How many shoppable procedure prices are published for Saint Joseph East?

Saint Joseph East in Lexington, KY currently has 116 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Saint Joseph East's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Saint Joseph East's median negotiated commercial rate is 1.7× the regionally adjusted fair BaseRate benchmark.

What is Saint Joseph East's CMS Care Compare overall star rating?

CMS Care Compare assigns Saint Joseph East an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 138 Beds · urban Updated: 2026-02-28

Saint Joseph East

150 North Eagle Creek Drive, Lexington, KY 40509 · 116 Priced Procedures · 65% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

High Markup · Shop Alternatives

1.66×vs. Fair Market Price

Typical commercial prices here are +66% above the fair benchmark (1.66×) even after accounting for local nurse/doctor wages and patient complexity.

82/100 · Corroborated

82/100Self-Pay Cash Beats Insurance 79% of the Time

File Completeness66

Price Logic89

Peer Alignment76

Clean Billing80

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.66× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +62% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Saint Joseph East prices routine shoppable procedures at 2.4× Medicare (median 1.33× Fair BaseRate) while upper-quartile commercial rates jump +62% to 2.16× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#55 of 68 in KY · 79th State Percentile#2,839 of 3,385 in U.S. · 83rd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.98× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 79% of shoppable procedures (99/100 Cash Honesty)
2-Star CMS clinical rating with 65% patient recommendation (64/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (26.0% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (1.66× 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.
Commercial insurance median sits at 1.33× Fair BaseRate (2.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.16×) jump +62% above the median procedure ratio (Q50 1.33×)
Consolidated metro market (HHI 2,973) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.4× Medicare

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

Back-Door Captive & ER0.46× Divergence

1.1× Medicare

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

Quantile Tail Spread+62% Upper Tail

Q25 0.98× · Q50 1.33× · Q75 2.16×

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

2.4× MedicareFair

Outpatient Surgery & ORBack-Door Captive

0.9× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.0× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

3.5× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

4.1× MedicareElevated

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

1.4× MedicareGood

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

79% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 64/100Elevated

Procedure Prices at Saint Joseph East

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 116 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`	—	$23,844	$30,775	0.8×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$15,607	$19,087	0.8×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$15,231	$19,432	0.8×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$14,486	$17,936	0.8×
Total hip replacement CPT Code: `27130`	—	$12,831	$13,413	1.0×
Total knee replacement CPT Code: `27447`	—	$12,831	$13,523	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$6,945	$8,223	0.8×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,732	$6,109	0.9×
Breast lump removal CPT Code: `19120`	—	$3,866	$3,875	1.0×
Inguinal hernia repair CPT Code: `49505`	—	$3,589	$3,629	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,299	$3,372	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,299	$3,446	1.0×
Vaginal delivery (full package) CPT Code: `59400`	—	$3,078	$2,680	1.1×
C-section delivery (full package) CPT Code: `59510`	—	$3,078	$2,975	1.0×
Rabies immune globulin HCPCS Code: `90375`	$3,028	$3,028	$322	9.4×
Cataract surgery with lens implant CPT Code: `66984`	—	$2,342	$2,540	0.9×
Colonoscopy with biopsy CPT Code: `45380`	$1,434	$1,785	$1,256	1.4×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,625	$1,758	$1,021	1.7×
Upper endoscopy with biopsy CPT Code: `43239`	$1,205	$1,500	$987	1.5×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,877	$1,258	$583	2.2×
MRI, brain (no contrast) CPT Code: `70551`	$1,400	$1,147	$343	3.3×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$1,607	$1,030	$448	2.3×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,428	$915	$511	1.8×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$936	$981	1.0×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,430	$916	$303	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$1,367	$876	$169	5.2×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,324	$849	$168	unverified
Injection procedure for pain management HCPCS Code: `G0260`	$570	$714	$855	0.8×
CT scan, head (with and without contrast) CPT Code: `70470`	$991	$635	$258	2.5×
MRI, lower back (no contrast) CPT Code: `72148`	$829	$590	$338	1.7×
MRI, knee or other leg joint CPT Code: `73721`	$955	$612	$369	1.7×
CT scan, sinuses CPT Code: `70486`	$819	$525	$166	3.2×
CT scan, chest (no contrast) CPT Code: `71250`	$796	$510	$167	3.1×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$754	$493	$272	1.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$760	$492	$134	unverified
CT scan, head (no contrast) CPT Code: `70450`	$718	$460	$160	2.9×
CT scan, pelvis CPT Code: `72192`	$709	$455	$163	2.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$737	$477	$126	unverified
Ultrasound, pelvis CPT Code: `76856`	$659	$427	$130	3.3×
CT scan, head (with contrast) CPT Code: `70460`	$675	$432	$242	1.8×
Blood transfusion CPT Code: `36430`	$592	$451	$498	0.9×
X-ray, shoulder CPT Code: `73030`	$298	$425	$92	unverified
Psychological testing by technician CPT Code: `96138`	$237	$381	$395	1.0×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$220	$345	$148	2.3×
Ultrasound, thyroid and neck CPT Code: `76536`	$486	$315	$132	2.4×
Hepatitis B immune globulin HCPCS Code: `90371`	$238	$335	$151	2.2×
Neurobehavioral status check CPT Code: `96116`	$369	$320	$231	1.4×
Speech therapy (language evaluation) CPT Code: `92507`	$153	$231	$86	2.7×
New patient office visit (30-44 min) CPT Code: `99203`	$161	$253	$110	2.3×
Office visit, established patient (20-29 min) CPT Code: `99213`	$136	$214	$87	2.5×
X-ray, lower back CPT Code: `72110`	$367	$238	$112	2.1×
Screening mammogram (both breasts) CPT Code: `77067`	$139	$218	$123	1.8×
X-ray, neck (cervical spine) CPT Code: `72040`	$297	$192	$93	2.1×
X-ray, ankle CPT Code: `73610`	$271	$175	$93	1.9×
X-ray, foot CPT Code: `73630`	$264	$173	$92	1.9×
X-ray, hand CPT Code: `73130`	$260	$172	$93	1.8×
X-ray, chest (two views) CPT Code: `71046`	$254	$168	$93	1.8×
Office visit, established patient (30-39 min) CPT Code: `99214`	$114	$179	$123	1.5×
Psychiatric evaluation (first visit) CPT Code: `90791`	$301	$202	$185	1.1×
Psychological testing evaluation CPT Code: `96136`	$239	$160	$128	1.3×
Psychotherapy session (45 minutes) CPT Code: `90834`	$249	$165	$166	1.0×
Psychotherapy session (60 minutes) CPT Code: `90837`	$249	$165	$181	0.9×
Physical therapy (gait training) CPT Code: `97116`	$76	$118	$33	3.6×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$86	$107	$35	3.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$186	$121	$64	1.9×
X-ray, hip CPT Code: `73502`	$196	$130	$93	1.4×
X-ray, chest (single view) CPT Code: `71045`	$185	$122	$92	1.3×
X-ray, pelvis CPT Code: `72170`	$194	$128	$110	1.2×
Speech therapy (group session) CPT Code: `92508`	$143	$143	$27	unverified
Physical therapy (manual therapy) CPT Code: `97140`	$94	$107	$34	3.1×
Occupational therapy (self-care training) CPT Code: `97535`	$76	$119	$38	3.1×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$73	$109	$38	2.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$65	$101	$38	2.7×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$69	$103	$40	2.6×
Breathing treatment (nebulizer) CPT Code: `94640`	$56	$89	$201	0.4×
Orthotic fitting and training CPT Code: `97760`	$113	$113	$51	unverified
Electrical stimulation therapy HCPCS Code: `G0283`	$123	$123	$14	unverified
Typhoid vaccine HCPCS Code: `90675`	$475	$508	$347	1.5×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$143	$149	$111	1.3×
Drug screening test HCPCS Code: `G0480`	$104	$114	$116	1.0×
Culture, bacterial CPT Code: `87070`	$68	$68	$9	7.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$78	$88	$56	1.6×
Pneumococcal vaccine HCPCS Code: `90732`	$105	$97	$140	0.7×
Diagnostic procedure preparation HCPCS Code: `G0279`	$33	$51	$35	1.5×
Prosthetic fitting and training CPT Code: `97761`	$41	$63	$45	1.4×
Blood antibody screen CPT Code: `86850`	$80	$52	$46	1.1×
Flu vaccine injection HCPCS Code: `G0008`	$34	$47	$48	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$53	$72	$203	0.4×
Blood test, glucose (blood sugar) CPT Code: `82947`	$11	$8	$4	2.0×
Blood test, amylase CPT Code: `82150`	$46	$13	$7	1.9×
Blood test, basic metabolic panel CPT Code: `80048`	$90	$9	$9	1.0×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$172	$11	$11	1.0×
Blood test, liver function panel CPT Code: `80076`	$100	$9	$9	1.0×
Blood test, vitamin D CPT Code: `82306`	$32	$31	$31	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$48	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$37	$5	$5	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$67	$16	$16	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$80	$14	$14	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$88	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$63	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$49	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$20	$5	$5	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$102	$19	$19	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$17	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$71	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$65	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$64	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$69	$11	$11	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$70	$20	$20	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$68	$17	$18	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$52	$13	$14	0.9×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$48	$4	$5	0.8×
Hepatitis B vaccine HCPCS Code: `90744`	$45	$29	$37	0.8×
Blood test, hemoglobin CPT Code: `85018`	$27	$2	$3	0.7×
Blood test, creatinine (kidney) CPT Code: `82565`	$19	$19	$5	unverified
Blood test, sodium CPT Code: `84295`	$18	$18	$5	unverified

Showing top 25 high-impact procedures of 116 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 26.0%

Audit a Bill or Quote at Saint Joseph East (Zero PHI Required)

CMS CCN: 180143

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $23,844

1. Amount on Your Bill or Quote ($) Pre-filled with Saint Joseph East’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 501(r) AGB Cap: $14,879 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $14,879

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (26.0% of gross = $14,879).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Saint Joseph East's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$26,451 Above Fair BaseRate

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

Your bill ($57,226) is $26,451 above the denoised Fair BaseRate ($30,775) and 2.4× 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) 501(c)(3) Nonprofit Hospital

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

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (26.0% 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.

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 Recommend65%

Rated 9 or 10 (HCAHPS)65%

Median ER Wait136 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate4.9%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

C. diff Hospital-Onset Infectionbetter

Source: CMS Hospital Care Compare (328 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

Higher-Quality, Above-Median Price Tier

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Saint Joseph East.

Price Index: 1.98× regional baseline

Quality: 57/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Blue Cross Blue Shield

-49.8%

Median Household Income$67,631U.S. Census ACS

Local Uninsured Share6.8%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 82/100 · Corroborated CMS CCN 180143

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 180143) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-02-28

Validated Rate Rows2,729 (CMS v3.0.0)

File Integrity DigestVerified · CCN 180143

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