Supplies, drugs & other prices at HCA Florida Lake Monroe Hospital
Sanford, FL · every code in this section with a posted price and a Medicare benchmark.
44 codes. Prices are the hospital's own posted facility charges.
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| Procedure | Cash price | Gross charge | × Medicare |
|---|---|---|---|
| Adm tocilizu covid-19 1st (M0249) | $772.50 | $772.50 | 1.7× |
| Adm tocilizu covid-19 2nd (M0250) | $772.50 | $772.50 | 1.7× |
| Admin hepatitis b vaccine (G0010) | $229.75 | $229.75 | 4.7× |
| Admin influenza virus vac (G0008) | $473.75 | $473.75 | 9.7× |
| Admin pneumococcal vaccine (G0009) | $547.25 | $547.25 | 11.2× |
| Catheterize for urine spec (P9612) | $470 | $470 | 50.3× |
| Covid-19 lab test non-cdc (U0002) | $59.62 | $59.62 | 1.2× |
| Diab manage trn per indiv (G0108) | $309.50 | $309.50 | 5.5× |
| Diab manage trn ind/group (G0109) | $312.75 | $312.75 | 19.5× |
| Direct refer hospital observ (G0379) | $119.75 | $119.75 | 0.2× |
| Drug test def 1-7 classes (G0480) | $183.75 | $183.75 | 1.6× |
| Drug test def 15-21 classes (G0482) | $579.25 | $579.25 | 2.9× |
| Drug test def 22+ classes (G0483) | $1,126 | $1,126 | 4.6× |
| Drug test def 8-14 classes (G0481) | $715.75 | $715.75 | 4.6× |
| Elec stim other than wound (G0283) | $192 | $192 | 15.1× |
| Fecal blood scrn immunoassay (G0328) | $92 | $92 | 5.1× |
| Lev 1 hosp type b ed visit (G0380) | $1,217.50 | $1,217.50 | 15.7× |
| Lev 2 hosp type b ed visit (G0381) | $1,983.50 | $1,983.50 | 20.4× |
| Lev 3 hosp type b ed visit (G0382) | $2,758.50 | $2,758.50 | 15.4× |
| Lev 4 hosp type b ed visit (G0383) | $4,612.62 | $4,612.62 | 16.7× |
| Lev 5 hosp type b ed visit (G0384) | $6,114.75 | $6,114.75 | 14.3× |
| Mra w/cont, abd (C8900) | $12,777.25 | $12,777.25 | 35.1× |
| Mra w/cont, chest (C8909) | $12,777.25 | $12,777.25 | 35.1× |
| Mra w/cont, lwr ext (C8912) | $12,777.25 | $12,777.25 | 35.1× |
| Mra w/cont, pelvis (C8918) | $11,104.75 | $11,104.75 | 30.5× |
| Mra w/o cont, abd (C8901) | $12,777.25 | $12,777.25 | 51.3× |
| Mra w/o cont, chest (C8910) | $12,777.25 | $12,777.25 | 51.3× |
| Mra w/o cont, lwr ext (C8913) | $12,777.25 | $12,777.25 | 51.3× |
| Mra w/o cont, pelvis (C8919) | $9,891.50 | $9,891.50 | 39.7× |
| Mra w/o fol w/cont, abd (C8902) | $12,777.25 | $12,777.25 | 35.1× |
| Mra w/o fol w/cont, chest (C8911) | $12,777.25 | $12,777.25 | 35.1× |
| Mra w/o fol w/cont, lwr ext (C8914) | $12,777.25 | $12,777.25 | 35.1× |
| Mra w/o fol w/cont, pelvis (C8920) | $11,705.50 | $11,705.50 | 32.1× |
| Mra, w/o&w/dye, spinal canal (C8933) | $1,540 | $1,540 | 4.2× |
| Mri w/cont, breast, bi (C8906) | $12,512 | $12,512 | 34.3× |
| Mri w/cont, breast, uni (C8903) | $9,499.75 | $9,499.75 | 51.9× |
| Mri w/o fol w/cont, breast, (C8908) | $12,512 | $12,512 | 34.3× |
| Mri w/o fol w/cont, brst, un (C8905) | $9,499.75 | $9,499.75 | 26.1× |
| Place device/marker, non pro (C9728) | $2,974.75 | $2,974.75 | 2.1× |
| Psa screening (G0103) | $114.62 | $114.62 | 5.9× |
| Tomosynthesis, mammo (G0279) | $299.75 | $299.75 | 23.6× |
| Trauma respons w/hosp criti (G0390) | $24,500 | $24,500 | 17.6× |
| Unsched dialysis esrd pt hos (G0257) | $2,598 | $2,598 | 3.6× |
| Wet mounts/ w preparations (Q0111) | $505.25 | $505.25 | 27.3× |