Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at Baptist Health Lexington
1740 Nicholasville Rd, Lexington, KY · Baptisthealth · · NPI 1538244918
$184.78
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.
$246.37
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.
$22.17 with AETNA BETTER HLTH MCAID vs $325.00 with CIGNA COMM - ALL PLANS — 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 |
|---|---|---|---|
| AETNA BETTER HLTH MCAID | AETNA BETTER HLTH MCAID | $22.17 | ↓ -88% |
| WELLCARE MCAID | WELLCARE MCAID | $22.17 | ↓ -88% |
| HUMANA MCAID HMO | HUMANA MCAID HMO | $22.17 | ↓ -88% |
| UHC MCAID | UHC MCAID | $22.17 | ↓ -88% |
| MOLINA MCAID - ALL PLANS | MOLINA MCAID - ALL PLANS | $22.17 | ↓ -88% |
| SIGNATURE ADV - ALL PLANS | SIGNATURE ADV - ALL PLANS | $46.33 | ↓ -75% |
| ANTHEM MCR ADV | ANTHEM MCR ADV | $46.56 | ↓ -75% |
| HUMANA MCR ADV - ALL OTHER PLANS | HUMANA MCR ADV - ALL OTHER PLANS | $49.57 | ↓ -73% |
| ANTHEM BHS1 | ANTHEM BHS1 | $60.68 | ↓ -67% |
| ANTHEM BLUE ACCESS PPO | ANTHEM BLUE ACCESS PPO | $60.72 | ↓ -67% |
| HEALTHLINK-ALL PLANS | HEALTHLINK-ALL PLANS | $60.72 | ↓ -67% |
| ANTHEM BLUE PREF HMO | ANTHEM BLUE PREF HMO | $60.72 | ↓ -67% |
| ANTHEM PATHWAY HPN | ANTHEM PATHWAY HPN | $60.72 | ↓ -67% |
| ANTHEM PATHWAY HMO | ANTHEM PATHWAY HMO | $60.72 | ↓ -67% |
| ALLIANCE COAL - ALL PLANS | ALLIANCE COAL - ALL PLANS | $92.66 | ↓ -50% |
| CARESOURCE-ALL PLANS | CARESOURCE-ALL PLANS | $92.66 | ↓ -50% |
| AMBETTER/WCARE DIRECT IND - ALL PLANS | AMBETTER/WCARE DIRECT IND - ALL PLANS | $94.19 | ↓ -49% |
| AMBETTER/WCARE IND MRKT | AMBETTER/WCARE IND MRKT | $94.19 | ↓ -49% |
| AETNA NEW BUS | AETNA NEW BUS | $101.75 | ↓ -45% |
| CENTER CARE - ALL PLANS | CENTER CARE - ALL PLANS | $110.55 | ↓ -40% |
| ENCORE PREFERRED | ENCORE PREFERRED | $124.42 | ↓ -33% |
| ANTHEM TRAD - ALL OTHER PLANS | ANTHEM TRAD - ALL OTHER PLANS | $130.97 | ↓ -29% |
| UHC NEW BUSINESS - ALL OTHER PLANS | UHC NEW BUSINESS - ALL OTHER PLANS | $131.07 | ↓ -29% |
| AETNA COMM - ALL OTHER PLANS | AETNA COMM - ALL OTHER PLANS | $134.27 | ↓ -27% |
| SIHO-ALL PLANS | SIHO-ALL PLANS | $172.46 | ↓ -7% |
| UHC OLD BUSINESS | UHC OLD BUSINESS | $182.81 | ↓ -1% |
| PHCS-ALL PLANS | PHCS-ALL PLANS | $192.17 | ↑ +4% |
| MULTIPLAN-ALL PLANS | MULTIPLAN-ALL PLANS | $194.63 | ↑ +5% |
| ENCORE PPO - ALL OTHER PLANS | ENCORE PPO - ALL OTHER PLANS | $211.63 | ↑ +15% |
| AETNA MCR ADV | AETNA MCR ADV | $246.37 | ↑ +33% |
| ANTHEM MCR SELECT | ANTHEM MCR SELECT | $246.37 | ↑ +33% |
| CIGNA COMM - ALL PLANS | CIGNA COMM - ALL PLANS | $325.00 | ↑ +76% |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $63.47 | $29.09 – $108.29 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $79.58 | $27.96 – $108.29 |
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $68.94 | $34.77 – $114.66 |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $52.41 | $19.47 – $84.63 |
| CHI Saint Joseph Health - Saint Joseph London | London | $49.96 | $13.14 – $83.72 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $63.65 | $20.11 – $103.74 |
| Baptist Health Corbin | Corbin | $184.78 | $60.72 – $492.74 |
| Whitesburg ARH Hospital | Whitesburg | $163.20 | $46.33 – $89.96 |