Biopsy of heart lining at CHI Saint Joseph Health - Saint Joseph Hospital
1 Saint Joseph Drive, Lexington, KY · CommonSpirit Health · · NPI 1437150984
$1,295.95
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.
$2,751.00
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.
$646.21 with Passport by Molina vs $9,080.00 with Humana — 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 |
|---|---|---|---|
| Passport by Molina | Medicaid|All Plans | $646.21 | ↓ -50% |
| Humana | Medicaid|All Plans | $727.92 | ↓ -44% |
| Aetna | Medicaid|Better Health | $742.77 | ↓ -43% |
| United | Medicaid|All Plans | $757.63 | ↓ -42% |
| Wellcare | Medicaid|All Plans | $765.06 | ↓ -41% |
| BCBS - Anthem | Medicaid|All Plans | $779.91 | ↓ -40% |
| United | Commercial|All Other Plans | $1,320.48 | ↑ +2% |
| Cigna | Commercial|All Other Plans | $1,733.13 | ↑ +34% |
| Aetna | Commercial|HMO | $1,733.13 | ↑ +34% |
| Aetna | Commercial|PPO | $1,733.13 | ↑ +34% |
| Cigna | Commercial|PPO | $1,733.13 | ↑ +34% |
| Aetna | Commercial|All Other Plans | $1,733.13 | ↑ +34% |
| United | Commercial|PPO | $2,063.25 | ↑ +59% |
| Multiplan | Commercial|All Plans | $2,503.41 | ↑ +93% |
| Humana | Medicare|All Plans | $3,092.36 | ↑ +139% |
| Wellcare | Medicare|All Plans | $3,092.36 | ↑ +139% |
| BCBS - Anthem | Medicare|All Plans | $3,092.36 | ↑ +139% |
| Aetna | Medicare|All Plans | $3,185.13 | ↑ +146% |
| United | Medicare|All Plans | $3,216.05 | ↑ +148% |
| Passport by Molina | Medicare|All Plans | $3,246.98 | ↑ +151% |
| CareSource | Commercial|All Plans | $6,184.72 | ↑ +377% |
| Humana | Commercial|All Plans | $9,080.00 | ↑ +601% |
Visitor-reported prices
Comments
Biopsy of heart lining at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Adventhealth Manchester | Manchester | not published | $2,962.64 – $2,962.64 |