CMS Price Transparency Data

Digestive disorders treatment (inpatient stay)

Facility: Pikeville Medical Center

Billing Code: 392 (MS-DRG)

The BaseRate · fair price high confidence

A fair price for this

$7,121

about 1.3× the $5,676 Medicare rate · typically $4,239–$7,140

modeled estimate · not a bill or quote

What this hospital charges insurers

$6,543

About the fair price

about $578 under the fair price · 1.2× Medicare

Medicare pays $5,676 Fair price $7,121 This hospital $6,543

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 $5,231 Priciest $6,543

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

A fair price for a Digestive disorders treatment (inpatient stay) is about $7,121 (about 1.3× the $5,676 Medicare rate). Pikeville Medical Center charges insurers about $6,543 — about the fair price. Located in Pikeville, KY.

What each insurance company pays

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

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

✓ UnitedHealthcare✓ Blue Cross Blue Shield✓ Aetna✓ Humana CignaKaiser 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	$5,448	96%
Blue Cross Blue Shieldmajor	$5,341 - $12,539	94%
Aetnamajor	$5,341	94%
Humanamajor	$5,341	94%
CareSource	$7,744	136%
Sentara	$5,341	94%
WellCare	$5,341 - $7,477	94%
+ 3 smaller / regional plans	$5,341 - $10,682

Self-Pay How to get the cash price

Tell the billing desk you want to be billed as self-pay — not through insurance — before your visit.
Ask for the cash / prompt-pay discount in writing, with the exact price, before you agree to anything.
Get it in writing that they won’t also bill your insurance, so the cash price is what you owe.
Check the MS-DRG code on your bill matches exactly: 392.

Insurance Before you use insurance

Call your insurance company to confirm Pikeville Medical Center is in-network.
Ask your insurer whether prior approval is required for MS-DRG code 392.
Confirm the doctor or provider is in-network too — not just the hospital building.
Check your Explanation of Benefits against the hospital’s final itemized bill.

Estimate your out-of-pocket cost

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

How you’d pay

Deductible left to meet ($)

Your coinsurance (%)

Enter your details and press estimate to compare.

Other Procedures at Pikeville Medical Center

Compare: Digestive disorders treatment (inpatient stay) at other KY hospitals

Murray-Calloway County Hospital · Murray $5,231
Taylor Regional Hospital · Campbellsville $5,392
Georgetown Community Hospital · Georgetown $5,432
Tj Health Columbia · Columbia $5,444
Bourbon Community Hospital · Paris $5,499
Clark Regional Medical Center · Winchester $5,582
Fleming County Hospital · Flemingsburg $5,733
Jackson Purchase Medical Center · Mayfield $5,763

Insurance negotiated median for the same procedure, sorted lowest first.