▸ Hospital · KY · CCN 181305
Arh Our Lady Of The Way
MAIN STREET RR 1428, MARTIN, KY, 41649
25 bedsCritical Access Hospitals2
Compliance grade
A
97/100
Procedures tracked
87
of 209 target codes
Payers
8
with negotiated rates
Rates published
7,798
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychiatric diagnostic evaluation | CPT | 90791 | 8 | $365 | $219 | $73 | $73 | $321.2 |
| Psychiatric eval with medical services | CPT | 90792 | 8 | $270 | $162 | $54 | $54 | $237.6 |
| Psychotherapy 30 minutes | CPT | 90832 | 8 | $170 | $102 | $34 | $34 | $149.6 |
| Psychotherapy 45 minutes | CPT | 90834 | 8 | $230 | $138 | $46 | $46 | $202.4 |
| Psychotherapy 60 minutes | CPT | 90837 | 8 | $310 | $186 | $62 | $62 | $272.8 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 8 | $102 | $61.2 | $20.4 | $20.4 | $89.76 |
| ED visit level 2 | CPT | 99282 | 8 | $239 | $143.4 | $47.8 | $47.8 | $210.32 |
| ED visit level 3 | CPT | 99283 | 8 | $463 | $277.8 | $92.6 | $92.6 | $407.44 |
| ED visit level 4 | CPT | 99284 | 8 | $2,909 | $1,745.4 | $581.8 | $581.8 | $2,559.92 |
| ED visit level 5 | CPT | 99285 | 8 | $4,960 | $2,976 | $116.04 | $767.86 | $4,364.8 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 8 | $2,401 | $1,440.6 | $480.2 | $480.2 | $2,112.88 |
| CT head with contrast | CPT | 70460 | 8 | $2,629 | $1,577.4 | $525.8 | $525.8 | $2,313.52 |
| CT head with and without contrast | CPT | 70470 | 8 | $3,734 | $2,240.4 | $542 | $746.8 | $3,285.92 |
| CT neck with contrast | CPT | 70491 | 8 | $3,446 | $2,067.6 | $542 | $689.2 | $3,032.48 |
| MRI brain without contrast | CPT | 70551 | 8 | $5,342 | $3,205.2 | $760 | $1,068.4 | $4,700.96 |
| MRI brain with and without contrast | CPT | 70553 | 8 | $7,671 | $4,602.6 | $760 | $1,534.2 | $6,750.48 |
| Chest X-ray single view | CPT | 71045 | 8 | $356 | $213.6 | $71.2 | $71.2 | $313.28 |
| Chest X-ray 2 views | CPT | 71046 | 8 | $419 | $251.4 | $83.8 | $83.8 | $368.72 |
| CT chest without contrast | CPT | 71250 | 8 | $2,955 | $1,773 | $542 | $591 | $2,600.4 |
| CT chest with contrast | CPT | 71260 | 8 | $4,038 | $2,422.8 | $542 | $807.6 | $3,553.44 |
| CT chest with and without contrast | CPT | 71270 | 8 | $4,833 | $2,899.8 | $542 | $966.6 | $4,253.04 |
| Lumbosacral spine X-ray | CPT | 72100 | 8 | $580 | $348 | $116 | $116 | $510.4 |
| CT cervical spine without contrast | CPT | 72125 | 8 | $4,229 | $2,537.4 | $542 | $845.8 | $3,721.52 |
| CT thoracic spine without contrast | CPT | 72128 | 8 | $3,745 | $2,247 | $542 | $749 | $3,295.6 |
| CT lumbar spine without contrast | CPT | 72131 | 8 | $3,481 | $2,088.6 | $542 | $696.2 | $3,063.28 |
| MRI cervical spine without contrast | CPT | 72141 | 8 | $5,087 | $3,052.2 | $760 | $1,017.4 | $4,476.56 |
| MRI thoracic spine without contrast | CPT | 72146 | 8 | $5,017 | $3,010.2 | $760 | $1,003.4 | $4,414.96 |
| MRI lumbar spine without contrast | CPT | 72148 | 8 | $5,089 | $3,053.4 | $760 | $1,017.8 | $4,478.32 |
| MRI lumbar spine with contrast | CPT | 72158 | 8 | $6,258 | $3,754.8 | $760 | $1,251.6 | $5,507.04 |
| CT pelvis without contrast | CPT | 72192 | 8 | $2,834 | $1,700.4 | $542 | $566.8 | $2,493.92 |
| CT pelvis with contrast | CPT | 72193 | 8 | $3,929 | $2,357.4 | $542 | $785.8 | $3,457.52 |
| Shoulder X-ray | CPT | 73030 | 8 | $824 | $494.4 | $82.6 | $164.8 | $725.12 |
| Humerus X-ray | CPT | 73060 | 8 | $982 | $589.2 | $98 | $196.4 | $864.16 |
| Hand X-ray 3 views | CPT | 73130 | 8 | $1,001 | $600.6 | $100.2 | $200.2 | $880.88 |
| MRI upper extremity joint without contrast | CPT | 73221 | 8 | $5,342 | $3,205.2 | $760 | $1,068.4 | $4,700.96 |
| Knee X-ray 1-2 views | CPT | 73560 | 8 | $794 | $476.4 | $79.4 | $158.8 | $698.72 |
| Ankle X-ray 3 views | CPT | 73610 | 8 | $1,058 | $634.8 | $105.8 | $211.6 | $931.04 |
| MRI lower extremity joint without contrast | CPT | 73721 | 8 | $5,342 | $3,205.2 | $760 | $1,068.4 | $4,700.96 |
| CT abdomen without contrast | CPT | 74150 | 8 | $2,555 | $1,533 | $511 | $511 | $2,248.4 |
| CT abdomen with contrast | CPT | 74160 | 8 | $3,154 | $1,892.4 | $542 | $630.8 | $2,775.52 |
| CT abdomen with and without contrast | CPT | 74170 | 8 | $3,761 | $2,256.6 | $542 | $752.2 | $3,309.68 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 8 | $5,385 | $3,231 | $542 | $1,077 | $4,738.8 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 8 | $7,079 | $4,247.4 | $542 | $1,415.8 | $6,229.52 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 8 | $8,784 | $5,270.4 | $542 | $1,756.8 | $7,729.92 |
| MRI abdomen without contrast | CPT | 74181 | 8 | $3,611 | $2,166.6 | $722.2 | $722.2 | $3,177.68 |
| MRI abdomen with and without contrast | CPT | 74183 | 8 | $4,445 | $2,667 | $760 | $889 | $3,911.6 |
| Abdominal ultrasound complete | CPT | 76700 | 8 | $1,546 | $927.6 | $309.2 | $309.2 | $1,360.48 |
| Abdominal ultrasound limited | CPT | 76705 | 8 | $958 | $574.8 | $191.6 | $191.6 | $843.04 |
| Obstetric ultrasound first trimester | CPT | 76801 | 8 | $1,349 | $809.4 | $269.8 | $269.8 | $1,187.12 |
| Transvaginal ultrasound | CPT | 76830 | 8 | $1,464 | $878.4 | $292.8 | $292.8 | $1,288.32 |
| Pelvic ultrasound complete | CPT | 76856 | 8 | $1,531 | $918.6 | $306.2 | $306.2 | $1,347.28 |
| Scrotal ultrasound | CPT | 76870 | 8 | $1,512 | $907.2 | $302.4 | $302.4 | $1,330.56 |
| Diagnostic mammography unilateral | CPT | 77065 | 8 | $946 | $567.6 | $120 | $189.2 | $832.48 |
| Diagnostic mammography bilateral | CPT | 77066 | 8 | $946 | $567.6 | $120 | $189.2 | $832.48 |
| Screening mammography bilateral | CPT | 77067 | 8 | $382 | $229.2 | $10 | $76.4 | $336.16 |
| EKG tracing only | CPT | 93005 | 8 | $397 | $238.2 | $79.4 | $79.4 | $349.36 |
| Transthoracic echocardiogram complete | CPT | 93306 | 8 | $3,961 | $2,376.6 | $792.2 | $792.2 | $3,485.68 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 1 | — | — | $20,828 | $21,376 | $21,924 |
| COPD w MCC | MS-DRG | 190 | 1 | — | — | $14,764 | $15,152 | $15,541 |
| COPD w CC | MS-DRG | 191 | 1 | — | — | $11,236 | $11,531 | $11,827 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 1 | — | — | $10,741 | $11,024 | $11,307 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 1 | — | — | $8,376.79 | $8,597.23 | $8,817.67 |
| Heart failure & shock w MCC | MS-DRG | 291 | 1 | — | — | $17,111 | $17,561 | $18,011 |
| Heart failure & shock w CC | MS-DRG | 292 | 1 | — | — | $11,316 | $11,613 | $11,911 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 1 | — | — | $7,543.77 | $7,742.3 | $7,940.82 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 1 | — | — | $16,047 | $16,469 | $16,892 |
| Kidney/UTI w MCC | MS-DRG | 689 | 1 | — | — | $15,465 | $15,872 | $16,279 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 1 | — | — | $10,789 | $11,073 | $11,357 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 1 | — | — | $25,890 | $26,571 | $27,253 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 1 | — | — | $13,639 | $13,998 | $14,357 |
| Hospital discharge, >30 min | CPT | 99239 | 4 | $198 | $118.8 | $72.89 | $103.34 | $103.34 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 8 | $248 | $148.8 | $8.46 | $49.6 | $218.24 |
| Comprehensive metabolic panel | CPT | 80053 | 8 | $288 | $172.8 | $10.56 | $57.6 | $253.44 |
| Lipid panel | CPT | 80061 | 8 | $190 | $114 | $13.39 | $38 | $167.2 |
| Renal function panel | CPT | 80069 | 8 | $392 | $235.2 | $8.68 | $78.4 | $344.96 |
| Hepatic function panel | CPT | 80076 | 8 | $333 | $199.8 | $66.6 | $66.6 | $293.04 |
| Urinalysis non-automated | CPT | 81002 | 8 | $48 | $28.8 | $4.6 | $9.6 | $42.24 |
| Urinalysis automated | CPT | 81003 | 8 | $57 | $34.2 | $2.25 | $11.4 | $50.16 |
| Glucose quantitative | CPT | 82947 | 8 | $113 | $67.8 | $3.93 | $22.6 | $99.44 |
| Hemoglobin A1c | CPT | 83036 | 8 | $134 | $80.4 | $9.71 | $26.8 | $117.92 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 8 | $107 | $64.2 | $16.8 | $21.4 | $94.16 |
| Complete blood count with automated differential | CPT | 85025 | 8 | $137 | $82.2 | $7.77 | $27.4 | $120.56 |
| Complete blood count without differential | CPT | 85027 | 8 | $107 | $64.2 | $21.4 | $21.4 | $94.16 |
| Urine culture bacterial | CPT | 87086 | 8 | $235 | $141 | $47 | $47 | $206.8 |
| Tissue exam by pathologist level IV | CPT | 88305 | 8 | $184 | $110.4 | $36.8 | $36.8 | $161.92 |
| maternity | ||||||||
| Vaginal delivery only | CPT | 59409 | 8 | $5,641 | $3,384.6 | $1,128.2 | $1,128.2 | $4,964.08 |
| office | ||||||||
| Office visit, established patient, 5 min | CPT | 99211 | 8 | $689 | $413.4 | $137.8 | $137.8 | $606.32 |
Payer mix (top 8)
| Payer | Codes covered | Median rate |
|---|---|---|
| Anthem BCBS | 86 | $424.5 |
| Aetna | 74 | $375.22 |
| optum ccn region 1 | 74 | $194 |
| optum ccn region 2 | 74 | $194 |
| WellCare | 74 | $197.38 |
| caresoure kentucky | 73 | $644.48 |
| Humana | 73 | $198.3 |
| Molina | 73 | $202.27 |