Biopsy of tear gland at Adventhealth Gordon
1035 Red Bud Road, Calhoun, GA · AdventHealth · · NPI 1760402424
not published by hospital
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
not published by hospital
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$791.00 with Bcbs vs $4,786.22 with Oscar — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Bcbs | Hmo | $791.00 | — |
| Bcbs | Ppo | $1,244.00 | — |
| Multiplan | Ppo | $1,717.00 | — |
| Private Healthcare Systems | Ppo | $1,717.00 | — |
| Cigna | Medicare Managed Care Plan | $2,366.55 | — |
| Freedom Health | Medicare Managed Care Plan | $2,414.84 | — |
| Aetna | Medicare Managed Care Plan | $2,463.14 | — |
| Bcbs | Medicare Managed Care Plan | $2,487.29 | — |
| Alliant Health Plans | Ppo | $2,535.00 | — |
| Alliant Health Plans | Solocare Exchange | $3,622.27 | — |
| Oscar | Individual Plan Hmo Exchange | $4,786.22 | — |
Visitor-reported prices
Comments
Biopsy of tear gland at other Georgia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Wellstar Cobb Hospital | Austell | $2,682.42 | $1,308.00 – $6,179.00 |
| Wellstar Douglas Hospital | Douglasville | $2,682.42 | $1,308.00 – $6,179.00 |
| Wellstar Kennestone Hospital | Marietta | $2,682.42 | $1,308.00 – $6,179.00 |
| Wellstar MCG Health | Augusta | $2,682.42 | $1,308.00 – $4,238.00 |
| Wellstar North Fulton Hospital | Roswell | $2,682.42 | $1,308.00 – $6,179.00 |
| Wellstar Paulding Hospital | Hiram | $2,682.42 | $1,308.00 – $6,179.00 |
| Wellstar Roosevelt Long Term Acute Care at Warm Springs | P O Box 280 | $2,682.42 | not published |
| Wellstar Spalding Regional Hospital | Griffin | $2,682.42 | $1,308.00 – $6,179.00 |