Ghs intermed repair 12.6 - 20.0 cm-12035 at CHI Saint Joseph Health - Saint Joseph Hospital
1 Saint Joseph Drive, Lexington, KY · CommonSpirit Health · · NPI 1437150984
$468.26
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.
$994.00
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.
$233.50 with Passport by Molina vs $2,376.00 with BCBS - Anthem — 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 |
|---|---|---|---|
| Passport by Molina | Medicaid|All Plans | $233.50 | ↓ -50% |
| Humana | Medicaid|All Plans | $263.02 | ↓ -44% |
| Aetna | Medicaid|Better Health | $268.38 | ↓ -43% |
| United | Medicaid|All Plans | $273.75 | ↓ -42% |
| Wellcare | Medicaid|All Plans | $276.44 | ↓ -41% |
| BCBS - Anthem | Medicaid|All Plans | $281.80 | ↓ -40% |
| Wellcare | Medicare|All Plans | $392.53 | ↓ -16% |
| BCBS - Anthem | Medicare|All Plans | $392.53 | ↓ -16% |
| Humana | Medicare|All Plans | $392.53 | ↓ -16% |
| Aetna | Medicare|All Plans | $404.31 | ↓ -14% |
| United | Medicare|All Plans | $408.23 | ↓ -13% |
| Passport by Molina | Medicare|All Plans | $412.16 | ↓ -12% |
| United | Commercial|All Other Plans | $477.12 | ↑ +2% |
| Aetna | Commercial|HMO | $626.22 | ↑ +34% |
| Cigna | Commercial|All Other Plans | $626.22 | ↑ +34% |
| Cigna | Commercial|PPO | $626.22 | ↑ +34% |
| Aetna | Commercial|PPO | $626.22 | ↑ +34% |
| Aetna | Commercial|All Other Plans | $626.22 | ↑ +34% |
| United | Commercial|PPO | $745.50 | ↑ +59% |
| CareSource | Commercial|All Plans | $785.06 | ↑ +68% |
| Multiplan | Commercial|All Plans | $904.54 | ↑ +93% |
| Humana | Commercial|All Plans | $1,923.63 | ↑ +311% |
| BCBS - Anthem | Commercial|Pathway | $2,011.00 | ↑ +329% |
| BCBS - Anthem | Commercial|HMO PPO | $2,376.00 | ↑ +407% |
| United | Commercial|Non-Options | not published by hospital | — |
| United | Commercial|Options | not published by hospital | — |
Visitor-reported prices
Comments
Ghs intermed repair 12.6 - 20.0 cm-12035 at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $399.27 | $242.94 – $904.54 |
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $282.97 | $161.96 – $534.17 |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $355.12 | $202.82 – $881.79 |
| CHI Saint Joseph Health - Saint Joseph London | London | $750.79 | $300.46 – $1,914.64 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $731.47 | $304.12 – $1,568.84 |
| Adventhealth Manchester | Manchester | not published | $381.43 – $381.43 |