Ghs simple repair 12.6 - 20.0 cm - 12016 at Atrium Health Pineville
10628 Park Rd, Charlotte, NC · Atrium Health · · NPI 1417432840
$444.18
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.
$888.35
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.
$88.84 with Partners vs $817.28 with Multiplan — 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 |
|---|---|---|---|
| Partners | Managed Medicaid | $88.84 | ↓ -80% |
| Amerihealth Caritas | Managed Medicaid | $90.17 | ↓ -80% |
| Alliance | Behavioral Health | $91.06 | ↓ -79% |
| Healthy Blue | Managed Medicaid | $91.86 | ↓ -79% |
| Wellcare | Managed Medicaid | $91.86 | ↓ -79% |
| Carolina Complete Health | Managed Medicaid | $91.86 | ↓ -79% |
| Vaya | Managed Medicaid | $92.74 | ↓ -79% |
| Alliance | Managed Medicaid | $94.17 | ↓ -79% |
| Trillium | Managed Medicaid | $94.61 | ↓ -79% |
| Cigna Healthspring | Medicare Advantage | $115.89 | ↓ -74% |
| Humana | Medicare Advantage | $118.21 | ↓ -73% |
| Aetna | Medicare Advantage | $119.95 | ↓ -73% |
| United Healthcare | Medicare Advantage | $120.28 | ↓ -73% |
| United Healthcare | Managed Medicaid | $132.90 | ↓ -70% |
| Ortho Carolina | Commercial | $144.86 | ↓ -67% |
| Aetna | Connected North Carolina Individual HMO | $235.41 | ↓ -47% |
| Ambetter | CoBranded Commercial | $258.07 | ↓ -42% |
| United Healthcare | IEX Commercial | $286.94 | ↓ -35% |
| Aetna | Whole Health HMO | $303.82 | ↓ -32% |
| Ambetter | Individual Commercial | $322.47 | ↓ -27% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $346.37 | ↓ -22% |
| Cigna | HMO-PPO Managed Care | $355.34 | ↓ -20% |
| Aetna | North Carolina Preferred Plus Commercial | $361.56 | ↓ -19% |
| Cigna | Commercial NB | $384.66 | ↓ -13% |
| Employers Health Network | Commercial | $392.65 | ↓ -12% |
| Aetna | Broad Network | $406.86 | ↓ -8% |
| United Healthcare | HMO-PPO Managed Care | $418.41 | ↓ -6% |
| Physician Reach Out | Plan P | $444.18 | ↑ +0% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $455.72 | ↑ +3% |
| MedCost | Ultra | $477.93 | ↑ +8% |
| MedCost | PPO | $531.23 | ↑ +20% |
| Magellan | Behavioral Health | $533.01 | ↑ +20% |
| GMMI | Commercial | $577.43 | ↑ +30% |
| Quik Trip | Commercial | $577.43 | ↑ +30% |
| Cigna | Commercial SAR | $599.64 | ↑ +35% |
| ChoiceCare | Commercial | $639.61 | ↑ +44% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $671.50 | ↑ +51% |
| Healthgram | Commercial | $710.68 | ↑ +60% |
| Provider Select | Commercial | $719.56 | ↑ +62% |
| Private Health Care Systems | Commercial | $728.45 | ↑ +64% |
| First Health | Commercial | $737.33 | ↑ +66% |
| Aetna First Health | Commercial | $737.33 | ↑ +66% |
| Beechstreet | Commercial | $799.52 | ↑ +80% |
| Multiplan | Commercial | $817.28 | ↑ +84% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Ghs simple repair 12.6 - 20.0 cm - 12016 at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Behavioral Health Charlotte | Charlotte | $444.18 | $115.89 – $781.75 |
| Atrium Health Mercy | Charlotte | $444.18 | $75.38 – $817.28 |
| Atrium Health University City | Charlotte | $444.18 | $88.84 – $817.28 |
| Atrium Health Carolinas Medical Center | Charlotte | $444.18 | $75.38 – $799.52 |
| Carolinas Rehabilitation Charlotte | Charlotte | $444.18 | $115.89 – $817.28 |
| Atrium Health Anson | Wadesboro | $444.18 | $115.89 – $843.93 |
| Atrium Health Cabarrus | Concord | $444.18 | $109.00 – $843.93 |
| Atrium Health Cleveland | Shelby | $444.18 | $115.89 – $843.93 |