Ghs simple repair 12.6 - 20.0 cm - 12016 at CHI Saint Joseph Health - Saint Joseph Hospital
1 Saint Joseph Drive, Lexington, KY · CommonSpirit Health · · NPI 1437150984
$415.97
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.
$883.00
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.
$207.42 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 | $207.42 | ↓ -50% |
| Humana | Medicaid|All Plans | $233.65 | ↓ -44% |
| Aetna | Medicaid|Better Health | $238.41 | ↓ -43% |
| United | Medicaid|All Plans | $243.18 | ↓ -42% |
| Wellcare | Medicaid|All Plans | $245.57 | ↓ -41% |
| BCBS - Anthem | Medicaid|All Plans | $250.34 | ↓ -40% |
| Wellcare | Medicare|All Plans | $392.53 | ↓ -6% |
| BCBS - Anthem | Medicare|All Plans | $392.53 | ↓ -6% |
| Humana | Medicare|All Plans | $392.53 | ↓ -6% |
| Aetna | Medicare|All Plans | $404.31 | ↓ -3% |
| United | Medicare|All Plans | $408.23 | ↓ -2% |
| Passport by Molina | Medicare|All Plans | $412.16 | ↓ -1% |
| United | Commercial|All Other Plans | $423.84 | ↑ +2% |
| Aetna | Commercial|HMO | $556.29 | ↑ +34% |
| Cigna | Commercial|All Other Plans | $556.29 | ↑ +34% |
| Cigna | Commercial|PPO | $556.29 | ↑ +34% |
| Aetna | Commercial|PPO | $556.29 | ↑ +34% |
| Aetna | Commercial|All Other Plans | $556.29 | ↑ +34% |
| United | Commercial|PPO | $662.25 | ↑ +59% |
| CareSource | Commercial|All Plans | $785.06 | ↑ +89% |
| Multiplan | Commercial|All Plans | $803.53 | ↑ +93% |
| Humana | Commercial|All Plans | $1,923.63 | ↑ +362% |
| BCBS - Anthem | Commercial|Pathway | $2,011.00 | ↑ +383% |
| BCBS - Anthem | Commercial|HMO PPO | $2,376.00 | ↑ +471% |
| United | Commercial|Non-Options | not published by hospital | — |
| United | Commercial|Options | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 12.6 - 20.0 cm - 12016 at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $354.68 | $215.81 – $803.53 |
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $374.08 | $214.10 – $706.16 |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $409.00 | $233.58 – $1,015.56 |
| CHI Saint Joseph Health - Saint Joseph London | London | $644.81 | $258.04 – $1,644.37 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $303.37 | $126.13 – $650.65 |
| Adventhealth Manchester | Manchester | not published | $381.43 – $381.43 |