New Patient Office Visit (level 3) at Middlesboro ARH Hospital
3600 W Cumberland Avenue, Middlesboro, KY · Arh · · NPI 1891792495
$192.60
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.
$321.00
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.
$19.65 with Aetna Better Health vs $268.20 with Aetna POS — 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 |
|---|---|---|---|
| Aetna Better Health | Medicaid | $19.65 | ↓ -90% |
| Humana | Choice Care | $19.65 | ↓ -90% |
| WellCare of Kentucky | Medicaid | $26.75 | ↓ -86% |
| Anthem | Medicaid | $54.71 | ↓ -72% |
| Passport Molina | Medicaid | $54.71 | ↓ -72% |
| CareSoure Kentucky | Commercial | $64.20 | ↓ -67% |
| WellCare of Kentucky | Medicare | $69.96 | ↓ -64% |
| United Healthcare | Medicare | $69.96 | ↓ -64% |
| Optum CCN Region 1 | Veterans Affairs Plan | $69.96 | ↓ -64% |
| Optum CCN Region 2 | Veterans Affairs Plan | $69.96 | ↓ -64% |
| Aetna | Medicare | $69.96 | ↓ -64% |
| UMR | Commercial | $222.01 | ↑ +15% |
| United Healthcare HMO | Commercial | $222.01 | ↑ +15% |
| United Healthcare PPO | Commercial | $222.01 | ↑ +15% |
| Anthem HMO | Commercial | $247.52 | ↑ +29% |
| Anthem Traditional/PPO | Commercial | $260.54 | ↑ +35% |
| Aetna PPO | Commercial | $268.20 | ↑ +39% |
| Aetna POS | Commercial | $268.20 | ↑ +39% |
| Anthem | Medicare Advantage | not published by hospital | — |
| Humana | Medicare | not published by hospital | — |
Visitor-reported prices
Comments
New Patient Office Visit (level 3) at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $181.74 | $104.02 – $343.07 |
| Marcum Wallace Hospital | Irvine | $235.20 | not published |
| Lourdes Hospital | Paducah | $556.20 | not published |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $120.21 | $68.66 – $298.48 |
| CHI Saint Joseph Health - Saint Joseph London | London | $94.92 | $37.99 – $242.06 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $161.48 | $98.25 – $365.82 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $189.38 | $94.43 – $365.82 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $230.81 | $95.97 – $495.04 |