How many shoppable procedure prices are published for HCA Florida Highlands Hospital?

HCA Florida Highlands Hospital in Sebring, FL currently has 125 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do HCA Florida Highlands Hospital's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, HCA Florida Highlands Hospital's median negotiated commercial rate is 1.6× the regionally adjusted fair BaseRate benchmark.

What is HCA Florida Highlands Hospital's CMS Care Compare overall star rating?

CMS Care Compare assigns HCA Florida Highlands Hospital an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 109 Beds · urban Updated: 2026-03-01

HCA Florida Highlands Hospital

3600 S Highlands Ave, Sebring, FL 33870 · 125 Priced Procedures · 66% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

High Markup · Shop Alternatives

1.64×vs. Fair Market Price

Typical commercial prices here are +64% above the fair benchmark (1.64×) even after accounting for local nurse/doctor wages and patient complexity.

62/100 · Caution

62/100Self-Pay Cash Beats Insurance 1% of the Time

File Completeness56

Price Logic86

Peer Alignment56

Clean Billing94

Real Cash Discount7

High Price · Lower Safety

2-Star CMS clinical quality rating paired with 1.64× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +157% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

HCA Florida Highlands Hospital prices routine shoppable procedures at 2.8× Medicare (median 1.07× Fair BaseRate) while upper-quartile commercial rates jump +157% to 2.75× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#146 of 165 in FL · 87th State Percentile#2,809 of 3,385 in U.S. · 82nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.96× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 1% of shoppable procedures (25/100 Cash Honesty)
CMS clinical safety score (62/100 safety score) with 66% patient recommendation
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 3.5× markup over Medicare rates
Commercial insurance median sits at 1.07× Fair BaseRate (2.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.75×) jump +157% above the median procedure ratio (Q50 1.07×)
Consolidated metro market (HHI 6,130) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.8× Medicare

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

Back-Door Captive & ER0.39× Divergence

1.1× Medicare

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

Quantile Tail Spread+157% Upper Tail

Q25 0.96× · Q50 1.07× · Q75 2.75×

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

2.8× MedicareFair

Outpatient Surgery & ORBack-Door Captive

3.5× MedicareElevated

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.5× MedicareWatchout

Back-Door Captive ER VisitsBack-Door Captive

4.1× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

3.5× MedicareElevated

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

2.5× MedicareFair

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

1% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 62/100Elevated

Procedure Prices at HCA Florida Highlands Hospital

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 125 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$30,823	$17,936	unverified
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$28,892	$30,775	0.9×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$26,308	$19,432	1.4×
Total hip replacement CPT Code: `27130`	—	$23,689	$13,413	1.8×
Total knee replacement CPT Code: `27447`	—	$23,689	$13,523	1.8×
Breast lump removal CPT Code: `19120`	—	$23,011	$3,875	unverified
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$22,332	$3,372	unverified
Rabies immune globulin HCPCS Code: `90375`	$21,634	$21,634	$322	67.2×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$21,197	$6,109	3.5×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$20,994	$19,087	1.1×
Inguinal hernia repair CPT Code: `49505`	—	$15,153	$3,629	4.2×
Bunion correction surgery CPT Code: `28296`	—	$15,153	$3,446	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$13,836	$13,836	$448	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$11,045	$11,045	$303	36.5×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$9,977	$8,223	1.2×
Cataract surgery with lens implant CPT Code: `66984`	—	$9,818	$2,540	3.9×
MRI, lower back (no contrast) CPT Code: `72148`	$9,454	$9,454	$338	28.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$7,724	$2,680	2.9×
C-section delivery (full package) CPT Code: `59510`	—	$7,724	$2,975	2.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$6,717	$6,717	$169	39.7×
CT scan, sinuses CPT Code: `70486`	$6,637	$6,637	$166	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$6,570	$6,570	$168	39.1×
CT scan, head (no contrast) CPT Code: `70450`	$6,499	$6,499	$160	40.6×
CT scan, pelvis CPT Code: `72192`	$5,901	$5,901	$163	36.2×
CT scan, chest (no contrast) CPT Code: `71250`	$5,668	$5,668	$167	unverified
CT scan, head (with contrast) CPT Code: `70460`	$5,580	$5,580	$242	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$5,518	$5,518	$258	unverified
Colonoscopy (diagnostic) CPT Code: `45378`	—	$5,163	$981	5.3×
Upper endoscopy with biopsy CPT Code: `43239`	—	$5,163	$987	5.2×
Colonoscopy with biopsy CPT Code: `45380`	—	$5,163	$1,256	4.1×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$4,995	$1,021	4.9×
MRI, brain (no contrast) CPT Code: `70551`	$4,887	$4,887	$343	14.2×
MRI, knee or other leg joint CPT Code: `73721`	$7,409	$3,533	$369	9.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$6,812	$3,533	$511	6.9×
Hepatitis B immune globulin HCPCS Code: `90371`	$2,442	$2,442	$151	16.2×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,599	$1,599	$134	11.9×
Blood transfusion CPT Code: `36430`	$1,049	$1,049	$498	2.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$5,737	$906	$583	1.6×
Ultrasound, pelvis CPT Code: `76856`	$4,780	$607	$130	4.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,787	$555	$132	4.2×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,940	$535	$272	2.0×
X-ray, lower back CPT Code: `72110`	$2,070	$485	$112	unverified
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,555	$386	$126	3.1×
X-ray, hip CPT Code: `73502`	$1,869	$294	$93	3.2×
X-ray, foot CPT Code: `73630`	$2,860	$284	$92	3.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$2,578	$286	$93	3.1×
X-ray, ankle CPT Code: `73610`	$2,913	$284	$93	3.1×
X-ray, hand CPT Code: `73130`	$3,083	$281	$93	3.0×
X-ray, pelvis CPT Code: `72170`	$1,507	$303	$110	2.8×
X-ray, chest (two views) CPT Code: `71046`	$705	$297	$93	unverified
X-ray, shoulder CPT Code: `73030`	$3,446	$296	$92	unverified
X-ray, chest (single view) CPT Code: `71045`	$528	$264	$92	2.9×
Review of medical records for care CPT Code: `90889`	—	$211	$114	1.9×
New patient office visit (30-44 min) CPT Code: `99203`	$1,177	$160	$110	1.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	—	$183	$185	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	—	$174	$181	1.0×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$185	$25	unverified
Care planning with family CPT Code: `90887`	—	$147	$107	1.4×
Family therapy session CPT Code: `90847`	—	$162	$173	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$1,138	$126	$123	1.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	—	$151	$166	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$342	$124	$64	1.9×
Group therapy session CPT Code: `90853`	—	$121	$100	1.2×
Hospital observation (per hour) HCPCS Code: `G0378`	$415	$92	$86	1.1×
Office visit, established patient (20-29 min) CPT Code: `99213`	$865	$91	$87	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$2,672	$110	$148	0.7×
Screening mammogram (both breasts) CPT Code: `77067`	$1,496	$91	$123	0.7×
Typhoid vaccine HCPCS Code: `90675`	$2,540	$602	$347	1.7×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$263	$203	1.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$550	$170	$111	1.5×
Pneumococcal vaccine HCPCS Code: `90732`	$437	$179	$140	1.3×
Drug screening test HCPCS Code: `G0480`	$121	$119	$116	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$118	$92	$25	3.7×
Hepatitis B vaccine HCPCS Code: `90744`	$272	$101	$37	2.7×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$104	$39	2.7×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$551	$106	$56	1.9×
Colorectal cancer screening HCPCS Code: `G0010`	$496	$67	$49	1.4×
Pneumonia vaccine injection HCPCS Code: `G0009`	$279	$64	$49	1.3×
Speech therapy (language evaluation) CPT Code: `92507`	$492	$79	$86	0.9×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$28	$27	1.0×
Prosthetic fitting and training CPT Code: `97761`	$204	$41	$45	0.9×
Orthotic fitting and training CPT Code: `97760`	$235	$45	$51	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$415	$33	$38	0.9×
Breathing treatment (nebulizer) CPT Code: `94640`	$478	$54	$201	0.3×
Neurobehavioral status check CPT Code: `96116`	—	$53	$231	0.2×
Blood test, basic metabolic panel CPT Code: `80048`	$332	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$424	$11	$11	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$583	$14	$14	1.0×
Blood test, liver function panel CPT Code: `80076`	$511	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$440	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$644	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$134	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$158	$5	$5	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$158	$16	$16	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$823	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$158	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$778	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$449	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$36	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$158	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$560	$19	$19	1.0×
Blood test, sodium CPT Code: `84295`	$158	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$1,163	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$73	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	—	$8	$8	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$240	$5	$5	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$281	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$41	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$606	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$783	$9	$9	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$360	$20	$20	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$78	$13	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	$143	$25	$27	0.9×
Physical therapy (gait training) CPT Code: `97116`	$259	$29	$33	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$276	$34	$40	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$305	$32	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$322	$32	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$280	$29	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$274	$27	$34	0.8×
Blood test, hemoglobin CPT Code: `85018`	$200	$2	$3	0.7×
Blood test, vitamin D CPT Code: `82306`	$19	$19	$31	0.6×
Flu vaccine injection HCPCS Code: `G0008`	$267	$21	$48	0.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$13	$35	0.4×
Blood antibody screen CPT Code: `86850`	$1,145	$10	$46	0.2×
Psychological testing evaluation CPT Code: `96136`	—	$20	$128	0.2×

Showing top 25 high-impact procedures of 125 total

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

Audit a Bill or Quote at HCA Florida Highlands Hospital (Zero PHI Required)

CMS CCN: 100049

CPT 322

Select Procedure to Audit:

Fair BaseRate™ $17,936

Medicare Rate $12,807

Self-Pay Cash Request Quote

Insurer Median $30,823

1. Amount on Your Bill or Quote ($) Pre-filled with HCA Florida Highlands 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 HCA Florida Highlands 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 +$56,039 Above Fair BaseRate

Negotiate Toward $17,936 Fair BaseRate ($12,807 Medicare)

Your bill ($73,975) is $56,039 above the denoised Fair BaseRate ($17,936) and 5.8× the $12,807 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)

Public IRS & CMS ownership records classify HCA Florida Highlands 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 Overall2/5 Stars (2/5)

Safety Composite62/100

Would Recommend66%

Rated 9 or 10 (HCAHPS)64%

Median ER Wait125 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate3%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

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 HCA Florida Highlands Hospital. Prior administrative notices do not necessarily reflect current compliance status.

2025-05-01·administrative_or_closure
Met Requirements
Recorded
2024-02-14·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (452 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 Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for HCA Florida Highlands Hospital.

Price Index: 1.00× regional baseline

Quality: 49/100 CMS composite

Median Household Income$55,581U.S. Census ACS

Local Uninsured Share12.7%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 62/100 · Caution CMS CCN 100049

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 100049) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-01

Validated Rate Rows3,887 (CMS v3.0.0)

File Integrity DigestVerified · CCN 100049

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