St Elizabeth Edgewood
ST Elizabeth Edgewood in Edgewood, Kentucky charges 4.7x the Medicare reimbursement rate on average across 140 analyzed procedures at this nonprofit religious hospital.
Edgewood, KY 41017 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Billing patterns — nonprofit-religious
Nonprofit religious hospitals, representing 203 facilities in the dataset, demonstrate an average markup of 5.4x Medicare rates, positioning them in the mid-range compared to other ownership types. These institutions typically maintain standardized charge structures across their health system networks, often reflecting their mission-driven approach to healthcare delivery. Patients at nonprofit religious hospitals may encounter charges above the benchmark for routine procedures, though many offer financial assistance programs and charity care policies that can significantly reduce out-of-pocket expenses for qualifying individuals. Common billing patterns include transparent pricing for elective procedures and comprehensive financial counseling services. The potential difference between listed charges and actual patient responsibility can be substantial, particularly for uninsured patients who may qualify for sliding-scale payment options. Patients should inquire about available financial assistance programs during the admissions process, as these hospitals often have more flexible payment arrangements compared to for-profit facilities, reflecting their tax-exempt status and community benefit obligations.
Pricing grade
C
Average
Avg markup vs Medicare
4.69x
Charge / Medicare rate
Max markup
8.04x
Worst procedure
Procedures analyzed
140
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC | 322 | $77,724 | $38,862 | — | 8x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $75,336 | $37,668 | — | 7.9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $22,574 | $11,287 | — | 7.6x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 220 | $166,755 | $83,377 | — | 7.2x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $104,885 | $52,443 | — | 7.1x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $31,461 | $15,731 | — | 7x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $70,439 | $35,220 | — | 6.9x |
| AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | 269 | $145,151 | $72,576 | — | 6.9x |
| OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC | 271 | $146,668 | $73,334 | — | 6.8x |
| AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | 617 | $59,870 | $29,935 | — | 6.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $88,654 | $44,327 | — | 6.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $14,938 | $7,469 | — | 6.5x |
| MAJOR CHEST PROCEDURES WITHOUT CC/MCC | 165 | $64,053 | $32,027 | — | 6.4x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC | 314 | $77,477 | $38,738 | — | 6.3x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $38,466 | $19,233 | — | 6.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $48,594 | $24,297 | — | 6.1x |
| ATHEROSCLEROSIS WITHOUT MCC | 303 | $18,447 | $9,224 | — | 6.1x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC | 982 | $85,502 | $42,751 | — | 6.1x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | 331 | $53,178 | $26,589 | — | 5.9x |
| DIGESTIVE MALIGNANCY WITH MCC | 374 | $69,270 | $34,635 | — | 5.9x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC | 417 | $93,270 | $46,635 | — | 5.8x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $29,293 | $14,647 | — | 5.8x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $113,883 | $56,941 | — | 5.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $27,738 | $13,869 | — | 5.6x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $20,811 | $10,405 | — | 5.5x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $51,232 | $25,616 | — | 5.5x |
| DISORDERS OF THE BILIARY TRACT WITH MCC | 444 | $53,636 | $26,818 | — | 5.5x |
| HYPERTENSION WITHOUT MCC | 305 | $22,092 | $11,046 | — | 5.5x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $30,302 | $15,151 | — | 5.4x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $71,572 | $35,786 | — | 5.4x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $20,693 | $10,347 | — | 5.4x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $96,292 | $48,146 | — | 5.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $69,179 | $34,589 | — | 5.3x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $114,056 | $57,028 | — | 5.3x |
| CHEST PAIN | 313 | $19,307 | $9,653 | — | 5.3x |
| HYPERTENSION WITH MCC | 304 | $36,137 | $18,069 | — | 5.2x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $117,072 | $58,536 | — | 5.2x |
| BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | 519 | $54,821 | $27,411 | — | 5.1x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $31,846 | $15,923 | — | 5.1x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC | 233 | $202,438 | $101,219 | — | 5.1x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $43,527 | $21,764 | — | 5x |
| DYSEQUILIBRIUM | 149 | $19,604 | $9,802 | — | 5x |
| OTHER CARDIOTHORACIC PROCEDURES WITH MCC | 228 | $158,031 | $79,015 | — | 5x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $26,659 | $13,329 | — | 5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $41,036 | $20,518 | — | 5x |
| OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC | 580 | $43,765 | $21,882 | — | 5x |
| EXTRACRANIAL PROCEDURES WITH CC | 038 | $45,791 | $22,895 | — | 4.9x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $79,422 | $39,711 | — | 4.9x |
| MAJOR CHEST PROCEDURES WITH CC | 164 | $71,871 | $35,935 | — | 4.9x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $24,754 | $12,377 | — | 4.8x |
Showing 50 of 140 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — nonprofit-religious hospital billing
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use