Observation direct referral from physician office for admission at CHI Saint Joseph Health - Saint Joseph Hospital
1 Saint Joseph Drive, Lexington, KY · CommonSpirit Health · · NPI 1437150984
$283.60
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.
$602.00
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.
$141.41 with Passport by Molina vs $2,938.38 with Humana — 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 | $141.41 | ↓ -50% |
| Humana | Medicaid|All Plans | $159.29 | ↓ -44% |
| Aetna | Medicaid|Better Health | $162.54 | ↓ -43% |
| United | Medicaid|All Plans | $165.80 | ↓ -42% |
| Wellcare | Medicaid|All Plans | $167.42 | ↓ -41% |
| BCBS - Anthem | Medicaid|All Plans | $170.67 | ↓ -40% |
| Aetna | Commercial|All Other Plans | $379.26 | ↑ +34% |
| Aetna | Commercial|PPO | $379.26 | ↑ +34% |
| Cigna | Commercial|All Other Plans | $379.26 | ↑ +34% |
| Aetna | Commercial|HMO | $379.26 | ↑ +34% |
| Cigna | Commercial|PPO | $379.26 | ↑ +34% |
| United | Commercial|PPO | $439.46 | ↑ +55% |
| Multiplan | Commercial|All Plans | $547.82 | ↑ +93% |
| Wellcare | Medicare|All Plans | $602.36 | ↑ +112% |
| Humana | Medicare|All Plans | $602.36 | ↑ +112% |
| BCBS - Anthem | Medicare|All Plans | $602.36 | ↑ +112% |
| Aetna | Medicare|All Plans | $620.43 | ↑ +119% |
| United | Medicare|All Plans | $626.45 | ↑ +121% |
| Passport by Molina | Medicare|All Plans | $632.48 | ↑ +123% |
| BCBS - Anthem | Commercial|Pathway | $1,067.54 | ↑ +276% |
| CareSource | Commercial|All Plans | $1,204.72 | ↑ +325% |
| BCBS - Anthem | Commercial|HMO PPO | $1,210.75 | ↑ +327% |
| United | Commercial|All Other Plans | $2,418.00 | ↑ +753% |
| Humana | Commercial|All Plans | $2,938.38 | ↑ +936% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $241.81 | $147.13 – $547.82 |
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $290.20 | $166.10 – $547.82 |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $216.23 | $123.49 – $536.90 |
| CHI Saint Joseph Health - Saint Joseph London | London | $208.75 | $83.54 – $532.35 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $257.97 | $107.26 – $553.28 |
| Adventhealth Manchester | Manchester | $184.72 | $558.78 – $558.78 |