CMS Price Transparency Data

Office visit, established patient (30-39 min)

Facility: Saint Joseph Hospital

Billing Code: 99214 (CPT)

The BaseRate · fair price medium confidence
A fair price for this
$193
about 1.4× the $136 Medicare rate · typically $103–$344
modeled estimate · not a bill or quote
What this hospital charges insurers
$350
Well above the fair price
about $157 over the fair price · 2.6× Medicare
Medicare pays $136 Fair price $193 This hospital $350 Cash price $266 Hospital's list price $565

How we calculate the fair BaseRate →

How this hospital compares to other KY hospitals

Highest price of the 9 KY hospitals we have prices for — worth calling around.

Cheapest $66 Priciest $350

Black dot = this hospital, among the 9 KY hospitals with a price for this procedure. Full list below.

A fair price for a Office visit, established patient (30-39 min) is about $193 (about 1.4× the $136 Medicare rate). Saint Joseph Hospital charges insurers about $350, or about $266 in cash — well above the fair price. Located in Lexington, KY.

This price is above the fair BaseRate — you may be able to pay less

Ask the hospital for the cash / self-pay price, check whether you qualify for financial assistance, or negotiate the bill down toward the fair price of about $193. Many patients pay well below the first number they’re quoted — the checklists below walk you through it.

What each insurance company pays

Which insurers have negotiated a price with this hospital for this procedure — and which haven’t.

5 of 6 major insurers have a published price at this hospital

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Cigna✓ Humana Kaiser Permanente

Crossed out = this hospital hasn’t published a negotiated price for that insurer for this procedure. It doesn’t necessarily mean they aren’t accepted — ask your insurer.

Insurance company Price range vs. Medicare
UnitedHealthcaremajor $156 - $412 115%
Blue Cross Blue Shieldmajor $160 - $299 118%
Aetnamajor $153 - $356 113%
Cignamajor $356 263%
Humanamajor $150 111%
Molina $133 98%
WellCare $157 116%
Excludes 1 rental-network / third-party entry (e.g. Multiplan, PHCS) — these are pricing networks, not insurers.

Self-Pay How to get the cash price

Insurance Before you use insurance

Estimate your out-of-pocket cost

A rough estimate of what you’d pay with insurance (deductible + coinsurance) versus paying the cash price yourself.

Enter your details and press estimate to compare.

Facility Profile & Credentials

  • Address: One Saint Joseph Drive, Lexington, KY 40504
  • CMS Rating: ★★★☆☆
  • Ownership Type: Voluntary non-profit - Church
  • Hospital Type: Acute Care Hospitals