Exploration of knee joint at CHI Saint Joseph Health - Saint Joseph Mount Sterling
225 FALCON DR, Mt. Sterling, KY · CommonSpirit Health · · NPI 1679679146
$2,722.95
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.
$7,430.00
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.
$1,555.10 with Wellcare vs $6,761.30 with Multiplan — 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 | $1,555.10 | ↓ -43% |
| Aetna | Medicaid|Better Health | $1,708.90 | ↓ -37% |
| Humana | Medicaid|All Plans | $1,725.99 | ↓ -37% |
| United | Medicaid|All Plans | $1,743.08 | ↓ -36% |
| Passport by Molina | Medicaid|All Plans | $1,743.08 | ↓ -36% |
| BCBS - Anthem | Medicaid|All Plans | $1,794.35 | ↓ -34% |
| BCBS - Anthem | Commercial|Pathway | $2,958.00 | ↑ +9% |
| Humana | Medicare|All Plans | $3,050.71 | ↑ +12% |
| Wellcare | Medicare|All Plans | $3,050.71 | ↑ +12% |
| BCBS - Anthem | Medicare|All Plans | $3,050.71 | ↑ +12% |
| United | Medicare|All Plans | $3,111.72 | ↑ +14% |
| Aetna | Medicare|All Plans | $3,142.23 | ↑ +15% |
| Humana | Commercial|All Plans | $3,194.90 | ↑ +17% |
| Passport by Molina | Medicare|All Plans | $3,203.25 | ↑ +18% |
| BCBS - Anthem | Commercial|HMO PPO | $3,496.00 | ↑ +28% |
| United | Commercial|Non-Options | $3,789.30 | ↑ +39% |
| United | Commercial|Options | $3,789.30 | ↑ +39% |
| Aetna | Commercial|All Other Plans | $4,978.10 | ↑ +83% |
| Aetna | Commercial|HMO | $4,978.10 | ↑ +83% |
| Aetna | Commercial|PPO | $4,978.10 | ↑ +83% |
| CareSource | Commercial|All Plans | $6,101.42 | ↑ +124% |
| Multiplan | Commercial|All Plans | $6,761.30 | ↑ +148% |
Visitor-reported prices
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Exploration of knee joint at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $3,581.67 | $2,049.94 – $6,761.30 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $2,955.93 | $1,798.54 – $6,696.69 |
| CHI Saint Joseph Health - Saint Joseph Hospital | Lexington | $3,706.13 | $1,728.63 – $6,696.69 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $3,152.41 | $1,310.66 – $6,761.30 |
| Adventhealth Manchester | Manchester | not published | $3,070.09 – $3,070.09 |