75/100
#501 nationally
St Claire Regional Medical Center
222 Medical Circle, Morehead, KY 40351 · (606) 783-6500
Charges moderately above what care is paid for
For every $1 of care Medicare actually paid for here, St Claire Regional Medical Center billed $3.47 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 3.5x
- volume-weighted across all its priced work
- Procedures priced
- 34
- inpatient and outpatient combined
- Rank in KY
- #10
- lower markup ranks higher
- CMS quality stars
- 2/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 76% of U.S. hospitals.
Better than 67% of U.S. hospitals.
Better than 80% of U.S. hospitals.
Better than 79% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
198 | $40,775 | $14,457 | -38% |
|
Level 1 Intraocular Procedures
APC 5491 · Hospital outpatient visit |
187 | $10,096 | $2,148 | -14% |
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
179 | $13,328 | $2,523 | -31% |
|
Level 2 Urology and Related Services
APC 5372 · Hospital outpatient visit |
84 | $1,411 | $630 | -55% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
78 | $5,244 | $1,494 | -48% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
54 | $7,604 | $1,877 | -41% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
47 | $16,586 | $3,213 | -20% |
|
Level 1 Nerve Procedures
APC 5431 · Hospital outpatient visit |
46 | $8,770 | $1,780 | -23% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
44 | $24,505 | $3,008 | about average |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
39 | $24,350 | $9,659 | -44% |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
$24,505 | $3,008 | about average |
|
Level 4 Endovascular Procedures
APC 5194 · Hospital outpatient visit |
$88,408 | $16,130 | -7% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
$56,284 | $12,115 | -10% |
|
Level 3 Endovascular Procedures
APC 5193 · Hospital outpatient visit |
$58,662 | $10,132 | -13% |
|
Level 1 Intraocular Procedures
APC 5491 · Hospital outpatient visit |
$10,096 | $2,148 | -14% |
|
Level 2 Upper GI Procedures
APC 5302 · Hospital outpatient visit |
$9,875 | $1,716 | -16% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
$22,241 | $4,770 | -19% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
$16,586 | $3,213 | -20% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Sepsis (without major complications)
MS-DRG 872 · Inpatient stay |
$16,248 | $7,743 | -59% |
|
Red Blood Cell Disorders with Major Complications
MS-DRG 811 · Inpatient stay |
$23,438 | $10,628 | -58% |
|
Kidney Failure (severe)
MS-DRG 682 · Inpatient stay |
$23,129 | $10,702 | -56% |
|
Level 2 Urology and Related Services
APC 5372 · Hospital outpatient visit |
$1,411 | $630 | -55% |
|
Urinary Tract Infection (severe)
MS-DRG 689 · Inpatient stay |
$18,413 | $8,268 | -55% |
|
Irregular Heartbeat (with complications)
MS-DRG 309 · Inpatient stay |
$15,715 | $5,899 | -49% |
|
Kidney Failure (with complications)
MS-DRG 683 · Inpatient stay |
$17,100 | $6,968 | -48% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
$5,244 | $1,494 | -48% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.