HCA Florida Lake City Hospital
HCA Florida Lake City Hospital charges 7.8x the Medicare reimbursement rate across 53 analyzed procedures, representing a significant markup for this for-profit healthcare facility in Lake City, Florida.
Lake City, FL 32055 · Acute Care Hospitals · CMS Rating: 2/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
D
High
Avg markup vs Medicare
7.77x
Charge / Medicare rate
Max markup
13.91x
Worst procedure
Procedures analyzed
53
With pricing data
Outlier procedures
5.7%
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 |
|---|---|---|---|---|---|
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $118,692 | $59,346 | — | 13.9x |
| DYSEQUILIBRIUM | 149 | $60,546 | $30,273 | — | 12.1x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $63,639 | $31,819 | — | 11.1x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $66,482 | $33,241 | — | 10.9x |
| SEIZURES WITHOUT MCC | 101 | $73,979 | $36,989 | — | 10.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $59,490 | $29,745 | — | 10.3x |
| CHEST PAIN | 313 | $51,327 | $25,664 | — | 10.3x |
| HYPERTENSION WITHOUT MCC | 305 | $54,913 | $27,456 | — | 10.2x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $37,476 | $18,738 | — | 10.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $58,230 | $29,115 | — | 10x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $55,167 | $27,584 | — | 9.6x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $74,975 | $37,487 | — | 9.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $68,295 | $34,147 | — | 9.5x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $67,248 | $33,624 | — | 9.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $66,431 | $33,215 | — | 9.2x |
| CELLULITIS WITHOUT MCC | 603 | $58,623 | $29,311 | — | 8.7x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $66,915 | $33,458 | — | 8.5x |
| RENAL FAILURE WITH CC | 683 | $57,955 | $28,977 | — | 8.5x |
| SYNCOPE AND COLLAPSE | 312 | $54,434 | $27,217 | — | 8.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $66,929 | $33,465 | — | 8.4x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $68,558 | $34,279 | — | 8.3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $73,909 | $36,955 | — | 8.2x |
| DIABETES WITH MCC | 637 | $84,101 | $42,050 | — | 7.9x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $57,263 | $28,631 | — | 7.7x |
| DIABETES WITH CC | 638 | $48,529 | $24,265 | — | 7.5x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $109,935 | $54,967 | — | 7.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $41,311 | $20,655 | — | 7.3x |
| CELLULITIS WITH MCC | 602 | $80,752 | $40,376 | — | 7.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $66,709 | $33,354 | — | 7.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $74,689 | $37,344 | — | 7.1x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $125,721 | $62,861 | — | 7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $64,509 | $32,255 | — | 6.8x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $41,932 | $20,966 | — | 6.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $70,684 | $35,342 | — | 6.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $107,467 | $53,733 | — | 6.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $67,291 | $33,646 | — | 6.5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $56,473 | $28,236 | — | 6.5x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $46,203 | $23,101 | — | 6.4x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $143,355 | $71,678 | — | 6.4x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $88,793 | $44,397 | — | 6.4x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $63,424 | $31,712 | — | 6.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $80,750 | $40,375 | — | 6.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $97,269 | $48,634 | — | 6.1x |
| RENAL FAILURE WITH MCC | 682 | $70,699 | $35,350 | — | 5.8x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $70,122 | $35,061 | — | 5.6x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $66,018 | $33,009 | — | 5.6x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $39,701 | $19,850 | — | 5.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $229,472 | $114,736 | — | 5.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $54,651 | $27,325 | — | 5.3x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $89,986 | $44,993 | — | 5.1x |
Showing 50 of 53 procedures
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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.
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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