Lexington Regional Health Center
P O Box 980, 1201 North Erie St, Lexington, NE 68850 · 98 Priced Procedures · 70% Patient Recommendation
Typical commercial prices here are +199% above the fair benchmark (2.99×) 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
Lexington Regional Health Center prices routine shoppable procedures at 4.8× Medicare (median 2.63× Fair BaseRate) while upper-quartile commercial rates jump +53% to 4.02× 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 2.01× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 33% of shoppable procedures (40/100 Cash Honesty)
- CMS clinical safety score (70/100 safety score) with 70% patient recommendation
- Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.8× markup over Medicare rates
- Commercial insurance median sits at 2.63× Fair BaseRate (4.8× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 4.02×) jump +53% above the median procedure ratio (Q50 2.63×)
- Consolidated metro market (HHI 3,484) 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 Lexington Regional Health Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 98 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $4,371 | 9.8× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $4,186 | 4.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $3,989 | 7.8× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $3,667 | 12.1× |
| MRI, brain (no contrast) CPT Code: 70551 | $3,461 | 10.1× |
| Rabies immune globulin HCPCS Code: 90375 | $2,633 | 8.2× |
| CT scan, chest (no contrast) CPT Code: 71250 | $2,424 | 14.5× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,316 | 2.3× |
| CT scan, pelvis CPT Code: 72192 | $2,173 | 13.3× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $2,161 | 3.7× |
| CT scan, head (with contrast) CPT Code: 70460 | $2,112 | 8.7× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $1,952 | 11.6× |
| MRI, lower back (no contrast) CPT Code: 72148 | $1,954 | 5.8× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,950 | 1.6× |
| Trauma team activation HCPCS Code: G0390 | $1,904 | 1.3× |
| CT scan, sinuses CPT Code: 70486 | $1,740 | 10.5× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $1,737 | 6.7× |
| MRI, knee or other leg joint CPT Code: 73721 | $1,485 | 4.0× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $1,417 | 8.4× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $1,407 | 5.2× |
| CT scan, head (no contrast) CPT Code: 70450 | $1,371 | 8.6× |
| Blood transfusion CPT Code: 36430 | $966 | 1.9× |
| Ultrasound, abdomen (complete) CPT Code: 76700 | $828 | 6.2× |
| Ultrasound, pelvis CPT Code: 76856 | $792 | 6.1× |
| Ultrasound, abdomen (limited) CPT Code: 76705 | $673 | 5.3× |
Audit a Bill or Quote at Lexington Regional Health Center (Zero PHI Required)
Above Standard 400% FPL Financial-Assistance Ceiling
At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.
Self-Pay Cash Rate ($4,371) Beats Your Bill
Lexington Regional Health Center's published 45 CFR § 180 self-pay cash rate is $4,371 (vs. $4,371 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $448 Fair BaseRate ($356 Medicare)
Your bill ($4,553) is $4,105 above the denoised Fair BaseRate ($448) and 12.8× the $356 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Public IRS & CMS ownership records classify Lexington Regional Health Center as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.
Clinical Quality, Patient Experience & Infection Benchmarks
Source: CMS Hospital Care Compare (67 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 Lexington Regional Health Center.
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.