Biopsy skin incisional single lesion at CHI Saint Joseph Health - Saint Joseph Mount Sterling
225 FALCON DR, Mt. Sterling, KY · CommonSpirit Health · · NPI 1679679146
$382.61
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.
$1,044.00
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.
$218.51 with Wellcare vs $1,834.00 with BCBS - Anthem — 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 |
|---|---|---|---|
| Wellcare | Medicaid|All Plans | $218.51 | ↓ -43% |
| Aetna | Medicaid|Better Health | $240.12 | ↓ -37% |
| Humana | Medicaid|All Plans | $242.53 | ↓ -37% |
| United | Medicaid|All Plans | $244.93 | ↓ -36% |
| Passport by Molina | Medicaid|All Plans | $244.93 | ↓ -36% |
| BCBS - Anthem | Medicaid|All Plans | $252.13 | ↓ -34% |
| Humana | Commercial|All Plans | $417.60 | ↑ +9% |
| United | Commercial|Options | $532.44 | ↑ +39% |
| United | Commercial|Non-Options | $532.44 | ↑ +39% |
| Wellcare | Medicare|All Plans | $575.55 | ↑ +50% |
| Humana | Medicare|All Plans | $575.55 | ↑ +50% |
| BCBS - Anthem | Medicare|All Plans | $575.55 | ↑ +50% |
| United | Medicare|All Plans | $587.06 | ↑ +53% |
| Aetna | Medicare|All Plans | $592.82 | ↑ +55% |
| Passport by Molina | Medicare|All Plans | $604.33 | ↑ +58% |
| Aetna | Commercial|HMO | $699.48 | ↑ +83% |
| Aetna | Commercial|PPO | $699.48 | ↑ +83% |
| Aetna | Commercial|All Other Plans | $699.48 | ↑ +83% |
| Multiplan | Commercial|All Plans | $950.04 | ↑ +148% |
| CareSource | Commercial|All Plans | $1,151.10 | ↑ +201% |
| BCBS - Anthem | Commercial|Pathway | $1,551.00 | ↑ +305% |
| BCBS - Anthem | Commercial|HMO PPO | $1,834.00 | ↑ +379% |
Visitor-reported prices
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Biopsy skin incisional single lesion at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $503.27 | $288.04 – $950.04 |
| CHI Saint Joseph Health - Saint Joseph London | London | $365.40 | $146.23 – $931.84 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $415.34 | $252.71 – $940.94 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $487.10 | $242.89 – $940.94 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $442.95 | $184.17 – $950.04 |
| Adventhealth Manchester | Manchester | $1,141.80 | $693.47 – $693.47 |