Adventhealth Palm Coast
AdventHealth Palm Coast, a nonprofit-religious hospital in Palm Coast, FL, charges 5.3x the Medicare reimbursement rate across 66 analyzed procedures.
Palm Coast, FL 32164 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
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Billing patterns — nonprofit-religious
Nonprofit religious hospitals, representing 203 facilities in the dataset, demonstrate an average markup of 5.4x Medicare rates, positioning them in the mid-range compared to other ownership types. These institutions typically maintain standardized charge structures across their health system networks, often reflecting their mission-driven approach to healthcare delivery. Patients at nonprofit religious hospitals may encounter charges above the benchmark for routine procedures, though many offer financial assistance programs and charity care policies that can significantly reduce out-of-pocket expenses for qualifying individuals. Common billing patterns include transparent pricing for elective procedures and comprehensive financial counseling services. The potential difference between listed charges and actual patient responsibility can be substantial, particularly for uninsured patients who may qualify for sliding-scale payment options. Patients should inquire about available financial assistance programs during the admissions process, as these hospitals often have more flexible payment arrangements compared to for-profit facilities, reflecting their tax-exempt status and community benefit obligations.
Pricing grade
D
High
Avg markup vs Medicare
5.32x
Charge / Medicare rate
Max markup
8.34x
Worst procedure
Procedures analyzed
66
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $40,176 | $20,088 | — | 8.3x |
| SEIZURES WITHOUT MCC | 101 | $40,214 | $20,107 | — | 7.7x |
| CHEST PAIN | 313 | $32,451 | $16,226 | — | 7.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $23,822 | $11,911 | — | 7.4x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $33,471 | $16,736 | — | 7.2x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $42,700 | $21,350 | — | 6.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $92,136 | $46,068 | — | 6.8x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $91,443 | $45,722 | — | 6.7x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $80,303 | $40,151 | — | 6.6x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $36,748 | $18,374 | — | 6.6x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $53,258 | $26,629 | — | 6.6x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $111,549 | $55,775 | — | 6.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $40,637 | $20,319 | — | 6.5x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $30,640 | $15,320 | — | 6.5x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $96,493 | $48,246 | — | 6.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $25,049 | $12,525 | — | 6.2x |
| RENAL FAILURE WITH CC | 683 | $32,510 | $16,255 | — | 6.1x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $39,388 | $19,694 | — | 6.1x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $45,531 | $22,766 | — | 6.1x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $140,122 | $70,061 | — | 6x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $70,856 | $35,428 | — | 6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $27,675 | $13,837 | — | 5.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $32,847 | $16,424 | — | 5.9x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $88,137 | $44,068 | — | 5.9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $47,535 | $23,767 | — | 5.9x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $26,253 | $13,126 | — | 5.8x |
| SYNCOPE AND COLLAPSE | 312 | $29,237 | $14,619 | — | 5.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $34,479 | $17,240 | — | 5.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $39,261 | $19,631 | — | 5.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $49,351 | $24,676 | — | 5.5x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $40,511 | $20,256 | — | 5.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $34,570 | $17,285 | — | 5.3x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $24,854 | $12,427 | — | 5.3x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $67,003 | $33,502 | — | 5.3x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $47,973 | $23,987 | — | 5.2x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $46,188 | $23,094 | — | 5.2x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $106,973 | $53,486 | — | 5.2x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $72,545 | $36,273 | — | 5.1x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $59,390 | $29,695 | — | 5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $64,585 | $32,293 | — | 4.9x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $79,829 | $39,914 | — | 4.9x |
| COAGULATION DISORDERS | 813 | $56,100 | $28,050 | — | 4.9x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $26,372 | $13,186 | — | 4.9x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $47,538 | $23,769 | — | 4.9x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $31,206 | $15,603 | — | 4.8x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $39,419 | $19,709 | — | 4.6x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $53,948 | $26,974 | — | 4.5x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | 521 | $99,556 | $49,778 | — | 4.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $48,054 | $24,027 | — | 4.3x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $33,913 | $16,956 | — | 4.3x |
Showing 50 of 66 procedures
How AdventHealth Palm Coast compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — nonprofit-religious hospital billing
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use