Villages Regional Hospital, The
1451 El Camino Real, The Villages, FL 32159 · 140 Priced Procedures · 64% Patient Recommendation
Typical commercial prices here are 3% below the fair benchmark (0.97×) after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 0.97× fair market pricing.
Aligned Regional Benchmark Peer
Villages Regional Hospital, The prices shoppable and inpatient services (1.1× to 1.0× Medicare, divergence 0.91×) in alignment with regional hospital peers (0.97× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 3% below peer Fair BaseRate (0.97×)
- Self-pay cash beats commercial insurance on 66% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 64% patient recommendation (67/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (41.2% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (0.97× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 0.99× Fair BaseRate (1.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Specialty infusion drugs (J-codes) average 1.1× Medicare — verify per-unit billing on itemized statements
- Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
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 Villages Regional Hospital, The
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 140 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $25,135 | 0.8× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $15,216 | 0.8× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $15,040 | 0.8× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $13,884 | 0.8× |
| Total hip replacement CPT Code: 27130 | $13,497 | 1.0× |
| Total knee replacement CPT Code: 27447 | $13,497 | 1.0× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,120 | 1.0× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $6,121 | 0.7× |
| Breast lump removal CPT Code: 19120 | $3,998 | 1.0× |
| Inguinal hernia repair CPT Code: 49505 | $3,702 | 1.0× |
| Bunion correction surgery CPT Code: 28296 | $3,554 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,403 | 1.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $2,392 | 0.9× |
| C-section delivery (full package) CPT Code: 59510 | $1,681 | 0.6× |
| Vaginal delivery (full package) CPT Code: 59400 | $1,520 | 0.6× |
| Trauma team activation HCPCS Code: G0390 | $1,448 | 1.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,300 | 1.0× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,008 | 1.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $987 | 1.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $951 | 0.9× |
| Injection procedure for pain management HCPCS Code: G0260 | $766 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $575 | unverified |
| Blood transfusion CPT Code: 36430 | $459 | 0.9× |
| Psychological testing by technician CPT Code: 96138 | $431 | 1.1× |
| Residential mental health treatment HCPCS Code: H2036 | $383 | 0.9× |
Audit a Bill or Quote at Villages Regional Hospital, The (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $24,866
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (41.2% of gross = $24,866).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Villages Regional Hospital, The's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($60,324) is $29,549 above the denoised Fair BaseRate ($30,775) and 2.6× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (41.2% of gross charges)
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. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (3,445 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
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 Villages Regional Hospital, The.
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.