ST CLAIRE REGIONAL MEDICAL CENTER
MOREHEAD, KY 40351 · Acute Care Hospitals
13 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
13
With CMS pricing data
Avg Charge-to-Medicare Ratio
3.1x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Government - Federal
Above 90th Percentile
0%
Compared to KY hospitals
Understanding Your Costs
When you receive a bill from ST CLAIRE REGIONAL MEDICAL CENTER, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, ST CLAIRE REGIONAL MEDICAL CENTER lists chargemaster rates that average 3.1x the corresponding Medicare reimbursement amount across 13 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in KY has a chargemaster-to-Medicare ratio of 5.1x, with ratios across the state ranging from 2.5x to 10.5x. At 3.1x, this facility’s average ratio is below the state median. 57 hospitals in KY report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at ST CLAIRE REGIONAL MEDICAL CENTER is Circulatory Disorders Except Ami, with Cardiac Catheterization without Major Complications (DRG 287). The listed chargemaster rate is $34,885, while Medicare reimburses $6,425 for the same procedure — a ratio of 5.4x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
ST CLAIRE REGIONAL MEDICAL CENTER is a government - federal acute care hospitals facility with a CMS quality rating of 4/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| Circulatory Disorders Except Ami, with Cardiac Catheterization without Major Complications | 287 | $34,885 | $6,425 | 5.4x | 0th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Complications | 309 | $17,118 | $4,046 | 4.2x | 0th | Compare your bill |
| Pulmonary Edema and Respiratory Failure | 189 | $23,530 | $7,182 | 3.3x | 0th | Compare your bill |
| Kidney and Urinary Tract Infections with Major Complications or Comorbidities | 689 | $22,057 | $6,796 | 3.3x | 0th | Compare your bill |
| Other Kidney and Urinary Tract Diagnoses with Major Complications or Comorbidities | 698 | $33,055 | $10,201 | 3.2x | 0th | Compare your bill |
| Renal Failure with Complications | 683 | $16,716 | $5,300 | 3.1x | 0th | Compare your bill |
| Septicemia or Severe Sepsis without Mechanical Ventilation over 96 Hours with Major Complications or Comorbidities | 871 | $37,084 | $12,813 | 2.9x | 0th | Compare your bill |
| Septicemia or Severe Sepsis without Mechanical Ventilation over 96 Hours without Major Complications | 872 | $16,134 | $6,002 | 2.7x | 0th | Compare your bill |
| Simple Pneumonia and Pleurisy with Major Complications or Comorbidities | 193 | $20,092 | $7,524 | 2.7x | 0th | Compare your bill |
| Respiratory Infections and Inflammations with Major Complications or Comorbidities | 177 | $28,498 | $10,803 | 2.6x | 0th | Compare your bill |
| Renal Failure with Major Complications or Comorbidities | 682 | $22,045 | $8,385 | 2.6x | 0th | Compare your bill |
| Infectious and Parasitic Diseases with Operating Room Procedures with Major Complications or Comorbidities | 853 | $77,093 | $30,747 | 2.5x | 0th | Compare your bill |
| Heart Failure and Shock with Major Complications or Comorbidities | 291 | $17,914 | $7,801 | 2.3x | 0th | Compare your bill |
Showing 13 of 13 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across KY hospitals
57 hospitals in KY report pricing data to CMS. This facility's average ratio of 3.1x places it at the lower end of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About ST CLAIRE REGIONAL MEDICAL CENTER
How much does ST CLAIRE REGIONAL MEDICAL CENTER charge compared to Medicare?
According to CMS IPPS data, ST CLAIRE REGIONAL MEDICAL CENTER's listed chargemaster rates average 3.1x the Medicare reimbursement amount across 13 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at ST CLAIRE REGIONAL MEDICAL CENTER?
The procedure with the highest chargemaster-to-Medicare ratio at ST CLAIRE REGIONAL MEDICAL CENTER is Circulatory Disorders Except Ami, with Cardiac Catheterization without Major Complications (DRG 287), with a listed charge of $34,885 compared to Medicare reimbursement of $6,425 — a ratio of 5.4x. Source: CMS IPPS Provider Summary.
Is ST CLAIRE REGIONAL MEDICAL CENTER expensive compared to other KY hospitals?
ST CLAIRE REGIONAL MEDICAL CENTER's average chargemaster-to-Medicare ratio is 3.1x. Ratios vary significantly across KY hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for ST CLAIRE REGIONAL MEDICAL CENTER come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from ST CLAIRE REGIONAL MEDICAL CENTER is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does ST CLAIRE REGIONAL MEDICAL CENTER in MOREHEAD, KY accept Medicare?
ST CLAIRE REGIONAL MEDICAL CENTER is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact ST CLAIRE REGIONAL MEDICAL CENTER directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.