+143% Upper Tail

Q25 0.97× · Q50 1.05× · Q75 2.55×

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

3.6× MedicareElevated

Outpatient Surgery & ORBack-Door Captive

1.6× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.5× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

1.7× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

2.8× MedicareFair

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

4.0× MedicareElevated

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

6% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 53/100Elevated

Procedure Prices at Central Florida Lake Monroe Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 127 published procedures.

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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`	—	$29,595	$30,775	1.0×
Trauma team activation HCPCS Code: `G0390`	$24,500	$24,500	$1,453	16.9×
CT scan, head (no contrast) CPT Code: `70450`	$19,321	$19,321	$160	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$18,801	$19,432	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$18,622	$19,087	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$17,249	$17,936	1.0×
Total hip replacement CPT Code: `27130`	—	$14,130	$13,413	1.1×
Total knee replacement CPT Code: `27447`	—	$14,130	$13,523	1.0×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$12,293	$6,109	2.0×
Inguinal hernia repair CPT Code: `49505`	—	$9,252	$3,629	2.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,150	$8,223	1.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$9,116	$3,372	2.7×
Breast lump removal CPT Code: `19120`	—	$8,886	$3,875	2.3×
Bunion correction surgery CPT Code: `28296`	—	$7,355	$3,446	2.1×
Ultrasound, abdomen (complete) CPT Code: `76700`	$6,154	$6,154	$134	45.9×
Ultrasound, pelvis CPT Code: `76856`	$5,102	$5,102	$130	39.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$4,826	$2,540	1.9×
Ultrasound, thyroid and neck CPT Code: `76536`	$4,434	$4,434	$132	33.6×
X-ray, lower back CPT Code: `72110`	$4,158	$4,158	$112	37.1×
Vaginal delivery (full package) CPT Code: `59400`	—	$3,682	$2,680	1.4×
C-section delivery (full package) CPT Code: `59510`	—	$3,682	$2,975	1.2×
Colonoscopy with biopsy CPT Code: `45380`	—	$3,313	$1,256	2.6×
Upper endoscopy with biopsy CPT Code: `43239`	—	$2,930	$987	3.0×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$2,668	$981	2.7×
MRI, brain (with and without contrast) CPT Code: `70553`	$24,331	$2,658	$511	unverified
Injection procedure for pain management HCPCS Code: `G0260`	—	$2,521	$855	2.9×
MRI, brain (no contrast) CPT Code: `70551`	$20,779	$2,252	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$6,223	$2,272	$338	unverified
MRI, knee or other leg joint CPT Code: `73721`	$16,351	$2,207	$369	unverified
Sleep study (overnight, in lab) CPT Code: `95810`	$15,686	$2,021	$1,021	2.0×
CT scan, pelvis CPT Code: `72192`	$19,201	$1,659	$163	10.2×
CT scan, sinuses CPT Code: `70486`	$12,153	$1,659	$166	10.0×
CT scan, chest (no contrast) CPT Code: `71250`	$19,290	$1,659	$167	9.9×
CT scan, head (with and without contrast) CPT Code: `70470`	$26,169	$1,659	$258	6.4×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$29,551	$1,659	$303	5.5×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$29,551	$1,659	$448	3.7×
CT scan, head (with contrast) CPT Code: `70460`	$20,209	$1,659	$242	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$13,880	$1,659	$169	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$13,880	$1,659	$168	unverified
Rabies immune globulin HCPCS Code: `90375`	$1,578	$1,578	$322	unverified
Echocardiogram (heart ultrasound) CPT Code: `93306`	$10,957	$966	$583	1.7×
Blood transfusion CPT Code: `36430`	$814	$814	$498	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$774	$774	$151	5.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$2,046	$569	$126	4.5×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$3,845	$569	$272	2.1×
X-ray, shoulder CPT Code: `73030`	$4,064	$442	$92	4.8×
X-ray, hip CPT Code: `73502`	$486	$439	$93	4.7×
X-ray, foot CPT Code: `73630`	$3,881	$418	$92	4.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$2,952	$421	$93	4.5×
X-ray, hand CPT Code: `73130`	$3,622	$410	$93	4.4×
X-ray, chest (two views) CPT Code: `71046`	$409	$409	$93	4.4×
X-ray, ankle CPT Code: `73610`	$3,919	$418	$93	unverified
X-ray, chest (single view) CPT Code: `71045`	$409	$374	$92	4.1×
X-ray, pelvis CPT Code: `72170`	$3,025	$390	$110	3.5×
New patient office visit (30-44 min) CPT Code: `99203`	$1,207	$253	$110	2.3×
Review of medical records for care CPT Code: `90889`	—	$230	$114	2.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$1,663	$178	$123	1.4×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$193	$185	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$183	$181	1.0×
Care planning with family CPT Code: `90887`	—	$156	$107	1.5×
Family therapy session CPT Code: `90847`	—	$172	$173	1.0×
Office visit, established patient (20-29 min) CPT Code: `99213`	$557	$135	$87	1.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$160	$166	1.0×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$622	$132	$64	2.1×
Group therapy session CPT Code: `90853`	—	$129	$100	1.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$106	$100	$86	1.2×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$1,260	$112	$148	0.8×
Speech therapy (language evaluation) CPT Code: `92507`	$444	$80	$86	0.9×
Screening mammogram (both breasts) CPT Code: `77067`	$1,260	$93	$123	0.8×
Typhoid vaccine HCPCS Code: `90675`	$1,909	$1,909	$347	5.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$599	$163	$111	1.5×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$582	$181	$203	0.9×
Pneumococcal vaccine HCPCS Code: `90732`	$300	$151	$140	1.1×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$732	$158	$56	unverified
Flu vaccine (high dose) HCPCS Code: `90656`	$110	$110	$25	4.4×
Drug screening test HCPCS Code: `G0480`	$184	$121	$116	1.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$127	$127	$39	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$230	$74	$49	1.5×
Pneumonia vaccine injection HCPCS Code: `G0009`	$547	$70	$49	1.4×
Blood test, ferritin (iron stores) CPT Code: `82728`	$18	$15	$14	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$28	$27	1.0×
Blood test, vitamin D CPT Code: `82306`	$49	$32	$31	1.0×
Blood test, basic metabolic panel CPT Code: `80048`	$326	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$498	$11	$11	1.0×
Blood test, liver function panel CPT Code: `80076`	$363	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$233	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$166	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$256	$5	$5	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$55	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$94	$10	$10	1.0×
Blood test, magnesium CPT Code: `83735`	$24	$7	$7	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$115	$20	$20	1.0×
Behavioral health living support HCPCS Code: `H2019`	—	$33	$34	1.0×
Prosthetic fitting and training CPT Code: `97761`	—	$42	$45	0.9×
Orthotic fitting and training CPT Code: `97760`	—	$45	$51	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$14	$14	$16	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$271	$35	$40	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$802	$33	$38	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$227	$58	$201	0.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$286	$32	$38	0.8×
Neurobehavioral status check CPT Code: `96116`	—	$53	$231	0.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$75	$20	$19	1.1×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$26	$25	1.0×
Blood test, potassium CPT Code: `84132`	$92	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$80	$4	$4	1.0×
Blood test, hemoglobin CPT Code: `85018`	$88	$3	$3	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$8	$8	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$53	$5	$5	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$72	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$48	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$633	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$759	$9	$9	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$192	$13	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	$257	$25	$27	0.9×
Physical therapy (gait training) CPT Code: `97116`	$172	$29	$33	0.9×
Occupational therapy (self-care training) CPT Code: `97535`	$276	$32	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$294	$29	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$357	$27	$34	0.8×
Flu vaccine injection HCPCS Code: `G0008`	$474	$21	$48	0.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	$300	$13	$35	0.4×
Blood antibody screen CPT Code: `86850`	$114	$10	$46	0.2×
Psychological testing evaluation CPT Code: `96136`	—	$21	$128	0.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$585	$14	$14	unverified
Blood test, amylase CPT Code: `82150`	$35	$7	$7	unverified
Blood test, lipase CPT Code: `83690`	$232	$7	$7	unverified
Blood test, sodium CPT Code: `84295`	$92	$5	$5	unverified
Blood test, thyroid (TSH) CPT Code: `84443`	$138	$18	$18	unverified

Showing top 25 high-impact procedures of 127 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Central Florida Lake Monroe Hospital (Zero PHI Required)

CMS CCN: 100161

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $29,595

1. Amount on Your Bill or Quote ($) Pre-filled with Central Florida Lake Monroe Hospital’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 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Central Florida Lake Monroe Hospital'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 +$40,253 Above Fair BaseRate

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

Your bill ($71,028) is $40,253 above the denoised Fair BaseRate ($30,775) and 3.0× 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) For-Profit / Non-501(c)(3)

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

EIN: 591978725

Public IRS & CMS ownership records classify Central Florida Lake Monroe Hospital as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

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 Overall1/5 Stars (1/5)

Safety Composite53/100

Would Recommend54%

Rated 9 or 10 (HCAHPS)59%

Median ER Wait123 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate4.3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (665 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

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Central Florida Lake Monroe Hospital.

Price Index: 0.93× regional baseline

Quality: 38/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

AmeriHealth

+101.5%

Median Household Income$83,030U.S. Census ACS

Local Uninsured Share9.6%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 69/100 · Caution CMS CCN 100161 EIN 591978725

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 100161) ↗ Verify IRS Form 990 (EIN 591978725) ↗ CMS HCRIS Cost Reports ↗

Published MRF File59-1978725_HCA-FLORIDA-LAKE-MONROE-HOSPITAL_standardcharges.json

Publication / Vintage2026-09-01 · 340.33 MB

Validated Rate Rows6,688 (CMS v3.0.0)

File Integrity Digestbd9a84550d97fd8b99be…

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.

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