Repair lip full thkns >one-half vert height/cmplx at CHI Saint Joseph Health - Saint Joseph Hospital
1 Saint Joseph Drive, Lexington, KY · CommonSpirit Health · · NPI 1437150984
$971.38
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.
$2,062.00
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.
$484.37 with Passport by Molina vs $3,796.00 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 | $484.37 | ↓ -50% |
| Humana | Medicaid|All Plans | $545.61 | ↓ -44% |
| Aetna | Medicaid|Better Health | $556.74 | ↓ -43% |
| United | Medicaid|All Plans | $567.88 | ↓ -42% |
| Wellcare | Medicaid|All Plans | $573.45 | ↓ -41% |
| BCBS - Anthem | Medicaid|All Plans | $584.58 | ↓ -40% |
| United | Commercial|All Other Plans | $989.76 | ↑ +2% |
| Cigna | Commercial|PPO | $1,299.06 | ↑ +34% |
| Aetna | Commercial|All Other Plans | $1,299.06 | ↑ +34% |
| Aetna | Commercial|PPO | $1,299.06 | ↑ +34% |
| Aetna | Commercial|HMO | $1,299.06 | ↑ +34% |
| Cigna | Commercial|All Other Plans | $1,299.06 | ↑ +34% |
| BCBS - Anthem | Medicare|All Plans | $1,455.33 | ↑ +50% |
| Humana | Medicare|All Plans | $1,455.33 | ↑ +50% |
| Wellcare | Medicare|All Plans | $1,455.33 | ↑ +50% |
| Aetna | Medicare|All Plans | $1,498.99 | ↑ +54% |
| United | Medicare|All Plans | $1,513.54 | ↑ +56% |
| Passport by Molina | Medicare|All Plans | $1,528.10 | ↑ +57% |
| United | Commercial|PPO | $1,546.50 | ↑ +59% |
| Multiplan | Commercial|All Plans | $1,876.42 | ↑ +93% |
| Humana | Commercial|All Plans | $2,657.78 | ↑ +174% |
| CareSource | Commercial|All Plans | $2,910.66 | ↑ +200% |
| BCBS - Anthem | Commercial|Pathway | $3,212.00 | ↑ +231% |
| BCBS - Anthem | Commercial|HMO PPO | $3,796.00 | ↑ +291% |
| United | Commercial|Options | not published by hospital | — |
| United | Commercial|Non-Options | not published by hospital | — |
Visitor-reported prices
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Repair lip full thkns >one-half vert height/cmplx at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $828.26 | $503.96 – $1,876.42 |
| Adventhealth Manchester | Manchester | $3,832.69 | $1,455.84 – $1,455.84 |