Arh Our Lady of the Way
11203 Main Street, Martin, KY 41649 · 85 Priced Procedures · 78% Patient Recommendation
Typical commercial prices here are +29% above the fair benchmark (1.29×) even after accounting for local nurse/doctor wages and patient complexity.
Balances commercial hospital prices against CMS clinical safety, infection control, and patient experience.
Wide Procedure Spread · Upper-Quartile Skew Pricer
Arh Our Lady of the Way prices routine shoppable procedures at 2.7× Medicare (median 1.05× Fair BaseRate) while upper-quartile commercial rates jump +70% to 1.79× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 0.96× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 65% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (72/100 safety score) with 78% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (24.0% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 3.4× markup over Medicare rates
- Commercial insurance median sits at 1.05× Fair BaseRate (2.7× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.79×) jump +70% above the median procedure ratio (Q50 1.05×)
- Consolidated metro market (HHI 4,664) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Arh Our Lady of the Way
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 85 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $26,571 | 1.4× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,477 | 2.4× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,377 | 4.1× |
| Trauma team activation HCPCS Code: G0390 | $1,588 | 1.1× |
| Ultrasound, pelvis CPT Code: 76856 | $919 | 7.1× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $928 | 6.9× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $859 | 3.2× |
| MRI, lower back (no contrast) CPT Code: 72148 | $760 | 2.2× |
| MRI, brain (no contrast) CPT Code: 70551 | $760 | 2.2× |
| MRI, knee or other leg joint CPT Code: 73721 | $760 | 2.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $760 | 1.5× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $724 | 5.5× |
| Blood transfusion CPT Code: 36430 | $603 | 1.2× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $575 | 4.6× |
| CT scan, pelvis CPT Code: 72192 | $542 | 3.3× |
| CT scan, chest (no contrast) CPT Code: 71250 | $542 | 3.2× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $542 | 3.2× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $542 | 3.2× |
| CT scan, head (with contrast) CPT Code: 70460 | $542 | 2.2× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $542 | 2.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $542 | 1.8× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $542 | 1.2× |
| CT scan, head (no contrast) CPT Code: 70450 | $542 | unverified |
| CT scan, sinuses CPT Code: 70486 | $542 | unverified |
| X-ray, ankle CPT Code: 73610 | $476 | 5.1× |
Audit a Bill or Quote at Arh Our Lady of the Way (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $15,305
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (24.0% of gross = $15,305).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Arh Our Lady of the Way's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($63,770) is $44,683 above the denoised Fair BaseRate ($19,087) and 4.5× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (24.0% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)Source: CMS Hospital Care Compare (74 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Arh Our Lady of the Way.
Notable Payer Contract Outliers (SVD Matrix Anomalies)
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.