Tomosynthesis breast diagnostic left at ARH Our Lady of the Way Hospital
11203 Main Street, Martin, KY · Arh · · NPI 1306339460
$40.20
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.
$67.00
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.
$13.40 with Humana vs $120.00 with Anthem HMO — 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 |
|---|---|---|---|
| Humana | Medicare | $13.40 | ↓ -67% |
| Humana | Medicaid | $13.40 | ↓ -67% |
| Anthem | Medicaid | $13.40 | ↓ -67% |
| Anthem | Medicare Advantage | $13.40 | ↓ -67% |
| Aetna Better Health | Medicaid | $13.40 | ↓ -67% |
| Optum CCN Region 1 | Veterans Affairs Plan | $13.40 | ↓ -67% |
| Optum CCN Region 2 | Veterans Affairs Plan | $13.40 | ↓ -67% |
| WellCare of Kentucky | Medicare | $13.40 | ↓ -67% |
| WellCare of Kentucky | Medicaid | $13.53 | ↓ -66% |
| Passport Molina | Medicaid | $13.67 | ↓ -66% |
| Aetna | Medicare | $17.42 | ↓ -57% |
| CareSoure Kentucky | Commercial | $43.55 | ↑ +8% |
| Aetna POS | Commercial | $58.96 | ↑ +47% |
| Aetna PPO | Commercial | $58.96 | ↑ +47% |
| Anthem Traditional/PPO | Commercial | $120.00 | ↑ +199% |
| Anthem HMO | Commercial | $120.00 | ↑ +199% |
Visitor-reported prices
Comments
Tomosynthesis breast diagnostic left at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $40.02 | $22.90 – $75.53 |
| Marcum Wallace Hospital | Irvine | $24.00 | not published |
| Lourdes Hospital | Paducah | $52.20 | not published |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $46.91 | $17.59 – $76.44 |
| CHI Saint Joseph Health - Saint Joseph London | London | $36.76 | $11.86 – $75.53 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $32.54 | $19.80 – $73.71 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $38.16 | $19.03 – $73.71 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $60.25 | $14.65 – $75.53 |