Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health
101 E Florida Ave, Melbourne, FL 32901 · 60 Priced Procedures
Typical commercial prices here match the fair market benchmark (1.00×) after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Specialty Drug & Surgical Margin Engine
Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health concentrates commercial margin in outpatient surgical suites (4.5× Medicare) and specialty drug infusions (4.1× Medicare) relative to routine diagnostics (3.5×). Comparing freestanding ambulatory surgery centers or specialty pharmacy options before treatment yields substantial savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.78× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 50% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 4.5× markup over Medicare rates
- Captive ER (5.2×) & laboratory (3.8×) services average 1.06× higher multiples than routine shoppable care (3.6×)
- Upper-quartile procedures (Q75 1.28×) jump +28% above the median procedure ratio (Q50 1.00×)
- Unnegotiated chargemaster list prices average 3.7× Medicare (39¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 60 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| MRI, knee or other leg joint CPT Code: 73721 | $1,070 | 2.9× |
| Blood transfusion CPT Code: 36430 | $894 | 1.8× |
| CT scan, sinuses CPT Code: 70486 | $814 | 4.9× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $770 | 1.5× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $708 | 1.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $544 | 1.6× |
| MRI, lower back (no contrast) CPT Code: 72148 | $532 | 1.6× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $495 | 2.9× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $497 | 2.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $491 | 1.9× |
| CT scan, chest (no contrast) CPT Code: 71250 | $431 | 2.6× |
| CT scan, head (with contrast) CPT Code: 70460 | $446 | 1.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $459 | 1.5× |
| CT scan, pelvis CPT Code: 72192 | $411 | 2.5× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $401 | 1.5× |
| CT scan, head (no contrast) CPT Code: 70450 | $373 | 2.3× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $348 | 0.6× |
| Speech therapy (language evaluation) CPT Code: 92507 | $243 | 2.8× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $254 | 1.9× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $243 | 1.8× |
| Ultrasound, pelvis CPT Code: 76856 | $232 | 1.8× |
| X-ray, chest (single view) CPT Code: 71045 | $203 | 2.2× |
| X-ray, shoulder CPT Code: 73030 | $203 | 2.2× |
| X-ray, foot CPT Code: 73630 | $203 | 2.2× |
| X-ray, chest (two views) CPT Code: 71046 | $203 | 2.2× |
Audit a Bill or Quote at Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health (Zero PHI Required)
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.
Self-Pay Cash Rate ($1,070) Beats Your Bill
Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health's published 45 CFR § 180 self-pay cash rate is $1,070 (vs. $1,070 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $369 Fair BaseRate ($244 Medicare)
Your bill ($1,426) is $1,057 above the denoised Fair BaseRate ($369) and 5.8× the $244 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health 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.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Sea Pines Rehabilitation Hospital, An Affiliate of Encompass Health.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.