Bx breast 1st lesion strtctc at Middlesboro ARH Hospital
3600 W Cumberland Avenue, Middlesboro, KY · Arh · · NPI 1891792495
$4,746.60
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.
?
What you pay up front if you don't use insurance.
$7,911.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$1,110.62 with Humana vs $7,119.90 with Aetna PPO — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $1,110.62 | ↓ -77% |
| United Healthcare | Medicare | $1,110.62 | ↓ -77% |
| Anthem | Medicare Advantage | $1,110.62 | ↓ -77% |
| Aetna | Medicare | $1,110.62 | ↓ -77% |
| Optum CCN Region 1 | Veterans Affairs Plan | $1,110.62 | ↓ -77% |
| Optum CCN Region 2 | Veterans Affairs Plan | $1,110.62 | ↓ -77% |
| WellCare of Kentucky | Medicare | $1,110.62 | ↓ -77% |
| Humana | Choice Care | $1,452.46 | ↓ -69% |
| Anthem | Medicaid | $1,452.46 | ↓ -69% |
| Passport Molina | Medicaid | $1,452.46 | ↓ -69% |
| Aetna Better Health | Medicaid | $1,452.46 | ↓ -69% |
| WellCare of Kentucky | Medicaid | $1,977.75 | ↓ -58% |
| CareSoure Kentucky | Commercial | $4,746.60 | ↑ +0% |
| United Healthcare PPO | Commercial | $5,893.70 | ↑ +24% |
| UMR | Commercial | $5,893.70 | ↑ +24% |
| United Healthcare HMO | Commercial | $5,893.70 | ↑ +24% |
| Anthem HMO | Commercial | $6,570.88 | ↑ +38% |
| Anthem Traditional/PPO | Commercial | $6,916.59 | ↑ +46% |
| Aetna POS | Commercial | $7,119.90 | ↑ +50% |
| Aetna PPO | Commercial | $7,119.90 | ↑ +50% |
Visitor-reported prices
Comments
Bx breast 1st lesion strtctc at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $1,897.37 | $1,085.95 – $3,581.76 |
| Lourdes Hospital | Paducah | $6,612.00 | not published |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $2,106.53 | $1,203.06 – $5,230.68 |
| CHI Saint Joseph Health - Saint Joseph London | London | $641.95 | $256.90 – $1,637.09 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $2,186.72 | $1,330.52 – $4,954.04 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $2,564.58 | $1,278.80 – $4,954.04 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $2,628.43 | $1,092.80 – $5,637.45 |
| Tug Valley ARH Regional Medical Center | Williamson | $729.60 | $122.50 – $224.09 |