$5,102
Lowest contracted rate
$28,256
Highest contracted rate
5.5×
Spread (high ÷ low)
4
Insurers in file
The spread is 5.5×. Depending on which insurer is paying, AdventHealth Zephyrhills receives between $5,102 and $28,256 for Pneumonia w/o CC.
Rate by insurance company
Sorted lowest to highest. When a plan has multiple sub-plans, the median rate is shown.
| Insurance | Contracted rate |
|---|---|
| Humana 3 plans · range $5,102–$5,320 | $5,320Lowest |
| Oscar Health | $10,133 |
| Aetna 3 plans · range $5,277–$19,829 | $11,897 |
| Cigna 2 plans · range $5,364–$13,766 | $13,766Highest |
Source: AdventHealth Zephyrhills standard charges file, updated null.
What this means for you
This is the facility fee AdventHealth Zephyrhills contracts to accept from each insurer for Pneumonia w/o CC (DRG 195). It covers the hospital's portion of the bill — the room, nursing, equipment, and OR.
Not included: Surgeon fees, anesthesiologist fees, and specialist fees are billed separately — typically adding 20–40% to the total.
Your actual cost depends on where you stand with your deductible. Before your deductible is met, you pay the full contracted rate. After, you pay your coinsurance percentage.
Get a Good Faith Estimate. Federal law requires hospitals to provide a written cost estimate for planned procedures. Call AdventHealth Zephyrhills patient financial services and request one for DRG 195 under your specific plan before scheduling.