Wayne County Hospital
166 Hospital Street, Monticello, KY 42633 · 93 Priced Procedures
Typical commercial prices here are +119% above the fair benchmark (2.19×) 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
Wayne County Hospital prices routine shoppable procedures at 2.9× Medicare (median 2.00× Fair BaseRate) while upper-quartile commercial rates jump +51% to 3.03× 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 1.17× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 86% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (54/100 safety score) with 72% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (67.5% 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 2.00× Fair BaseRate (2.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 3.03×) jump +51% above the median procedure ratio (Q50 2.00×)
- Unnegotiated chargemaster list prices average 5.3× Medicare (31¢ 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 Wayne County Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 93 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| MRI, brain (with and without contrast) CPT Code: 70553 | $2,982 | unverified |
| MRI, brain (no contrast) CPT Code: 70551 | $1,758 | unverified |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,758 | unverified |
| MRI, knee or other leg joint CPT Code: 73721 | $1,758 | unverified |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $1,342 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $1,060 | 2.4× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $999 | unverified |
| CT scan, sinuses CPT Code: 70486 | $898 | unverified |
| Blood transfusion CPT Code: 36430 | $847 | 1.7× |
| CT scan, pelvis CPT Code: 72192 | $660 | 4.0× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $670 | 4.0× |
| CT scan, head (no contrast) CPT Code: 70450 | $613 | 3.8× |
| CT scan, chest (no contrast) CPT Code: 71250 | $636 | 3.8× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $613 | 3.6× |
| CT scan, head (with contrast) CPT Code: 70460 | $624 | 2.6× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $579 | 1.0× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $440 | 1.6× |
| Diagnostic mammogram (both breasts) CPT Code: 77066 | $449 | unverified |
| Psychiatric evaluation (first visit) CPT Code: 90791 | $375 | unverified |
| Screening mammogram (both breasts) CPT Code: 77067 | $321 | unverified |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $284 | 2.3× |
| Ultrasound, pelvis CPT Code: 76856 | $267 | 2.1× |
| Psychotherapy session (60 minutes) CPT Code: 90837 | $274 | 1.5× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $232 | 1.7× |
| Ultrasound, thyroid and neck CPT Code: 76536 | $208 | 1.6× |
Audit a Bill or Quote at Wayne County Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $2,012
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (67.5% of gross = $2,012).
Self-Pay Cash Rate ($1,939) Beats Your Bill
Wayne County Hospital's published 45 CFR § 180 self-pay cash rate is $1,939 (vs. $2,982 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $511 Fair BaseRate ($356 Medicare)
Your bill ($2,982) is $2,471 above the denoised Fair BaseRate ($511) and 8.4× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (67.5% 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
CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Wayne County Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2025-11-14·administrative_or_closure
Closure Notice
Recorded - 2025-09-02·cap_corrective_action
CAP Request
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 Wayne 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.