Diagnostic Mammogram (one breast) at Middlesboro ARH Hospital
3600 W Cumberland Avenue, Middlesboro, KY · Arh · · NPI 1891792495
$364.80
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.
$608.00
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.
$76.62 with Humana vs $547.20 with Aetna PPO — 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 | $76.62 | ↓ -79% |
| United Healthcare | Medicare | $76.62 | ↓ -79% |
| Anthem | Medicare Advantage | $76.62 | ↓ -79% |
| Aetna | Medicare | $76.62 | ↓ -79% |
| Optum CCN Region 1 | Veterans Affairs Plan | $76.62 | ↓ -79% |
| Optum CCN Region 2 | Veterans Affairs Plan | $76.62 | ↓ -79% |
| WellCare of Kentucky | Medicare | $76.62 | ↓ -79% |
| Humana | Choice Care | $111.63 | ↓ -69% |
| Anthem | Medicaid | $111.63 | ↓ -69% |
| Passport Molina | Medicaid | $111.63 | ↓ -69% |
| Aetna Better Health | Medicaid | $111.63 | ↓ -69% |
| Anthem Traditional/PPO | Commercial | $120.00 | ↓ -67% |
| Anthem HMO | Commercial | $120.00 | ↓ -67% |
| WellCare of Kentucky | Medicaid | $152.00 | ↓ -58% |
| CareSoure Kentucky | Commercial | $364.80 | ↑ +0% |
| United Healthcare PPO | Commercial | $452.96 | ↑ +24% |
| UMR | Commercial | $452.96 | ↑ +24% |
| United Healthcare HMO | Commercial | $452.96 | ↑ +24% |
| Aetna POS | Commercial | $547.20 | ↑ +50% |
| Aetna PPO | Commercial | $547.20 | ↑ +50% |
Visitor-reported prices
Comments
Diagnostic Mammogram (one breast) at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Marcum Wallace Hospital | Irvine | $359.40 | not published |
| Lourdes Hospital | Paducah | $331.80 | not published |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $118.38 | $67.61 – $293.93 |
| CHI Saint Joseph Health - Saint Joseph London | London | $122.76 | $49.13 – $313.04 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $179.96 | $109.50 – $407.68 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $211.05 | $105.24 – $407.68 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $159.96 | $66.51 – $343.07 |
| Adventhealth Manchester | Manchester | $994.26 | $76.62 – $76.62 |