One Market

Under the federal Hospital Price Transparency rule, Florida's hospitals are required to publish a list price, known in the rule as the gross charge, for every item and service they provide. This report measures what they actually publish. The threshold is 260% of Medicare, the line Indiana wrote into law for employer contracts, measured with the same instrument as Reports No. 1 through 7.

Of 201,400 list prices that could be matched to a 2026 Medicare rate, 190,076 sit above the line. That is 94.4%, the highest share in the series, above Texas at 94.1% and New Jersey at 93.8%. At 200% of Medicare the share is 96.4%. Move the line up to 300% of Medicare and 92.7% of prices are still above it. Excluding extreme prices moves the figure to 94.0%; excluding 316 rows published at exactly $1.00 moves it to 94.5%; excluding children's and specialty hospitals, or folding files that repeat one another, does not move it at all.

New York, in Report No. 7, was two markets 46 points apart. Florida is one market with many owners. Fourteen of the twenty-one systems that publish a CT scan of the head charge a single price for it at every hospital they own.

The files are as notable for what they leave out. Only 27% of the 2.2 million rows in Florida's files carry a list price. HCA, with 39% of the state's rows, publishes one on 10.6% of them.

Florida is measured on 148 hospital price files from 23 systems; see Methodology. Price counts reflect the current measurement table and may differ slightly from counts in earlier reports as hospital files are reloaded. Headline shares are unchanged unless a dated correction note says otherwise.

By region, assigned by county:

This table excludes 316 rows published at $1.00 or below, placeholders rather than prices, 276 of them at one Gainesville hospital. On this basis the statewide figure is 94.5%. Three hospitals with no benchmarkable list prices are not shown.

In six of the nine regions, carrying 91% of every price in this report, the gap between the highest and lowest system inside the region is wider than the 4.5 points that separate the regions themselves. South Florida's eight systems span 16.7 points, from Jackson Health at 81.8% to Mount Sinai and Baptist in the low 90s to Memorial at 96.5%. Orlando's six span 11.4. No one region is featured in this report because no one region is a finding. The finding is the system.

By system, the share above the line runs from Jackson Health System at 81.8% and Halifax Health at 86.3% to Mayo Clinic Florida at 98.1% and Orlando Health at 97.7%. HCA Florida Healthcare, with 49 of the 148 files, sits at 95.6%, AdventHealth at 96.3%, BayCare at 90.6%, Baptist Health South Florida at 93.8%, Cleveland Clinic Florida at 93.8%, and Tenet Florida at 94.1%.

In 2026, Medicare pays $106.81 for a CT scan of the head without contrast (CPT 70450). One hundred forty-five of the 148 hospitals in this report publish it. Each hospital's price here is its highest full-service list price for the code, lowest to highest:

There is no cheap hospital for this scan in Florida. The floor is twice New York's, and it does not depend on how it is defined: the lowest full-service line anywhere in the state and the lowest hospital's top price are the same $1,215 at the same hospital.

The same scan tells the report's second story when the 145 prices are grouped by owner.

Fourteen of Florida's twenty-one systems publish one identical price for this scan at every hospital they own. BayCare's ten hospitals all list $4,425. Orlando Health's nine all list $2,738. Memorial Healthcare's four all list $5,124; Lee Health's four, $5,840; Jackson's four, $1,561. The state's 19.4-fold spread on a CT scan is produced almost entirely by three multi-market chains that price each hospital on its own, sitting on top of a stack of systems that publish a single number statewide. HCA alone spans 7.0x between its cheapest hospital and its most expensive for this one scan, a wider range than what separates most Florida systems from each other. Two HCA hospitals in Miami-Dade County agree on 1% of the prices in their files.

Prices are each hospital's highest full-service list price for the code, excluding component-only lines (professional or technical only) and $1.00 placeholders; on these two codes there were none to exclude. In the exhibits, a hospital is named only where it sets the state's floor or ceiling. Cleveland Clinic Florida's $1,215 CT head price was set individually, outside the radiology band the hospital uses for 83 other imaging codes.

For inpatient care, hospitals publish the rates they have negotiated with each insurer for each diagnosis-related group, measured here against each hospital's own wage-adjusted Medicare payment. One hundred twenty-four providers, drawn from 148 files, carry a Medicare provider number that can be benchmarked this way; 107 of them publish negotiated inpatient rates.

At the ceiling, Florida's hospitals charge some insurer a median of 4.37 times Medicare for an inpatient stay, and 85.7% of those ceiling rates sit above the 260% line. That is the highest inpatient ceiling the series has measured, above New Jersey's 3.79x and North Carolina's 3.04x.

The floor requires care. At 51 of the 107 hospitals, the lowest negotiated rate per stay is a real price, clustered between 1.06 and 1.73 times Medicare, a band that includes SCAN's 1.12. SCAN is the California Medicare Advantage plan used as the control in this series since Report No. 5. At the other 56, the published minimum is not a price at all: 45 of them are HCA hospitals whose minimum column reads 3% to 21% of Medicare on every one of 770 diagnosis groups, a placeholder rather than a contract. This report does not average those two populations, because the average would describe neither. The lowest rate and the highest rate belong to different insurers at the same hospital. Nobody pays the range. Each payer pays its own number.

The payer names behind the floor were read from 75 of the 107 providers' published files. At 62 of 75 Florida hospitals with readable payer data, the insurer producing the lowest negotiated inpatient rate is a Medicare Advantage plan. One plan, Clear Spring Health, sets the floor at 26 of the 75 hospitals, more than a third of the state. The pattern matches New York's: the affordable inpatient rate exists, it is in the file, and it belongs to a Medicare Advantage contract.

Limits. The inpatient basis covers 124 of 148 files; four children's hospitals and one cancer center are exempt from Medicare's inpatient payment system, four are critical-access or new providers outside it, and fifteen share or lack a distinct provider number. Three Baptist files share one provider number and enter as a single provider.

Every hospital in this report has attested under federal rule that its price file is accurate and complete. The files were read as published. In Florida, the largest finding is not what the files say about prices; it is how little of the file carries a price at all.

• A list price on 27% of rows. Across the 2,212,132 rows the 148 files contain, 598,251 carry a list price. Eleven of the 23 systems publish a list price on fewer than one row in four, and those eleven account for two thirds of every row in the state. HCA Florida Healthcare, 39% of the state's rows on its own, publishes a list price on 10.6% of them. Nicklaus Children's Hospital publishes a list price on none of its 16,326 rows and no cash price either; every row carries a negotiated minimum and maximum only. At the other end, Lee Health, Jackson Health and Nemours publish a list price on 100% of rows. A hospital that publishes a list price for one row in ten has published a file. It has not published its prices.
• No cash price at all. Under federal guidance, a hospital that does not offer a cash discount is to publish its gross charge as the cash price. In Florida, 82 of the 148 files publish no cash price on any row: every hospital of HCA, AdventHealth, Broward Health, and Lee Health, plus Nemours, Nicklaus and Johns Hopkins All Children's. Where a Florida hospital publishes a cash price, it is usually a real one. More than half publish none.
• Placeholders and units. One HCA hospital in Gainesville lists 276 skin-substitute products at exactly $1.00, a third of its priced rows; measured on its real prices it sits at 97.4%, above its system's average. At the opposite end, the same family of codes produces the highest multiples in the state, because Medicare pays these products per square centimeter and hospitals price the whole graft. Both extremes are excluded from every illustration in this report, and neither moves the headline.
• Banded prices, not item-level prices. Across the 148 files, 63,017 published prices sit inside blocks where ten or more distinct procedures share one identical list price. At 29.6% of those, the procedures span three or more sections of the CPT code set: a radiology study, a surgical procedure and a lab test priced at the same dollar. Orlando Health publishes 99 different procedures, from skin lesion removal to nerve repair to ear surgery, at one price: $1,838, at all nine of its hospitals. A list price should tell you what a procedure costs. When 99 procedures share one, it's a list without the price. Cleveland Clinic Florida is the heaviest user, with 19.8% of its priced rows in cross-section blocks. Its chargemaster runs in bands of $700, $680 and $600, each mixing radiology, surgery, pathology and medicine. Six systems price without mixing unrelated procedures into the same tier, proving it can be done: Baptist Health of Northeast Florida, Memorial Healthcare, Broward Health, Sarasota Memorial, Johns Hopkins All Children's and Mount Sinai.
• Files that repeat one another. Two Memorial Healthcare hospitals publish identical files and are counted once in the robustness check. Five other groups, among them Orlando Health's nine hospitals and Jackson's four, share one chargemaster while negotiating separately by hospital; they are counted as published, as the series has treated shared chargemasters since Report No. 7. Folding all of them removes 16% of the denominator and moves the headline by nothing.

Florida has a large share of Medicare beneficiaries enrolled in Medicare Advantage, and millions of working residents covered by employer plans. Both groups buy from the same 148 hospitals. On these files, a Medicare Advantage plan can expect to pay a Florida hospital close to Medicare for an inpatient stay; the 51 hospitals whose floor is a real price show it. An employer's plan, on the same files, faces a list price above 260% of Medicare 94 times in 100 and a negotiated ceiling that is 4.37 times Medicare at the median. The distance between those two numbers is not geography, and it is not the hospital's cost. It is the contract.

The state is one market. Fourteen of its twenty-one hospital systems have already decided what a CT scan costs at every hospital they own, and published it. The question this report cannot answer is why the same scan costs $1,215 in Vero Beach and $23,586 in Trinity. The files can only show that it does.