How many shoppable procedure prices are published for Clark Regional Medical Center?

Clark Regional Medical Center in Winchester, KY currently has 110 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Clark Regional Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Clark Regional Medical Center's median negotiated commercial rate is 1.3× the regionally adjusted fair BaseRate benchmark.

What is Clark Regional Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Clark Regional Medical Center an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Proprietary 59 Beds · urban Updated: 4/16/2026

Clark Regional Medical Center

175 Hospital Drive, Winchester, KY 40391 · 110 Priced Procedures · 70% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Above Fair Market · Negotiate

1.29×vs. Fair Market Price

Typical commercial prices here are +29% above the fair benchmark (1.29×) even after accounting for local nurse/doctor wages and patient complexity.

75/100 · Corroborated

75/100Self-Pay Cash Beats Insurance 10% of the Time

File Completeness61

Price Logic98

Peer Alignment53

Clean Billing56

Real Cash Discount100

Regional Value Leader

3-Star CMS clinical quality rating paired with 1.29× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +151% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Clark Regional Medical Center prices routine shoppable procedures at 2.9× Medicare (median 0.95× Fair BaseRate) while upper-quartile commercial rates jump +151% to 2.38× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#46 of 68 in KY · 66th State Percentile#2,222 of 3,385 in U.S. · 65th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.87× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 10% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (64/100 safety score) with 70% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 1.5× markup over Medicare rates
Commercial insurance median sits at 0.95× Fair BaseRate (2.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.38×) jump +151% above the median procedure ratio (Q50 0.95×)
Consolidated metro market (HHI 2,973) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.9× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER0.31× Divergence

0.9× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+151% Upper Tail

Q25 0.87× · Q50 0.95× · Q75 2.38×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

2.9× MedicareFair

Outpatient Surgery & ORBack-Door Captive

1.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

4.1× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

4.2× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

5.4× MedicareWatchout

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.4× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

10% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 64/100Elevated

Procedure Prices at Clark Regional Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 110 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	$52,209	$22,075	$30,775	0.7×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$37,521	$14,036	$19,087	0.7×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$48,458	$13,488	$19,432	0.7×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$68,935	$12,942	$17,936	0.7×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$10,308	$11,355	$6,109	1.9×
Inguinal hernia repair CPT Code: `49505`	$12,242	$9,057	$3,629	2.5×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$7,614	$7,449	$3,372	2.2×
Cataract surgery with lens implant CPT Code: `66984`	$4,459	$7,081	$2,540	2.8×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$14,619	$5,582	$8,223	0.7×
Total hip replacement CPT Code: `27130`	$16,861	$4,847	$13,413	0.4×
Total knee replacement CPT Code: `27447`	$25,370	$4,847	$13,523	0.4×
Upper endoscopy with biopsy CPT Code: `43239`	$3,599	$4,378	$987	4.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$4,267	$4,267	$1,021	4.2×
Colonoscopy (diagnostic) CPT Code: `45378`	$3,539	$3,900	$981	4.0×
Colonoscopy with biopsy CPT Code: `45380`	$3,539	$3,900	$1,256	3.1×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$3,380	$3,380	$583	5.8×
Breast lump removal CPT Code: `19120`	$7,492	$2,848	$3,875	0.7×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,016	$1,016	$134	7.6×
Blood transfusion CPT Code: `36430`	$1,019	$1,019	$498	unverified
Ultrasound, leg veins (duplex) CPT Code: `93970`	$977	$977	$272	3.6×
Ultrasound, abdomen (limited) CPT Code: `76705`	$886	$886	$126	7.0×
Ultrasound, pelvis CPT Code: `76856`	$811	$811	$130	6.2×
Ultrasound, thyroid and neck CPT Code: `76536`	$785	$785	$132	5.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,666	$804	$511	1.6×
MRI, brain (no contrast) CPT Code: `70551`	$2,000	$804	$343	unverified
MRI, lower back (no contrast) CPT Code: `72148`	$2,090	$804	$338	unverified
MRI, knee or other leg joint CPT Code: `73721`	$2,038	$804	$369	unverified
X-ray, lower back CPT Code: `72110`	$697	$697	$112	6.2×
CT scan, head (with contrast) CPT Code: `70460`	$2,054	$481	$242	2.0×
CT scan, head (with and without contrast) CPT Code: `70470`	$2,452	$481	$258	1.9×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$3,860	$481	$303	1.6×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$4,108	$481	$448	1.1×
CT scan, head (no contrast) CPT Code: `70450`	$1,725	$481	$160	unverified
CT scan, sinuses CPT Code: `70486`	$1,725	$481	$166	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$1,901	$481	$167	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$1,651	$481	$169	unverified
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,173	$481	$168	unverified
CT scan, pelvis CPT Code: `72192`	$1,987	$481	$163	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$442	$442	$86	5.1×
X-ray, shoulder CPT Code: `73030`	$415	$415	$92	4.5×
X-ray, chest (two views) CPT Code: `71046`	$399	$399	$93	4.3×
Rabies immune globulin HCPCS Code: `90375`	$190	$419	$322	1.3×
X-ray, foot CPT Code: `73630`	$381	$381	$92	4.1×
X-ray, ankle CPT Code: `73610`	$381	$381	$93	4.1×
X-ray, hand CPT Code: `73130`	$352	$352	$93	3.8×
X-ray, hip CPT Code: `73502`	$352	$352	$93	3.8×
X-ray, pelvis CPT Code: `72170`	$375	$375	$110	3.4×
Office visit, established patient (30-39 min) CPT Code: `99214`	$361	$361	$123	2.9×
X-ray, neck (cervical spine) CPT Code: `72040`	$335	$335	$93	3.6×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$355	$355	$148	2.4×
X-ray, chest (single view) CPT Code: `71045`	$320	$320	$92	3.5×
Screening mammogram (both breasts) CPT Code: `77067`	$327	$327	$123	2.7×
Office visit, established patient (20-29 min) CPT Code: `99213`	$282	$282	$87	3.2×
New patient office visit (30-44 min) CPT Code: `99203`	$297	$297	$110	2.7×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$266	$266	$64	4.2×
Speech therapy (language evaluation) CPT Code: `92507`	$250	$250	$86	2.9×
Injection procedure for pain management HCPCS Code: `G0260`	$258	$258	$855	0.3×
Hepatitis B immune globulin HCPCS Code: `90371`	$548	$173	$151	1.1×
Breathing treatment (nebulizer) CPT Code: `94640`	$151	$151	$201	0.8×
Speech therapy (group session) CPT Code: `92508`	$94	$94	$27	3.5×
Physical therapy (manual therapy) CPT Code: `97140`	$78	$115	$34	3.4×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$99	$115	$35	3.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$126	$115	$38	3.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$59	$115	$38	3.0×
Prosthetic fitting and training CPT Code: `97761`	$64	$115	$45	2.6×
Orthotic fitting and training CPT Code: `97760`	$134	$115	$51	2.3×
Physical therapy (gait training) CPT Code: `97116`	$84	$115	$33	unverified
Occupational therapy (therapeutic activities) CPT Code: `97530`	$115	$115	$40	unverified
Occupational therapy (self-care training) CPT Code: `97535`	$111	$115	$38	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$1,015	$1,015	$49	20.7×
Typhoid vaccine HCPCS Code: `90675`	$1,346	$498	$347	1.4×
Drug screening test HCPCS Code: `G0480`	$283	$283	$116	2.4×
Pneumococcal vaccine HCPCS Code: `90732`	$291	$150	$140	1.1×
Colorectal cancer screening HCPCS Code: `G0010`	$107	$107	$49	2.2×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$187	$111	$111	1.0×
Electrical stimulation therapy HCPCS Code: `G0283`	$60	$60	$14	4.3×
Flu vaccine injection HCPCS Code: `G0008`	$67	$67	$48	1.4×
Diagnostic procedure preparation HCPCS Code: `G0279`	$44	$44	$35	1.3×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$112	$57	$56	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$94	$4	$4	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$40	$4	$4	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$122	$6	$6	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$123	$13	$14	0.9×
Flu vaccine (high dose) HCPCS Code: `90656`	$84	$23	$25	0.9×
Culture, blood CPT Code: `87040`	$108	$10	$11	0.9×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$110	$9	$10	0.9×
Blood test, PSA (prostate screen) CPT Code: `84153`	$178	$17	$19	0.9×
Hepatitis B vaccine HCPCS Code: `90744`	$54	$33	$37	0.9×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$104	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$50	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$26	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$129	$16	$18	0.9×
Culture, bacterial CPT Code: `87070`	$83	$8	$9	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$93	$14	$16	0.9×
Blood test, complete blood count (CBC) CPT Code: `85025`	$80	$7	$8	0.9×
Hepatitis C antibody test CPT Code: `86803`	$140	$13	$15	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$158	$12	$14	0.9×
Blood test, amylase CPT Code: `82150`	$108	$6	$7	0.9×
Blood test, lipase CPT Code: `83690`	$99	$6	$7	0.9×
Blood test, magnesium CPT Code: `83735`	$33	$6	$7	0.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$178	$17	$20	0.8×
Blood test, vitamin D CPT Code: `82306`	$132	$26	$31	0.8×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$200	$9	$11	0.8×
Blood test, potassium CPT Code: `84132`	$58	$4	$5	0.8×
Blood test, sodium CPT Code: `84295`	$62	$4	$5	0.8×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$18	$4	$5	0.8×
Blood test, basic metabolic panel CPT Code: `80048`	$142	$7	$9	0.8×
Blood test, liver function panel CPT Code: `80076`	$113	$7	$9	0.8×
Blood test, hemoglobin CPT Code: `85018`	$55	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	$97	$7	$46	0.2×

Showing top 25 high-impact procedures of 110 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Clark Regional Medical Center (Zero PHI Required)

CMS CCN: 180092

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $52,209

Insurer Median $22,075

1. Amount on Your Bill or Quote ($) Pre-filled with Clark Regional Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Save $78,314 Paying Cash

Self-Pay Cash Rate ($52,209) Beats Your Bill

Clark Regional Medical Center's published 45 CFR § 180 self-pay cash rate is $52,209 (vs. $22,075 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$99,748 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($130,523) is $99,748 above the denoised Fair BaseRate ($30,775) and 5.6× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Clark Regional Medical Center as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite64/100

Would Recommend70%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait177 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionsame

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Clark Regional Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-04-10·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (554 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Value & Quality Leader Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Clark Regional Medical Center.

Price Index: 0.84× regional baseline

Quality: 57/100 CMS composite

Median Household Income$67,824U.S. Census ACS

Local Uninsured Share3.8%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 75/100 · Corroborated CMS CCN 180092

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 180092) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage4/16/2026

Validated Rate Rows382 (CMS v3.0.0)

File Integrity DigestVerified · CCN 180092

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.

Submit MRF Update Correction Policy