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Critical Access Hospital

Marshall County Hospital

Benton, Kentucky · Marshall County · Emergency services listed

Marshall County Hospital is a critical access hospital at 615 Old Symsonia Road, Benton, KY 42025. Phone: (270) 527-4800. It has an emergency department. Medicare overall rating: 2 of 5 stars (CMS, October 2026).

Data as of October 26, 2026. Source: CMS Hospital General Information and the hospital’s website (checked November 2, 2026).

Summary

Marshall County Hospital is a critical access hospital in Benton, Kentucky. Medicare data lists emergency services. CMS overall star rating: 2 of 5 stars. Its official website lists 22 services, specialties and programs. Medicare lists 103 affiliated clinicians. Source: CMS Hospital General Information, data updated 2026-10-26.

What is a critical access hospital?

A small rural hospital with 24-hour emergency care, designated by Medicare to keep care available far from big cities. More about hospital types

Call(270) 527‑4800 Directions Website Medicare profile
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Profile from official sources

Built from official Medicare (CMS) data and the hospital’s own website (checked 2026-11-02). Every service links to the page that lists it. Services change: call the hospital to confirm before you go.

In a medical emergency, call 911.

At a glance

YesEmergency services
2 of 5 stars2 of 5 stars · Medicare rating
103Doctors and clinicians
22Services listed

Quick answers

Does Marshall County Hospital have an emergency room?
Yes. Medicare (CMS) data lists emergency services at Marshall County Hospital. In a medical emergency, call 911.
Where is Marshall County Hospital?
615 Old Symsonia Road, Benton, KY 42025, in Marshall County, Kentucky.
What is the phone number of Marshall County Hospital?
(270) 527-4800, as listed by Medicare (CMS).
What is the Medicare star rating of Marshall County Hospital?
2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-10-26).

Specialties and care areas[4][5][6]

Treatments[4][5]

Procedures[4][5]

  • Digital 3D mammography
  • CT imaging
  • MRI

Programs and centers[4][5][6]

  • Swing Bed Program
  • Center for Wound Healing
  • Virtual teleneuro services (with TriStar Health)

Emergency care (hospital website)[4][5][6]

Emergency roomYes
Open 24/7Yes

Visiting and practical information

VisitingVisiting hours are open; check with admissions or the main desk beforehand[7]
Patient portalMarshall County Hospital Patient Portal (MyCareCorner)

Recognition[4]

  • Joint Commission accreditation

Doctors and clinicians (103)

103 doctors and other clinicians list Marshall County Hospital as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

Doctors with a page on this site (103)

And 79 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Find the closest emergency room to where you are → · Compare ER wait times

Other hospitals near Benton

Hospitals in Marshall County · Hospitals near me

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

All nursing homes in the state →

Hospice providers

All hospice providers in the state →

Home health agencies

All home health agencies in the state →

Dialysis facilities

All dialysis facilities in the state →

Outpatient surgery centers nearby

Medicare-certified ambulatory surgery centers within 25 miles, by straight-line distance.

All outpatient surgery centers in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Clinics and urgent care

Pharmacies

Assisted living nearby

Licensed homes from the official state license list, by straight-line distance.

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Marshall County Hospital reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Rated the hospital 9 or 10 out of 1082%National average: 72%
Would definitely recommend the hospital86%National average: 71%
Nurses “always” communicated well78%National average: 80%
Doctors “always” communicated well76%National average: 80%
“Always” got help as soon as they wanted74%National average: 64%
Staff “always” explained medicines before giving them73%National average: 62%
Were given information about recovery at home88%National average: 86%
Room and bathroom “always” clean75%National average: 73%
Not reported to MedicareSummary star rating (all survey topics); Overall rating of the hospital; Would recommend the hospital; Nurses communicated well; Doctors communicated well; Patients got help quickly from staff; Staff explained medicines; Information about recovery at home; Room and bathroom kept clean; Restfulness of Environment; Care Coordination; Symptoms After Stay
Completed surveys49Response rate: 20%

Source: Patient survey (HCAHPS) - Hospital — CMS, released October 19, 2026; patients discharged January 2025 to December 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: pneumonia patients18.9%
Deaths within 30 days: COPD patients10.5%
Not reported to MedicareDeaths within 30 days: coronary bypass surgery (CABG); Serious complications (patient safety indicator PSI-90)
Too few cases to reportDeaths within 30 days: heart attack patients; Deaths within 30 days: heart failure patients; Deaths within 30 days: stroke patients; Complications after hip or knee replacement

Source: Complications and Deaths - Hospital — CMS, released October 20, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)17%
Readmitted within 30 days: pneumonia18.5%
Readmitted within 30 days: COPD19.5%
Not reported to MedicareReadmitted within 30 days: coronary bypass surgery
Too few cases to reportReadmitted within 30 days: heart attack; Readmitted within 30 days: heart failure; Readmitted within 30 days: hip or knee replacement

Source: Unplanned Hospital Visits - Hospital — CMS, released October 20, 2026; data from July 2024 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)Low (under 20,000)
Average (median) time patients spent in the emergency room before leaving (OP-18b)103 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)1%National average: 2%
Not reported to MedicareSepsis patients who got all the recommended early care (SEP-1)

Source: Timely and Effective Care - Hospital — CMS, released October 19, 2026; data from January 2024 to December 2024.

Not reported to Medicare: infections caught in the hospital. For these topics Medicare shows no result for this hospital (not reported, or too few cases).

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in KentuckyBest hospitals in Kentucky

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 40 common services exactly as Marshall County Hospital lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean
Hospital charge
The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price
The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates
The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees
A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Show the prices of 40 common services

Office and emergency visits

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) In the file: EVALUATION & MANAGEMENT LEVEL 3 INITIAL $382.30 $382.30 $236.03 – $318.30
New patient office visit (about 30–44 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $318.30
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $236.03
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $318.30
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $236.03
  • Medicaid Kentucky — Default: $240.85
  • Medicare A KY J15 — Default: $236.03
  • Medicare Railroad Palmetto GBA — Default: $236.03
  • UHC Community Plan - Multi State — Medicaid Replacement: $240.85
  • United Healthcare — Default: $304.69
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) In the file: EVALUATION & MANAGEMENT LEVEL 4 INITIAL $415 $415 $256.22 – $345.53
New patient office visit (about 45–59 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $345.53
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $256.22
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $345.53
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $256.22
  • Medicaid Kentucky — Default: $261.45
  • Medicare A KY J15 — Default: $256.22
  • Medicare Railroad Palmetto GBA — Default: $256.22
  • UHC Community Plan - Multi State — Medicaid Replacement: $261.45
  • United Healthcare — Default: $330.76
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) In the file: EVALUATION & MANAGEMENT LEVEL 5 INITIAL $447.80 $447.80 $276.47 – $372.84
New patient office visit (about 60–74 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $372.84
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $276.47
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $372.84
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $276.47
  • Medicaid Kentucky — Default: $282.11
  • Medicare A KY J15 — Default: $276.47
  • Medicare Railroad Palmetto GBA — Default: $276.47
  • UHC Community Plan - Multi State — Medicaid Replacement: $282.11
  • United Healthcare — Default: $356.90
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) In the file: EVALUATION & MANAGEMENT LEVEL 3 FOLLOW U $311.60 $311.60 $192.38 – $259.44
Established patient office visit (about 20–29 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $259.44
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $192.38
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $259.44
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $192.38
  • Medicaid Kentucky — Default: $196.31
  • Medicare A KY J15 — Default: $192.38
  • Medicare Railroad Palmetto GBA — Default: $192.38
  • UHC Community Plan - Multi State — Medicaid Replacement: $196.31
  • United Healthcare — Default: $248.35
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) In the file: EVALUATION & MANAGEMENT LEVEL 4 FOLLOW U $344.40 $344.40 $212.63 – $286.75
Established patient office visit (about 30–39 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $286.75
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $212.63
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $286.75
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $212.63
  • Medicaid Kentucky — Default: $216.97
  • Medicare A KY J15 — Default: $212.63
  • Medicare Railroad Palmetto GBA — Default: $212.63
  • UHC Community Plan - Multi State — Medicaid Replacement: $216.97
  • United Healthcare — Default: $274.49
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · modifier 25 In the file: ER LEVEL 3 $408.50 $408.50 $252.21 – $340.12
Emergency room visit (moderate): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $340.12
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $252.21
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $340.12
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $252.21
  • Medicaid Kentucky — Default: $257.36
  • Medicare A KY J15 — Default: $252.21
  • Medicare Railroad Palmetto GBA — Default: $252.21
  • UHC Community Plan - Multi State — Medicaid Replacement: $257.36
  • United Healthcare — Default: $325.57
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · modifier 25 In the file: ER LEVEL 4 $513.60 $513.60 $317.10 – $427.62
Emergency room visit (moderately high): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $427.62
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $317.10
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $427.62
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $317.10
  • Medicaid Kentucky — Default: $323.57
  • Medicare A KY J15 — Default: $317.10
  • Medicare Railroad Palmetto GBA — Default: $317.10
  • UHC Community Plan - Multi State — Medicaid Replacement: $323.57
  • United Healthcare — Default: $409.34
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · modifier 25 In the file: ER LEVEL 5 $619.70 $619.70 $382.60 – $515.96
Emergency room visit (high): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $515.96
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $382.60
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $515.96
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $382.60
  • Medicaid Kentucky — Default: $390.41
  • Medicare A KY J15 — Default: $382.60
  • Medicare Railroad Palmetto GBA — Default: $382.60
  • UHC Community Plan - Multi State — Medicaid Replacement: $390.41
  • United Healthcare — Default: $493.90
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)

Lab tests

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: CHEM 7 - BMP $50.30 $50.30 $31.06 – $40.09
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $31.06
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $31.06
  • Medicaid Kentucky — Default: $31.69
  • Medicare A KY J15 — Default: $31.06
  • Medicare Railroad Palmetto GBA — Default: $31.06
  • UHC Community Plan - Multi State — Medicaid Replacement: $31.69
  • United Healthcare — Default: $40.09
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Basic metabolic panel (blood test) CPT 80048 · Inpatient or outpatient In the file: ZZ BASIC METABOLIC 8 $43.60 $43.60 $26.92 – $34.75
Basic metabolic panel (blood test): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $26.92
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $26.92
  • Medicaid Kentucky — Default: $27.47
  • Medicare A KY J15 — Default: $26.92
  • Medicare Railroad Palmetto GBA — Default: $26.92
  • UHC Community Plan - Multi State — Medicaid Replacement: $27.47
  • United Healthcare — Default: $34.75
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: CHEM 12-CMP $67 $67 $41.37 – $53.40
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $41.37
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $41.37
  • Medicaid Kentucky — Default: $42.21
  • Medicare A KY J15 — Default: $41.37
  • Medicare Railroad Palmetto GBA — Default: $41.37
  • UHC Community Plan - Multi State — Medicaid Replacement: $42.21
  • United Healthcare — Default: $53.40
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Comprehensive metabolic panel (blood test) CPT 80053 · Inpatient or outpatient In the file: ZZ COMP METABOLIC PROFILE 14 $74.90 $74.90 $46.25 – $59.70
Comprehensive metabolic panel (blood test): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $46.25
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $46.25
  • Medicaid Kentucky — Default: $47.19
  • Medicare A KY J15 — Default: $46.25
  • Medicare Railroad Palmetto GBA — Default: $46.25
  • UHC Community Plan - Multi State — Medicaid Replacement: $47.19
  • United Healthcare — Default: $59.70
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: LIPID PROFILE $77.10 $77.10 $47.60 – $61.45
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $47.60
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $47.60
  • Medicaid Kentucky — Default: $48.57
  • Medicare A KY J15 — Default: $47.60
  • Medicare Railroad Palmetto GBA — Default: $47.60
  • UHC Community Plan - Multi State — Medicaid Replacement: $48.57
  • United Healthcare — Default: $61.45
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Cholesterol panel (lipid panel) CPT 80061 · Inpatient or outpatient In the file: ZZ LIPID PANEL W CHOL/HDL RATIO $78.20 $78.20 $48.28 – $62.33
Cholesterol panel (lipid panel): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $48.28
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $48.28
  • Medicaid Kentucky — Default: $49.27
  • Medicare A KY J15 — Default: $48.28
  • Medicare Railroad Palmetto GBA — Default: $48.28
  • UHC Community Plan - Multi State — Medicaid Replacement: $49.27
  • United Healthcare — Default: $62.33
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Kidney function panel CPT 80069 · Inpatient or outpatient In the file: RENAL FUNCTION PROFILE $71.50 $71.50 $44.14 – $56.99
Kidney function panel: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $44.14
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $44.15
  • Medicaid Kentucky — Default: $45.04
  • Medicare A KY J15 — Default: $44.15
  • Medicare Railroad Palmetto GBA — Default: $44.15
  • UHC Community Plan - Multi State — Medicaid Replacement: $45.04
  • United Healthcare — Default: $56.99
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: LIVER PROFILE $43.60 $43.60 $26.92 – $34.75
Liver function panel: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $26.92
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $26.92
  • Medicaid Kentucky — Default: $27.47
  • Medicare A KY J15 — Default: $26.92
  • Medicare Railroad Palmetto GBA — Default: $26.92
  • UHC Community Plan - Multi State — Medicaid Replacement: $27.47
  • United Healthcare — Default: $34.75
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Liver function panel CPT 80076 · Inpatient or outpatient In the file: ZZ HEPATIC FUNCTION 7 $57.10 $57.10 $35.25 – $45.51
Liver function panel: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $35.25
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $35.25
  • Medicaid Kentucky — Default: $35.97
  • Medicare A KY J15 — Default: $35.25
  • Medicare Railroad Palmetto GBA — Default: $35.25
  • UHC Community Plan - Multi State — Medicaid Replacement: $35.97
  • United Healthcare — Default: $45.51
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Urine test (automated, with microscope) CPT 81001 · Inpatient or outpatient In the file: URINALYSIS W MICRO (CHARGE) $37.60 $37.60 $23.22 – $29.97
Urine test (automated, with microscope): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $23.22
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $23.22
  • Medicaid Kentucky — Default: $23.69
  • Medicare A KY J15 — Default: $23.22
  • Medicare Railroad Palmetto GBA — Default: $23.22
  • UHC Community Plan - Multi State — Medicaid Replacement: $23.69
  • United Healthcare — Default: $29.97
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: ZZ URINALYSIS STX (CHARGE) $17.90 $17.90 $11.05 – $14.27
Urine test (automated, without microscope): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $11.05
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $11.05
  • Medicaid Kentucky — Default: $11.28
  • Medicare A KY J15 — Default: $11.05
  • Medicare Railroad Palmetto GBA — Default: $11.05
  • UHC Community Plan - Multi State — Medicaid Replacement: $11.28
  • United Healthcare — Default: $14.27
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Urine test (automated, without microscope) CPT 81003 · Inpatient or outpatient In the file: ZZ PH URINE $12.50 $12.50 $7.72 – $9.96
Urine test (automated, without microscope): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $7.72
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $7.72
  • Medicaid Kentucky — Default: $7.88
  • Medicare A KY J15 — Default: $7.72
  • Medicare Railroad Palmetto GBA — Default: $7.72
  • UHC Community Plan - Multi State — Medicaid Replacement: $7.88
  • United Healthcare — Default: $9.96
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
PSA (prostate specific antigen) blood test CPT 84153 · Inpatient or outpatient In the file: PSA $68.20 $68.20 $42.11 – $54.36
PSA (prostate specific antigen) blood test: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $42.11
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $42.11
  • Medicaid Kentucky — Default: $42.97
  • Medicare A KY J15 — Default: $42.11
  • Medicare Railroad Palmetto GBA — Default: $42.11
  • UHC Community Plan - Multi State — Medicaid Replacement: $42.97
  • United Healthcare — Default: $54.36
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: TSH $38.10 $38.10 $23.52 – $30.37
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $23.52
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $23.52
  • Medicaid Kentucky — Default: $24
  • Medicare A KY J15 — Default: $23.52
  • Medicare Railroad Palmetto GBA — Default: $23.52
  • UHC Community Plan - Multi State — Medicaid Replacement: $24
  • United Healthcare — Default: $30.37
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Thyroid stimulating hormone (TSH) test CPT 84443 · Inpatient or outpatient In the file: THYROID CASCADE $38.10 $38.10 $23.52 – $30.37
Thyroid stimulating hormone (TSH) test: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $23.52
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $23.52
  • Medicaid Kentucky — Default: $24
  • Medicare A KY J15 — Default: $23.52
  • Medicare Railroad Palmetto GBA — Default: $23.52
  • UHC Community Plan - Multi State — Medicaid Replacement: $24
  • United Healthcare — Default: $30.37
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC) with differential CPT 85025 · Inpatient or outpatient In the file: ZZ CBC WITH AUTO DIFF (CHARGE) $44.50 $44.50 $27.48 – $35.47
Complete blood count (CBC) with differential: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $27.48
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $27.48
  • Medicaid Kentucky — Default: $28.04
  • Medicare A KY J15 — Default: $27.48
  • Medicare Railroad Palmetto GBA — Default: $27.48
  • UHC Community Plan - Multi State — Medicaid Replacement: $28.04
  • United Healthcare — Default: $35.47
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Complete blood count (CBC), automated CPT 85027 · Inpatient or outpatient In the file: ZZ CBC AUTO COMPLETE $38.10 $38.10 $23.52 – $30.37
Complete blood count (CBC), automated: 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $23.52
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $23.52
  • Medicaid Kentucky — Default: $24
  • Medicare A KY J15 — Default: $23.52
  • Medicare Railroad Palmetto GBA — Default: $23.52
  • UHC Community Plan - Multi State — Medicaid Replacement: $24
  • United Healthcare — Default: $30.37
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Blood clotting time test (prothrombin time, PT) CPT 85610 · Inpatient or outpatient In the file: PROTIME $41.50 $41.50 $25.62 – $33.08
Blood clotting time test (prothrombin time, PT): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $25.62
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $25.63
  • Medicaid Kentucky — Default: $26.14
  • Medicare A KY J15 — Default: $25.63
  • Medicare Railroad Palmetto GBA — Default: $25.63
  • UHC Community Plan - Multi State — Medicaid Replacement: $26.14
  • United Healthcare — Default: $33.08
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: PTT $41.50 $41.50 $25.62 – $33.08
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $25.62
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $25.63
  • Medicaid Kentucky — Default: $26.14
  • Medicare A KY J15 — Default: $25.63
  • Medicare Railroad Palmetto GBA — Default: $25.63
  • UHC Community Plan - Multi State — Medicaid Replacement: $26.14
  • United Healthcare — Default: $33.08
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Inpatient or outpatient In the file: ZZ PTT ACTIVATED $29.10 $29.10 $17.96 – $23.19
Blood clotting test (partial thromboplastin time, PTT): 10 of 17 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $17.96
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $17.96
  • Medicaid Kentucky — Default: $18.33
  • Medicare A KY J15 — Default: $17.96
  • Medicare Railroad Palmetto GBA — Default: $17.96
  • UHC Community Plan - Multi State — Medicaid Replacement: $18.33
  • United Healthcare — Default: $23.19
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
  • Aetna — Medicare Advantage: 63% (a percentage in the contract, not a dollar amount)
  • Aetna Better Health KY — Medicaid Replacement: 63% (a percentage in the contract, not a dollar amount)

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Inpatient or outpatient In the file: CT HEAD WO CONTRAST $1,136 $1,136 $701.37 – $905.39
CT scan of the head or brain, without contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $890
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $701.37
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $890
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $701.37
  • Medicaid Kentucky — Default: $715.68
  • Medicare A KY J15 — Default: $701.37
  • Medicare Railroad Palmetto GBA — Default: $701.37
  • UHC Community Plan - Multi State — Medicaid Replacement: $715.68
  • United Healthcare — Default: $905.39
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI BRAIN W WO CONTRAST $2,519.80 $2,519.80 $700 – $2,008.28
MRI of the brain, before and after contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $700
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,555.72
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $700
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,555.72
  • Medicaid Kentucky — Default: $1,587.47
  • Medicare A KY J15 — Default: $1,555.72
  • Medicare Railroad Palmetto GBA — Default: $1,555.72
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,587.47
  • United Healthcare — Default: $2,008.28
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
MRI of the brain, before and after contrast CPT 70553 · Inpatient or outpatient In the file: MRI IACS W WO CONTRAST $2,519.80 $2,519.80 $700 – $2,008.28
MRI of the brain, before and after contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $700
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,555.72
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $700
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,555.72
  • Medicaid Kentucky — Default: $1,587.47
  • Medicare A KY J15 — Default: $1,555.72
  • Medicare Railroad Palmetto GBA — Default: $1,555.72
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,587.47
  • United Healthcare — Default: $2,008.28
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST PA & LAT 2 VIEWS $215.30 $215.30 $132.93 – $179.26
Chest X-ray, 2 views: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $179.26
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $132.93
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $179.26
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $132.93
  • Medicaid Kentucky — Default: $135.64
  • Medicare A KY J15 — Default: $132.93
  • Medicare Railroad Palmetto GBA — Default: $132.93
  • UHC Community Plan - Multi State — Medicaid Replacement: $135.64
  • United Healthcare — Default: $171.59
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Chest X-ray, 2 views CPT 71046 · Inpatient or outpatient In the file: XR CHEST DECUBITUS VIEWS 2 VIEWS $298.80 $298.80 $184.48 – $248.78
Chest X-ray, 2 views: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $248.78
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $184.48
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $248.78
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $184.48
  • Medicaid Kentucky — Default: $188.24
  • Medicare A KY J15 — Default: $184.48
  • Medicare Railroad Palmetto GBA — Default: $184.48
  • UHC Community Plan - Multi State — Medicaid Replacement: $188.24
  • United Healthcare — Default: $238.14
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
X-ray of the lower spine, at least 4 views CPT 72110 · Inpatient or outpatient In the file: XR SPINE LUMBAR W5 OBLIQUE $507.30 $507.30 $313.21 – $422.38
X-ray of the lower spine, at least 4 views: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $422.38
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $313.21
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $422.38
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $313.21
  • Medicaid Kentucky — Default: $319.60
  • Medicare A KY J15 — Default: $313.21
  • Medicare Railroad Palmetto GBA — Default: $313.21
  • UHC Community Plan - Multi State — Medicaid Replacement: $319.60
  • United Healthcare — Default: $404.32
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Inpatient or outpatient In the file: MRI LUMBAR WO CONTRAST $1,977.30 $1,977.30 $700 – $1,575.91
MRI of the lower back (lumbar spine), without contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $700
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,220.79
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $700
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,220.79
  • Medicaid Kentucky — Default: $1,245.70
  • Medicare A KY J15 — Default: $1,220.79
  • Medicare Railroad Palmetto GBA — Default: $1,220.79
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,245.70
  • United Healthcare — Default: $1,575.91
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
CT scan of the pelvis, with contrast CPT 72193 · Inpatient or outpatient In the file: CT PELVIS W CONTRAST $1,136 $1,136 $701.37 – $905.39
CT scan of the pelvis, with contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $890
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $701.37
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $890
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $701.37
  • Medicaid Kentucky — Default: $715.68
  • Medicare A KY J15 — Default: $701.37
  • Medicare Railroad Palmetto GBA — Default: $701.37
  • UHC Community Plan - Multi State — Medicaid Replacement: $715.68
  • United Healthcare — Default: $905.39
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier LT In the file: MRI LOWER JOINT LT WO CONTRAST $1,977.30 $1,977.30 $700 – $1,575.91
MRI of a leg joint (such as the knee), without contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $700
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,220.79
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $700
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,220.79
  • Medicaid Kentucky — Default: $1,245.70
  • Medicare A KY J15 — Default: $1,220.79
  • Medicare Railroad Palmetto GBA — Default: $1,220.79
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,245.70
  • United Healthcare — Default: $1,575.91
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Inpatient or outpatient · modifier RT In the file: MRI LOWER JOINT RT WO CONTRAST $1,977.30 $1,977.30 $700 – $1,575.91
MRI of a leg joint (such as the knee), without contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $700
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,220.79
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $700
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,220.79
  • Medicaid Kentucky — Default: $1,245.70
  • Medicare A KY J15 — Default: $1,220.79
  • Medicare Railroad Palmetto GBA — Default: $1,220.79
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,245.70
  • United Healthcare — Default: $1,575.91
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ABD & PELVIS WITH CONTRAST $1,993.10 $1,993.10 $890 – $1,588.50
CT scan of the abdomen and pelvis, with contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $890
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,230.54
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $890
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,230.54
  • Medicaid Kentucky — Default: $1,255.65
  • Medicare A KY J15 — Default: $1,230.54
  • Medicare Railroad Palmetto GBA — Default: $1,230.54
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,255.65
  • United Healthcare — Default: $1,588.50
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Inpatient or outpatient In the file: CT ENTEROGRAPHY W/CONTRAST $1,993.10 $1,993.10 $890 – $1,588.50
CT scan of the abdomen and pelvis, with contrast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $890
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,230.54
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $890
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,230.54
  • Medicaid Kentucky — Default: $1,255.65
  • Medicare A KY J15 — Default: $1,230.54
  • Medicare Railroad Palmetto GBA — Default: $1,230.54
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,255.65
  • United Healthcare — Default: $1,588.50
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Ultrasound of the abdomen, complete CPT 76700 · Inpatient or outpatient In the file: US ABDOMEN $770.40 $770.40 $475.64 – $641.44
Ultrasound of the abdomen, complete: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $641.44
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $475.64
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $641.44
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $475.64
  • Medicaid Kentucky — Default: $485.35
  • Medicare A KY J15 — Default: $475.64
  • Medicare Railroad Palmetto GBA — Default: $475.64
  • UHC Community Plan - Multi State — Medicaid Replacement: $485.35
  • United Healthcare — Default: $614.01
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Transvaginal ultrasound CPT 76830 · Inpatient or outpatient In the file: US TRANSVAGINAL NON OB $420.40 $420.40 $259.55 – $350.03
Transvaginal ultrasound: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $350.03
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $259.55
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $350.03
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $259.55
  • Medicaid Kentucky — Default: $264.85
  • Medicare A KY J15 — Default: $259.55
  • Medicare Railroad Palmetto GBA — Default: $259.55
  • UHC Community Plan - Multi State — Medicaid Replacement: $264.85
  • United Healthcare — Default: $335.06
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier RT In the file: MM MAMMO RT UNILATERAL W/CAD $220.50 $220.50 $112 – $175.74
Diagnostic mammogram, one breast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $112
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $136.14
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $112
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $136.14
  • Medicaid Kentucky — Default: $138.92
  • Medicare A KY J15 — Default: $136.14
  • Medicare Railroad Palmetto GBA — Default: $136.14
  • UHC Community Plan - Multi State — Medicaid Replacement: $138.92
  • United Healthcare — Default: $175.74
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, one breast CPT 77065 · Inpatient or outpatient · modifier LT In the file: MM MAMMO LT UNILATERAL W/CAD $220.50 $220.50 $112 – $175.74
Diagnostic mammogram, one breast: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $112
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $136.14
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $112
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $136.14
  • Medicaid Kentucky — Default: $138.92
  • Medicare A KY J15 — Default: $136.14
  • Medicare Railroad Palmetto GBA — Default: $136.14
  • UHC Community Plan - Multi State — Medicaid Replacement: $138.92
  • United Healthcare — Default: $175.74
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Diagnostic mammogram, both breasts CPT 77066 · Inpatient or outpatient In the file: MM MAMMO DIAG/BILAT W/CAD $267.40 $267.40 $112 – $213.12
Diagnostic mammogram, both breasts: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $112
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $165.09
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $112
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $165.09
  • Medicaid Kentucky — Default: $168.46
  • Medicare A KY J15 — Default: $165.09
  • Medicare Railroad Palmetto GBA — Default: $165.09
  • UHC Community Plan - Multi State — Medicaid Replacement: $168.46
  • United Healthcare — Default: $213.12
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) In the file: MM MAMMO SCREENING W/CAD $257.10 $257.10 $79.45 – $204.91
Screening mammogram, both breasts: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $112
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $158.73
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $112
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $79.45
  • Medicaid Kentucky — Default: $161.97
  • Medicare A KY J15 — Default: $79.45
  • Medicare Railroad Palmetto GBA — Default: $79.45
  • UHC Community Plan - Multi State — Medicaid Replacement: $161.97
  • United Healthcare — Default: $204.91
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Inpatient or outpatient · modifier RT In the file: MM MAMMO W/TOMO RT UNILATERAL $98.40 $98.40 $60.75 – $98.40
Screening mammogram, both breasts: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $98.40
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $60.75
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $98.40
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $60.75
  • Medicaid Kentucky — Default: $61.99
  • Medicare A KY J15 — Default: $60.75
  • Medicare Railroad Palmetto GBA — Default: $60.75
  • UHC Community Plan - Multi State — Medicaid Replacement: $61.99
  • United Healthcare — Default: $78.42
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · modifier 52 In the file: MM MAMMO UNILAT SCR W/CAD $220.50 $220.50 $79.45 – $175.74
Screening mammogram, both breasts: 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $112
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $136.14
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $112
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $79.45
  • Medicaid Kentucky — Default: $138.92
  • Medicare A KY J15 — Default: $79.45
  • Medicare Railroad Palmetto GBA — Default: $79.45
  • UHC Community Plan - Multi State — Medicaid Replacement: $138.92
  • United Healthcare — Default: $175.74
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)

Physical therapy and mental health

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GP In the file: EXERCISE PER 15 MINUTES $69.30 $69.30 $42.79 – $57.70
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $57.70
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $42.79
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $57.70
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $42.79
  • Medicaid Kentucky — Default: $43.66
  • Medicare A KY J15 — Default: $42.79
  • Medicare Railroad Palmetto GBA — Default: $42.79
  • UHC Community Plan - Multi State — Medicaid Replacement: $43.66
  • United Healthcare — Default: $55.23
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Inpatient or outpatient · modifier GO In the file: OT THERAPEUTIC EXERCISE 15 MIN UNITS $69.30 $69.30 $42.79 – $57.70
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $57.70
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $42.79
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $57.70
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $42.79
  • Medicaid Kentucky — Default: $43.66
  • Medicare A KY J15 — Default: $42.79
  • Medicare Railroad Palmetto GBA — Default: $42.79
  • UHC Community Plan - Multi State — Medicaid Replacement: $43.66
  • United Healthcare — Default: $55.23
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (low complexity) CPT 97161 · Inpatient or outpatient · modifier GP In the file: EVALUATION LOW COMPLEXITY $184 $184 $113.60 – $153.20
Physical therapy evaluation (low complexity): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $153.20
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $113.60
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $153.20
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $113.60
  • Medicaid Kentucky — Default: $115.92
  • Medicare A KY J15 — Default: $113.60
  • Medicare Railroad Palmetto GBA — Default: $113.60
  • UHC Community Plan - Multi State — Medicaid Replacement: $115.92
  • United Healthcare — Default: $146.65
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (moderate complexity) CPT 97162 · Inpatient or outpatient · modifier GP In the file: EVALUATION MODERATE COMPLEXITY $184 $184 $113.60 – $153.20
Physical therapy evaluation (moderate complexity): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $153.20
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $113.60
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $153.20
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $113.60
  • Medicaid Kentucky — Default: $115.92
  • Medicare A KY J15 — Default: $113.60
  • Medicare Railroad Palmetto GBA — Default: $113.60
  • UHC Community Plan - Multi State — Medicaid Replacement: $115.92
  • United Healthcare — Default: $146.65
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Physical therapy evaluation (high complexity) CPT 97163 · Inpatient or outpatient · modifier GP In the file: EVALUATION HIGH COMPLEXITY $184 $184 $113.60 – $153.20
Physical therapy evaluation (high complexity): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $153.20
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $113.60
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $153.20
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $113.60
  • Medicaid Kentucky — Default: $115.92
  • Medicare A KY J15 — Default: $113.60
  • Medicare Railroad Palmetto GBA — Default: $113.60
  • UHC Community Plan - Multi State — Medicaid Replacement: $115.92
  • United Healthcare — Default: $146.65
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)

Procedures and surgery

ServiceHospital chargeCash priceInsurance rates (lowest – highest)
Upper GI endoscopy (diagnostic) CPT 43235 · Inpatient or outpatient In the file: GASTROSCOPY $1,974.50 $1,974.50 $1,219.06 – $1,643.97
Upper GI endoscopy (diagnostic): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $1,643.97
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,219.06
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $1,643.97
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,219.06
  • Medicaid Kentucky — Default: $1,243.94
  • Medicare A KY J15 — Default: $1,219.06
  • Medicare Railroad Palmetto GBA — Default: $1,219.06
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,243.94
  • United Healthcare — Default: $1,573.68
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)
Colonoscopy (diagnostic) CPT 45378 · Inpatient or outpatient In the file: COLONOSCOPY $1,974.50 $1,974.50 $1,219.06 – $1,643.97
Colonoscopy (diagnostic): 10 of 19 insurance plan rates
  • Blue Cross Blue Shield of KY Anthem — HMO: $1,643.97
  • Blue Cross Blue Shield of KY Anthem — Medicare Advantage: $1,219.06
  • Blue Cross Blue Shield of KY Anthem — PATHWAY: $1,643.97
  • Humana Advantage Care Plans Med Advantage — Medicare Advantage: $1,219.06
  • Medicaid Kentucky — Default: $1,243.94
  • Medicare A KY J15 — Default: $1,219.06
  • Medicare Railroad Palmetto GBA — Default: $1,219.06
  • UHC Community Plan - Multi State — Medicaid Replacement: $1,243.94
  • United Healthcare — Default: $1,573.68
  • Aetna — Default: 89% (a percentage in the contract, not a dollar amount)

Source: Marshall County Hospital’s standard charges file (marshallcountyhospital.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on April 7, 2026; retrieved November 5, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital typeCritical Access Hospital
Address615 Old Symsonia Road, Benton, KY 42025
CountyMarshall County
StateKentucky
Phone(270) 527‑4800
Emergency servicesYes
OwnershipGovernment - Hospital District or Authority
Medicare overall rating2 of 5 stars
CMS Certification Number181327
Name in Medicare recordsMARSHALL COUNTY HOSPITAL
Profile levelMedicare data + hospital website
Official websitemarshallcountyhospital.org
CorrectionsReport an error or suggest an update →

Sources

  1. Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-10-26, retrieved 2026-11-13
  2. Medicare Care Compare — official Medicare profile of this hospital
  3. U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-11-02.

  1. Marshall County Hospital — marshallcountyhospital.org
  2. Services — marshallcountyhospital.org
  3. Emergency Department — marshallcountyhospital.org
  4. Visitor Information — marshallcountyhospital.org