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Somerset Area Hospital Prices

Cash and insurance-negotiated prices at hospitals in and around Somerset, 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.Good Deal · Below Fair Market
0.73×vs. Fair Market Price
Position vs. 1.00× Fair Price27% Below 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 27% below the fair benchmark (0.73×) 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.1 Hospitals Mapped
Hospitals Priced1 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 KY0.73× FairLowest confounder-adjusted hospital in Kentucky: Lake Cumberland Regional Hospital (Somerset) at 0.73× fair market price.

Most affordable Kentucky hospital: Lake Cumberland Regional Hospital (Somerset) at 0.73× the fair price (27% below benchmark).

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

This hospital maintains low, disciplined commercial pricing across both routine shoppable procedures (1.0× Medicare, p50 0.73× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.74× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#5 of 68 in KY · 5th State Percentile#160 of 3,385 in U.S. · 4th National Percentile
Advantage

Where They're Good (Patient & Payer Edge)

  • Elective shoppable care is priced 27% below peer Fair BaseRate (0.73×)
  • Self-pay cash beats commercial insurance on 0% of shoppable procedures (50/100 Cash Honesty)
  • 2-Star CMS clinical rating with 53% patient recommendation (63/100 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)

  • Outpatient surgery & OR suites carry a 1.2× markup over Medicare rates
  • Commercial insurance median sits at 0.73× Fair BaseRate (1.0× Medicare), so insured patients should always compare the self-pay cash price before paying.
  • Specialty infusion drugs (J-codes) average 1.2× Medicare — verify per-unit billing on itemized statements
  • Consolidated metro market (HHI 10,000) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Front-Door ShoppableElective / Imaging
1.0× Medicare

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

Back-Door Captive & ER1.00× Divergence
1.0× Medicare

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

Quantile Tail Spread+1% Upper Tail
Q25 0.73× · Q50 0.73× · Q75 0.74×

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
1.0× MedicareGood
Outpatient Surgery & ORBack-Door Captive
1.2× MedicareGood
Diagnostic Imaging (CT/MRI)Front-Door Shoppable
1.1× MedicareGood
Back-Door Captive ER VisitsBack-Door Captive
1.4× MedicareGood
Inpatient Lab & PathologyBack-Door Captive
1.3× MedicareGood
Specialty & Infusion Drugs (J-Codes)Back-Door Captive
1.2× MedicareGood
Self-Pay Cash Honesty & 501(r)Integrity & Outcomes
0% Cash Edge · 50/100Elevated
CMS Clinical Safety & Star ValueIntegrity & Outcomes
2 CMS · 63/100Elevated

Hospitals in the Somerset 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.

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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 →