Fleming County Hospital
55 Foundation Drive, Flemingsburg, KY 41041 · 52 Priced Procedures
Typical commercial prices here are +9% above the fair benchmark (1.09×) 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
Fleming County Hospital prices routine shoppable procedures at 3.1× Medicare (median 0.84× Fair BaseRate) while upper-quartile commercial rates jump +88% to 1.58× 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 0.79× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 3.9× markup over Medicare rates
- Commercial insurance median sits at 0.84× Fair BaseRate (3.1× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 1.58×) jump +88% above the median procedure ratio (Q50 0.84×)
- Unnegotiated chargemaster list prices average 3.8× Medicare (26¢ true HCRIS cost per $1 gross)
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 Fleming County Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 52 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $14,416 | 0.8× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $5,733 | 0.7× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $808 | 1.6× |
| MRI, brain (no contrast) CPT Code: 70551 | $808 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $808 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $808 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $484 | 1.6× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $484 | 1.1× |
| CT scan, head (no contrast) CPT Code: 70450 | $484 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $484 | unverified |
| CT scan, head (with and without contrast) CPT Code: 70470 | $484 | unverified |
| CT scan, sinuses CPT Code: 70486 | $484 | unverified |
| CT scan, chest (no contrast) CPT Code: 71250 | $484 | unverified |
| CT scan, neck (cervical spine) CPT Code: 72125 | $484 | unverified |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $484 | unverified |
| CT scan, pelvis CPT Code: 72192 | $484 | unverified |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $226 | 1.5× |
| Screening mammogram (both breasts) CPT Code: 77067 | $226 | unverified |
| Diagnostic procedure preparation HCPCS Code: G0279 | $226 | unverified |
| Typhoid vaccine HCPCS Code: 90675 | $498 | unverified |
| Pneumococcal vaccine HCPCS Code: 90732 | $150 | 1.1× |
| Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: 90715 | $57 | 1.0× |
| Urinalysis (automated, with microscopy) CPT Code: 81001 | $3 | 1.0× |
| Flu vaccine (high dose) HCPCS Code: 90656 | $23 | 0.9× |
| Blood test, complete blood count (CBC) CPT Code: 85025 | $7 | 0.9× |
Audit a Bill or Quote at Fleming County Hospital (Zero PHI Required)
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.
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Fleming County Hospital'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 ($34,598) is $15,511 above the denoised Fair BaseRate ($19,087) and 2.5× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Fleming County Hospital 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.
Clinical Quality, Patient Experience & Infection Benchmarks
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Fleming County Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-06-17·administrative_or_closure
Met Requirements
Recorded
Source: CMS Hospital Care Compare. 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 Fleming County Hospital.
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.