Ins picad w subq port 5yr> at CHI Saint Joseph Health - Saint Joseph Mount Sterling
225 FALCON DR, Mt. Sterling, KY · CommonSpirit Health · · NPI 1679679146
$1,094.32
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.
$2,986.00
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.
$624.97 with Wellcare vs $5,918.82 with CareSource — 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 | $624.97 | ↓ -43% |
| Aetna | Medicaid|Better Health | $686.78 | ↓ -37% |
| Humana | Medicaid|All Plans | $693.65 | ↓ -37% |
| United | Medicaid|All Plans | $700.52 | ↓ -36% |
| Passport by Molina | Medicaid|All Plans | $700.52 | ↓ -36% |
| BCBS - Anthem | Medicaid|All Plans | $721.12 | ↓ -34% |
| Humana | Commercial|All Plans | $1,283.98 | ↑ +17% |
| United | Commercial|Options | $1,522.86 | ↑ +39% |
| United | Commercial|Non-Options | $1,522.86 | ↑ +39% |
| Aetna | Commercial|HMO | $2,000.62 | ↑ +83% |
| Aetna | Commercial|PPO | $2,000.62 | ↑ +83% |
| Aetna | Commercial|All Other Plans | $2,000.62 | ↑ +83% |
| BCBS - Anthem | Commercial|Pathway | $2,613.00 | ↑ +139% |
| Multiplan | Commercial|All Plans | $2,717.26 | ↑ +148% |
| BCBS - Anthem | Medicare|All Plans | $2,959.41 | ↑ +170% |
| Wellcare | Medicare|All Plans | $2,959.41 | ↑ +170% |
| Humana | Medicare|All Plans | $2,959.41 | ↑ +170% |
| United | Medicare|All Plans | $3,018.60 | ↑ +176% |
| Aetna | Medicare|All Plans | $3,048.19 | ↑ +179% |
| BCBS - Anthem | Commercial|HMO PPO | $3,087.00 | ↑ +182% |
| Passport by Molina | Medicare|All Plans | $3,107.38 | ↑ +184% |
| CareSource | Commercial|All Plans | $5,918.82 | ↑ +441% |
Visitor-reported prices
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Ins picad w subq port 5yr> at other Kentucky hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Saint Joseph Health - Saint Joseph Berea | Berea | $1,442.79 | $825.77 – $2,723.63 |
| CHI Saint Joseph Health - Saint Joseph London | London | $1,173.28 | $469.53 – $2,992.08 |
| CHI Saint Joseph Health - Saint Joseph East | Lexington | $1,320.31 | $803.35 – $2,991.17 |
| CHI Saint Joseph Health - Flaget Memorial Hospital | Bardstown | $1,675.91 | $696.78 – $3,594.50 |
| Adventhealth Manchester | Manchester | $8,891.66 | $2,962.64 – $2,962.64 |