AdventHealth Polk — price list
← Hospital overviewVerified from AdventHealth Polk’s published price file
Includes list prices, insurance-negotiated rates. Open any row for plan-level negotiated rates. This is public hospital price transparency data, not a guaranteed estimate of your bill.
Showing the first 1,500 prices. Search a procedure or code below to narrow the list.
How to read these columns
- List
- The hospital’s full undiscounted (gross) charge — rarely what anyone actually pays.
- Cash
- The discounted self-pay price for paying directly, without insurance.
- Negotiated
- Rates agreed with insurers; open a row for plan-level detail. Your share depends on your benefits.
These are the hospital’s published reference prices, not a personalized estimate of your bill.
195 prices shown (filtered).
| Service | Code | List price | Cash price | Negotiated range | Allowed (median) | |
|---|---|---|---|---|---|---|
| 12 HOUR DECONGESTANT 0.05 % NA SOLN Inpatient & outpatient | 259 RC | $43.50 | — | — | — | |
| 7 DAY VAGINAL 2 % VA CREA Inpatient & outpatient | 259 RC | $58.85 | — | — | — | |
| ACETAMINOPHEN 160 MG/5ML PO SOLN Inpatient & outpatient | 259 RC | $27.51 | — | — | — | |
| ACETAMINOPHEN 650 MG/20.3ML PO SOLN Inpatient & outpatient | 259 RC | $10.04 | — | — | — | |
| ACETIC ACID 3 % SOLN Inpatient & outpatient | 259 RC | $3.47 | — | — | — | |
| ACETYLCYSTEINE 20 % IN SOLN Inpatient & outpatient | 259 RC | $109 | — | — | — | |
| ACTIDOSE WITH SORBITOL 25 GM/120ML PO SUSP Inpatient & outpatient | 259 RC | $154 | — | — | — | |
| ACTIDOSE-AQUA 25 GM/120ML PO LIQD Inpatient & outpatient | 259 RC | $154 | — | — | — | |
| ADRENALIN 0.1 % NA SOLN Inpatient & outpatient | 259 RC | $1,005 | — | — | — | |
| AFRIN NODRIP EXTRA MOISTURE 0.05 % NA SOLN Inpatient & outpatient | 259 RC | $117 | — | — | — | |
| AKTEN 3.5 % OP GEL Inpatient & outpatient | 259 RC | $195 | — | — | — | |
| ALAWAY 0.035 % OP SOLN Inpatient & outpatient | 259 RC | $142 | — | — | — | |
| ALBUTEROL SULFATE (2.5 MG/3ML) 0.083% IN NEBU Inpatient & outpatient | 259 RC | $7.40 | — | — | — | |
| ALBUTEROL SULFATE 1.25 MG/3ML IN NEBU Inpatient & outpatient | 259 RC | $13.87 | — | — | — | |
| ALBUTEROL SULFATE 2.5 MG/0.5ML IN NEBU Inpatient & outpatient | 259 RC | $12.88 | — | — | — | |
| ALBUTEROL SULFATE HFA 108 (90 BASE) MCG/ACT IN AERS Inpatient & outpatient | 259 RC | $38.70 | — | — | — | |
| ALPHAGAN P 0.1 % OP SOLN Inpatient & outpatient | 259 RC | $1,079 | — | — | — | |
| ALUM & MAG HYDROXIDE-SIMETH 1200-1200-120 MG/30ML PO SUSP Inpatient & outpatient | 259 RC | $15.76 | — | — | — | |
| AMANTADINE HCL 50 MG/5ML PO SOLN UNIT DOSE Inpatient & outpatient | 259 RC | $30.70 | — | — | — | |
| AMERICAINE 20 % EX AERO Inpatient & outpatient | 259 RC | $57.20 | — | — | — | |
| AMMONIUM LACTATE 12 % EX LOTN Inpatient & outpatient | 259 RC | $61.30 | — | — | — | |
| AMOXICILLIN 250 MG/5ML PO SUSR Inpatient & outpatient | 259 RC | $9.40 | — | — | — | |
| AMOXICILLIN 400 MG/5ML PO SUSR Inpatient & outpatient | 259 RC | $7.89 | — | — | — | |
| AMOXICILLIN-POT CLAVULANATE 400-57 MG/5ML PO SUSR UNIT DOSE Inpatient & outpatient | 259 RC | $12.33 | — | — | — | |
| ANECREAM 4 % EX CREA Inpatient & outpatient | 259 RC | $49.62 | — | — | — | |
| ANORO ELLIPTA 62.5-25 MCG/ACT IN AEPB Inpatient & outpatient | 259 RC | $373 | — | — | — | |
| ANTACID REGULAR STRENGTH 200-200-20 MG/5ML PO SUSP Inpatient & outpatient | 259 RC | $5.56 | — | — | — | |
| ANTACID/ANTIGAS 400-400-40 MG/10ML PO SUSP Inpatient & outpatient | 259 RC | $2.84 | — | — | — | |
| ANTI-ITCH 2-0.1 % EX CREA Inpatient & outpatient | 259 RC | $39.53 | — | — | — | |
| ANTIFUNGAL (CLOTRIMAZOLE) 1 % EX CREA Inpatient & outpatient | 259 RC | $44.95 | — | — | — |