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Metro Price Directory

Lexington Fayette Area Hospital Prices

Cash and insurance-negotiated prices at hospitals in and around Lexington Fayette, KY. Part of all Kentucky hospital prices.

Pillar 1 · The BaseRate™ CompositeHow 1.00× Fair BaseRate Works: Raw price averages unfairly penalize hospitals in high-wage cities or trauma centers treating sicker patients. We adjust for local CMS hospital wage levels and patient complexity first. A 1.00× score means right at the fair price average, 0.85× means 15% cheaper than fair market, and 1.30× means 30% above fair market.Near Fair BaseRate Benchmark
1.04×vs. Fair Market Price
Position vs. 1.00× Fair Price+4% Above Fair Price 1.00× (center of the bar) is the U.S. fair price average after accounting for local hospital wages and patient complexity. Left of center (<1.00×) is below fair price; right of center (>1.00×) is above fair price.

Typical commercial prices here are +4% above the fair benchmark (1.04×) even after accounting for local nurse/doctor wages and patient complexity.

Pillar 2 · VeriRate™ Data TrustHow VeriRate™ (0–100) Works: Hospitals are legally required to publish machine-readable price files, but some bury fake $0.01 numbers or omit cash discounts. VeriRate audits each file across 5 checks (hover any badge below to see what it tests).86/100 · Verified
86/100Hover Any Check Below to See How Prices Were Audited
File Completeness90Provenance (File Completeness): Checks whether the hospital published a complete, up-to-date machine-readable price file with valid CPT and MS-DRG billing codes instead of leaving blanks.
Price Logic88Coherence (Price Logic): Checks whether the hospital’s numbers make basic sense — e.g., self-pay cash price is lower than gross list price, with no fake $0.01 or $999,999 placeholder numbers.
Peer Alignment86Concordance (Peer Alignment): Checks whether reported prices sit in a realistic range compared to Medicare and nearby hospitals rather than wild 100× unit errors.
Clean Billing83Regularity (Clean Billing): Checks whether rates are structured consistently across procedures without erratic statistical spikes or hidden unbundled facility fees.
Real Cash Discount84Cash Honesty (Real Cash Discount): Checks whether the hospital offers a genuine self-pay cash discount that beats or matches commercial insurance rates instead of billing full sticker price.
Pillar 3 · Kentucky Market & Best ValueSummarizes statewide hospital price coverage across Kentucky, the average commercial markup over federal Medicare rates, and the #1 best-value hospital in the state.9 Hospitals · 119 Procedures
Hospitals Priced9 in KYTotal hospitals in Kentucky with verified machine-readable price disclosures indexed in the Crystal.
Avg vs. Medicare1.4× MedicareAverage commercial insurance negotiated rate across Kentucky hospitals compared to what federal Medicare pays for the same procedure.
Best Value in KY1.04× FairLowest confounder-adjusted hospital in Kentucky: University of Kentucky Hospital (Lexington) at 1.04× fair market price.

Most affordable Kentucky hospital: University of Kentucky Hospital (Lexington) at 1.04× the fair price (1% below benchmark).

Behavioral Pricing FingerprintConsistent Department Multiples

Aligned Regional Benchmark Peer

University of Kentucky Hospital prices shoppable and inpatient services (1.4× to 1.0× Medicare, divergence 0.71×) in alignment with regional hospital peers (1.04× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.

#33 of 68 in KY · 47th State Percentile#1,460 of 3,385 in U.S. · 43rd National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Bottom-quartile procedures (Q25) price at 0.91× the peer BaseRate benchmark
  • Self-pay cash beats commercial insurance on 14% of shoppable procedures (99/100 Cash Honesty)
  • 4-Star CMS clinical rating with 76% patient recommendation (73/100 safety score)
  • Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Watchout

Where You Can Get Burned (Markup Traps)

  • Even at low-cost facilities (1.04× 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 0.97× Fair BaseRate (1.4× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Upper-quartile procedures (Q75 1.25×) jump +29% above the median procedure ratio (Q50 0.97×)
  • Consolidated metro market (HHI 2,973) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
1.4× Medicare

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

Back-Door Captive & ER0.71× Divergence
1.0× Medicare

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

Quantile Tail Spread+29% Upper Tail
Q25 0.91× · Q50 0.97× · Q75 1.25×

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
1.4× MedicareGood
Outpatient Surgery & ORBack-Door Captive
0.7× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
0.6× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
0.5× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
0.5× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
0.5× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
14% Cash Edge · 99/100Good
CMS Clinical Safety & Star ValueIntegrity & Outcomes
4 CMS · 73/100Fair

Hospitals in the Lexington Fayette area

Ranked by how their prices compare to the fair BaseRate — best value first. The × fair figure is geo-adjusted. Tap any hospital for its full price list.

Compare prices by procedure in Lexington Fayette

Local prices across Lexington Fayette-area hospitals for 119 procedures.

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

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

Inpatient MS-DRG vs. Outpatient CPT Care-Setting Savings

Laparoscopic Gallbladder RemovalDRG 419 vs CPT 47562
Inpatient: $17,157Outpatient: $7,917 Save $9,240 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Cesarean Section DeliveryDRG 788 vs CPT 59510
Inpatient: $11,017Outpatient: $3,078 Save $7,939 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Upper GI Endoscopy (EGD) with BiopsyDRG 392 vs CPT 43239
Inpatient: $9,272Outpatient: $2,939 Save $6,333 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Uncomplicated Vaginal DeliveryDRG 807 vs CPT 59400
Inpatient: $7,085Outpatient: $3,078 Save $4,006 outpatient

Clinical Scope Note:Inpatient MS-DRG reflects a multi-day hospital admission (room, nursing, higher clinical acuity); outpatient CPT reflects the outpatient facility fee for clinically eligible low-acuity patients and excludes separate surgeon and anesthesia professional fees.

Prices are sourced from each hospital's federally-required public price file, most recently published October 2026. The BaseRate is a modeled fair-price estimate — not a bill or quote. How we build these numbers →