Cyclophosphamide 25 mg capsule at CHI Saint Joseph Health - Saint Joseph East
150 North Eagle Creek Drive, Lexington, KY · CommonSpirit Health · · NPI 1447457775
$277.06
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.
$689.76
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.
$0.99 with BCBS - Anthem vs $627.69 with Multiplan — 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 |
|---|---|---|---|
| BCBS - Anthem | Commercial|Pathway | $0.99 | ↓ -100% |
| BCBS - Anthem | Commercial|HMO PPO | $0.99 | ↓ -100% |
| Passport by Molina | Medicaid|All Plans | $168.58 | ↓ -39% |
| Wellcare | Medicaid|All Plans | $175.76 | ↓ -37% |
| Humana | Medicaid|All Plans | $177.55 | ↓ -36% |
| Aetna | Medicaid|Better Health | $179.34 | ↓ -35% |
| United | Medicaid|Community Plan | $182.93 | ↓ -34% |
| BCBS - Anthem | Medicaid|All Plans | $188.31 | ↓ -32% |
| Aetna | Commercial|HMO | $289.70 | ↑ +5% |
| Aetna | Commercial|PPO | $289.70 | ↑ +5% |
| Aetna | Commercial|All Other Plans | $289.70 | ↑ +5% |
| Cigna | Commercial|PPO | $379.37 | ↑ +37% |
| Cigna | Commercial|All Other Plans | $379.37 | ↑ +37% |
| Multiplan | Commercial|All Plans | $627.69 | ↑ +127% |
Visitor-reported prices
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Cyclophosphamide 25 mg capsule at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $252.79 | $0.99 – $627.69 |
| CHI Saint Joseph Health - Saint Joseph London | London | $246.14 | $0.99 – $627.69 |