Biopsy of lip 40490 at Atrium Health Stanly
301 Yadkin St, Albermarle, NC · Atrium Health · · NPI 1073988994
$399.75
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.
$799.50
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.
$55.20 with Trillium vs $767.52 with MedCost — 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 |
|---|---|---|---|
| Trillium | Managed Medicaid | $55.20 | ↓ -86% |
| Wellcare | Managed Medicaid | $55.75 | ↓ -86% |
| Carolina Complete Health | Managed Medicaid | $55.75 | ↓ -86% |
| Vaya | Managed Medicaid | $55.75 | ↓ -86% |
| United Healthcare | Managed Medicaid | $55.75 | ↓ -86% |
| Partners | Managed Medicaid | $55.75 | ↓ -86% |
| Amerihealth Caritas | Managed Medicaid | $55.75 | ↓ -86% |
| Healthy Blue | Managed Medicaid | $55.75 | ↓ -86% |
| Alliance | Managed Medicaid | $56.30 | ↓ -86% |
| Cigna Healthspring | Medicare Advantage | $64.12 | ↓ -84% |
| Humana | Medicare Advantage | $65.40 | ↓ -84% |
| Aetna | Medicare Advantage | $66.36 | ↓ -83% |
| United Healthcare | Medicare Advantage | $66.55 | ↓ -83% |
| Alliance | Behavioral Health | $96.02 | ↓ -76% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $151.11 | ↓ -62% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $185.24 | ↓ -54% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $209.79 | ↓ -48% |
| Aetna | Connected North Carolina Individual HMO | $211.87 | ↓ -47% |
| Ambetter | CoBranded Commercial | $244.57 | ↓ -39% |
| Aetna | Broad Network | $258.85 | ↓ -35% |
| Ambetter | Individual Commercial | $297.41 | ↓ -26% |
| United Healthcare | IEX Commercial | $321.40 | ↓ -20% |
| Cigna | Commercial NB | $346.18 | ↓ -13% |
| Employers Health Network | Commercial | $353.38 | ↓ -12% |
| Aetna | North Carolina Preferred Plus | $371.77 | ↓ -7% |
| Physician Reach Out | Plan P | $399.75 | ↑ +0% |
| Cigna | HMO-PPO Managed Care | $428.53 | ↑ +7% |
| Magellan | Behavioral Health | $479.70 | ↑ +20% |
| MedCost | Ultra | $509.28 | ↑ +27% |
| Quik Trip | Commercial | $519.68 | ↑ +30% |
| GMMI | Commercial | $519.68 | ↑ +30% |
| Cigna | Commercial SAR | $539.66 | ↑ +35% |
| United Healthcare | HMO-PPO Managed Care | $541.26 | ↑ +35% |
| Carolina Behavioral Health | Employee Commercial | $575.64 | ↑ +44% |
| Aetna | Whole Health HMO | $619.61 | ↑ +55% |
| Carolina Behavioral Health | Commercial | $639.60 | ↑ +60% |
| Cigna | Behavioral Health | $639.60 | ↑ +60% |
| Aetna First Health | Commercial | $719.55 | ↑ +80% |
| Healthgram | Commercial | $719.55 | ↑ +80% |
| First Health | Commercial | $719.55 | ↑ +80% |
| Lifesynch Community Choice Care | Behavioral Health | $751.53 | ↑ +88% |
| Multiplan | Commercial | $751.53 | ↑ +88% |
| ChoiceCare | Commercial | $751.53 | ↑ +88% |
| Private Health Care Systems | Commercial | $751.53 | ↑ +88% |
| Beechstreet | Commercial | $767.52 | ↑ +92% |
| MedCost | PPO | $767.52 | ↑ +92% |
| Physician Reach Out | Plan H | not published by hospital | — |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of lip 40490 at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $399.75 | $55.20 – $759.53 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $399.75 | $55.75 – $703.56 |
| Atrium Health Cabarrus | Concord | $399.75 | $55.20 – $759.53 |
| Atrium Health Cleveland | Shelby | $399.75 | $55.20 – $759.53 |
| Atrium Health Lincoln | Lincolnton | $399.75 | $55.20 – $759.53 |
| Atrium Health Mercy | Charlotte | $399.75 | $55.20 – $735.54 |
| Atrium Health Pineville | Charlotte | $399.75 | $55.20 – $735.54 |
| Atrium Health Union | Monroe | $399.75 | $55.20 – $759.53 |