Ot evaluation high complexity patient/family at Mary Breckinridge ARH Hospital
130 Kate Ireland Dr, Hayden, KY · Arh · · NPI 1649554007
$272.40
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.
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What you pay up front if you don't use insurance.
$454.00
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.
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The hospital's undiscounted list price — almost no one pays this.
$68.10 with Anthem vs $399.52 with Aetna POS — same scan, same building. Share
Negotiated rates by payer
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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 →
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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 |
|---|---|---|---|
| Anthem | Medicaid | $68.10 | ↓ -75% |
| Humana | Medicaid | $68.10 | ↓ -75% |
| Aetna Better Health | Medicaid | $68.10 | ↓ -75% |
| Humana | Medicare | $68.78 | ↓ -75% |
| Anthem | Medicare Advantage | $68.78 | ↓ -75% |
| Optum CCN Region 1 | Veterans Affairs Plan | $68.78 | ↓ -75% |
| Optum CCN Region 2 | Veterans Affairs Plan | $68.78 | ↓ -75% |
| WellCare of Kentucky | Medicare | $68.78 | ↓ -75% |
| WellCare of Kentucky | Medicaid | $68.78 | ↓ -75% |
| Passport Molina | Medicaid | $69.46 | ↓ -75% |
| United Healthcare | Medicare | $86.26 | ↓ -68% |
| Aetna | Medicare | $95.34 | ↓ -65% |
| Anthem HMO | Commercial | $122.74 | ↓ -55% |
| Anthem Traditional/PPO | Commercial | $122.74 | ↓ -55% |
| United Healthcare HMO | Commercial | $245.16 | ↓ -10% |
| UMR | Commercial | $245.16 | ↓ -10% |
| United Healthcare PPO | Commercial | $245.16 | ↓ -10% |
| CareSoure Kentucky | Commercial | $295.10 | ↑ +8% |
| Aetna PPO | Commercial | $399.52 | ↑ +47% |
| Aetna POS | Commercial | $399.52 | ↑ +47% |
Visitor-reported prices
Comments
Ot evaluation high complexity patient/family at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $150.41 | $86.09 – $283.92 |
| Marcum Wallace Hospital | Irvine | $387.00 | not published |
| Lourdes Hospital | Paducah | $387.00 | not published |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $159.06 | $82.85 – $394.94 |
| CHI Saint Joseph Health - Saint Joseph London | London | $126.32 | $50.56 – $322.14 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $466.75 | $284.00 – $1,057.42 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $547.40 | $272.96 – $1,057.42 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $183.29 | $76.21 – $393.12 |