Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at Baptist Health Lexington

1740 Nicholasville Rd, Lexington, KY · Baptisthealth · · NPI 1538244918

Source: hospital's published price file ↗ · Published Sep 3, 2026 · Ingested Sep 17, 2026

$184.78

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$246.37

Gross charge

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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.

Full explanation →

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 →

Payer
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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
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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

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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

All Kentucky hospitals for this procedure →