Rockcastle County Hospital, Inc.
145 Newcomb Avenue, Mount Vernon, KY 40456 · 113 Priced Procedures · 85% Patient Recommendation
Typical commercial prices here are 10% below the fair benchmark (0.90×) after accounting for local nurse/doctor wages and patient complexity.
2-Star CMS clinical quality rating paired with 0.90× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Rockcastle County Hospital, Inc. maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.88× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.97× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 10% below peer Fair BaseRate (0.90×)
- Self-pay cash beats commercial insurance on 44% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 85% patient recommendation (72/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (47.8% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
- Commercial insurance median sits at 0.88× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (0.90× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Consolidated metro market (HHI 4,815) 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 Rockcastle County Hospital, Inc.
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 113 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $13,311 | 0.7× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $13,217 | 0.7× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $5,342 | 0.6× |
| Inguinal hernia repair CPT Code: 49505 | $934 | 0.3× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $934 | 0.2× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $774 | unverified |
| Colonoscopy (diagnostic) CPT Code: 45378 | $611 | 0.6× |
| Colonoscopy with biopsy CPT Code: 45380 | $621 | 0.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $580 | 0.6× |
| Breast lump removal CPT Code: 19120 | $581 | 0.1× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $513 | 0.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $400 | 1.2× |
| Blood transfusion CPT Code: 36430 | $414 | 0.8× |
| Injection procedure for pain management HCPCS Code: G0260 | $412 | 0.5× |
| MRI, brain (no contrast) CPT Code: 70551 | $366 | 1.1× |
| MRI, knee or other leg joint CPT Code: 73721 | $345 | 0.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $327 | 0.7× |
| Rabies immune globulin HCPCS Code: 90375 | $275 | 0.9× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $246 | 1.0× |
| CT scan, pelvis CPT Code: 72192 | $206 | 1.3× |
| CT scan, chest (no contrast) CPT Code: 71250 | $209 | 1.3× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $209 | 1.2× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $209 | 1.2× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $224 | 0.8× |
| CT scan, sinuses CPT Code: 70486 | $177 | 1.1× |
Audit a Bill or Quote at Rockcastle County Hospital, Inc. (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $18,855
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (47.8% of gross = $18,855).
Self-Pay Cash Rate ($30,004) Beats Your Bill
Rockcastle County Hospital, Inc.'s published 45 CFR § 180 self-pay cash rate is $30,004 (vs. $13,311 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $19,087 Fair BaseRate ($14,117 Medicare)
Your bill ($39,479) is $20,392 above the denoised Fair BaseRate ($19,087) and 2.8× the $14,117 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (47.8% 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 (83 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 Rockcastle County Hospital, Inc..
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.