Incision of breast lesion at CHI Saint Joseph Health - Saint Joseph Berea
305 Estill Street, Berea, KY · CommonSpirit Health · · NPI 1740488386
$1,186.82
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
?
What you pay up front if you don't use insurance.
$2,462.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
?
The hospital's undiscounted list price — almost no one pays this.
$679.27 with Wellcare vs $2,565.00 with BCBS - Anthem — same scan, same building. Share
Negotiated rates by payer
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
?
Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Wellcare | Medicaid|All Plans | $679.27 | ↓ -43% |
| Wellcare | Medicare|All Plans | $689.36 | ↓ -42% |
| BCBS - Anthem | Medicare|All Plans | $689.36 | ↓ -42% |
| Humana | Medicare|All Plans | $689.36 | ↓ -42% |
| United | Medicare|All Plans | $703.15 | ↓ -41% |
| Aetna | Medicare|All Plans | $710.05 | ↓ -40% |
| Passport by Molina | Medicare|All Plans | $723.83 | ↓ -39% |
| Humana | Medicaid|All Plans | $763.22 | ↓ -36% |
| Aetna | Medicaid|Better Health | $763.22 | ↓ -36% |
| Passport by Molina | Medicaid|All Plans | $778.49 | ↓ -34% |
| United | Medicaid|All Plans | $778.49 | ↓ -34% |
| BCBS - Anthem | Medicaid|All Plans | $801.39 | ↓ -32% |
| Humana | Commercial|All Plans | $1,132.52 | ↓ -5% |
| United | Commercial|Non-Options | $1,354.10 | ↑ +14% |
| United | Commercial|Options | $1,354.10 | ↑ +14% |
| CareSource | Commercial|All Plans | $1,378.72 | ↑ +16% |
| Cigna | Commercial|PPO | $1,698.78 | ↑ +43% |
| Cigna | Commercial|All Other Plans | $1,698.78 | ↑ +43% |
| Aetna | Commercial|All Other Plans | $1,895.74 | ↑ +60% |
| Aetna | Commercial|HMO | $1,895.74 | ↑ +60% |
| Aetna | Commercial|PPO | $1,895.74 | ↑ +60% |
| BCBS - Anthem | Commercial|Pathway | $2,170.00 | ↑ +83% |
| Multiplan | Commercial|All Plans | $2,240.42 | ↑ +89% |
| BCBS - Anthem | Commercial|HMO PPO | $2,565.00 | ↑ +116% |
Visitor-reported prices
Comments
Incision of breast lesion at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $871.50 | $497.72 – $2,163.98 |
| CHI Saint Joseph Health - Saint Joseph London | London | $402.87 | $161.23 – $1,027.39 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $946.35 | $575.81 – $2,143.96 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $1,186.53 | $553.43 – $2,143.96 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $803.17 | $333.93 – $1,722.63 |
| Adventhealth Manchester | Manchester | not published | $1,549.68 – $1,549.68 |