Surgical pathology level 1 gross examination only at Middlesboro ARH Hospital
3600 W Cumberland Avenue, Middlesboro, KY · Arh · · NPI 1891792495
$186.60
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.
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What you pay up front if you don't use insurance.
$311.00
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.
$12.35 with Humana vs $279.90 with Aetna POS — 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 | Medicaid | $12.35 | ↓ -93% |
| Aetna Better Health | Medicaid | $12.35 | ↓ -93% |
| Passport Molina | Medicaid | $12.35 | ↓ -93% |
| Anthem | Medicaid | $12.43 | ↓ -93% |
| Humana | Medicare | $16.79 | ↓ -91% |
| United Healthcare | Medicare | $16.79 | ↓ -91% |
| Anthem | Medicare Advantage | $16.79 | ↓ -91% |
| Aetna | Medicare | $16.79 | ↓ -91% |
| Optum CCN Region 1 | Veterans Affairs Plan | $16.79 | ↓ -91% |
| Optum CCN Region 2 | Veterans Affairs Plan | $16.79 | ↓ -91% |
| WellCare of Kentucky | Medicare | $16.79 | ↓ -91% |
| WellCare of Kentucky | Medicaid | $77.75 | ↓ -58% |
| CareSoure Kentucky | Commercial | $186.60 | ↑ +0% |
| United Healthcare PPO | Commercial | $231.70 | ↑ +24% |
| UMR | Commercial | $231.70 | ↑ +24% |
| United Healthcare HMO | Commercial | $231.70 | ↑ +24% |
| Anthem HMO | Commercial | $258.32 | ↑ +38% |
| Anthem Traditional/PPO | Commercial | $271.91 | ↑ +46% |
| Aetna PPO | Commercial | $279.90 | ↑ +50% |
| Aetna POS | Commercial | $279.90 | ↑ +50% |
Visitor-reported prices
Comments
Surgical pathology level 1 gross examination only at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $36.16 | $12.35 – $68.25 |
| Marcum Wallace Hospital | Irvine | $71.40 | not published |
| Lourdes Hospital | Paducah | $54.00 | not published |
| CHI Saint Joseph Health - Saint Joseph Mount Sterling | Mt. Sterling | $15.76 | $12.35 – $39.13 |
| CHI Saint Joseph Health - Saint Joseph London | London | $103.49 | $12.35 – $263.90 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $41.38 | $12.43 – $93.73 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $48.53 | $12.35 – $93.73 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $36.49 | $12.43 – $78.26 |