Vaccine pneumococcal conjugate 13 valent (pcv13) im at CHI Saint Joseph Health - Saint Joseph Mount Sterling

225 FALCON DR, Mt. Sterling, KY · CommonSpirit Health · · NPI 1679679146

Source: hospital's published price file ↗ · Published Feb 28, 2026 · Ingested Sep 10, 2026

$294.58

Cash price

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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.

$803.80

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$158.11 with Aetna vs $773.97 with United — 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 →

Payer
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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
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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 Medicaid|Better Health $158.11 ↓ -46%
Wellcare Medicaid|All Plans $168.24 ↓ -43%
Humana Medicaid|All Plans $175.64 ↓ -40%
United Medicaid|All Plans $179.17 ↓ -39%
Passport by Molina Medicaid|All Plans $179.17 ↓ -39%
BCBS - Anthem Medicaid|All Plans $184.48 ↓ -37%
BCBS - Anthem Medicare|All Plans $184.88 ↓ -37%
Wellcare Medicare|All Plans $184.88 ↓ -37%
Humana Medicare|All Plans $184.88 ↓ -37%
United Medicare|All Plans $188.58 ↓ -36%
Aetna Medicare|All Plans $190.43 ↓ -35%
Passport by Molina Medicare|All Plans $194.12 ↓ -34%
BCBS - Anthem Commercial|Pathway $290.24 ↓ -1%
BCBS - Anthem Commercial|HMO PPO $290.24 ↓ -1%
CareSource Commercial|All Plans $369.75 ↑ +26%
Humana Commercial|All Plans $393.87 ↑ +34%
Aetna Commercial|PPO $538.55 ↑ +83%
Aetna Commercial|HMO $538.55 ↑ +83%
Aetna Commercial|All Other Plans $538.55 ↑ +83%
Multiplan Commercial|All Plans $731.46 ↑ +148%
United Commercial|Non-Options $773.97 ↑ +163%
United Commercial|Options $773.97 ↑ +163%

Visitor-reported prices

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Vaccine pneumococcal conjugate 13 valent (pcv13) im at other Kentucky hospitals

Hospital City Cash price Negotiated range
CHI Saint Joseph Health - Saint Joseph Berea Berea $387.48 $221.77 – $731.46
CHI Saint Joseph Health - Saint Joseph London London $286.83 $114.79 – $731.46
CHI Saint Joseph Health - Saint Joseph East Lexington $322.87 $164.94 – $731.46
CHI Saint Joseph Health - Saint Joseph Hospital Lexington $404.81 $128.61 – $731.46
CHI Saint Joseph Health - Flaget Memorial Hospital Bardstown $341.04 $141.80 – $731.46

All Kentucky hospitals for this procedure →