Ot evaluation low complexity patient/family at Atrium Health Pineville
10628 Park Rd, Charlotte, NC · Atrium Health · · NPI 1417432840
$180.38
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.
$360.75
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.
$36.08 with Partners vs $331.89 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 | $36.08 | ↓ -80% |
| Amerihealth Caritas | Managed Medicaid | $36.62 | ↓ -80% |
| Alliance | Behavioral Health | $36.98 | ↓ -79% |
| Carolina Complete Health | Managed Medicaid | $37.30 | ↓ -79% |
| Wellcare | Managed Medicaid | $37.30 | ↓ -79% |
| Healthy Blue | Managed Medicaid | $37.30 | ↓ -79% |
| Vaya | Managed Medicaid | $37.66 | ↓ -79% |
| Alliance | Managed Medicaid | $38.24 | ↓ -79% |
| Trillium | Managed Medicaid | $38.42 | ↓ -79% |
| United Healthcare | Managed Medicaid | $53.97 | ↓ -70% |
| Aetna | Connected North Carolina Individual HMO | $95.60 | ↓ -47% |
| Cigna Healthspring | Medicare Advantage | $96.50 | ↓ -47% |
| Humana | Medicare Advantage | $98.43 | ↓ -45% |
| Aetna | Medicare Advantage | $99.88 | ↓ -45% |
| United Healthcare | Medicare Advantage | $100.15 | ↓ -44% |
| Ambetter | CoBranded Commercial | $104.80 | ↓ -42% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $104.83 | ↓ -42% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $106.60 | ↓ -41% |
| Ortho Carolina | Commercial | $120.63 | ↓ -33% |
| Aetna | Whole Health HMO | $123.38 | ↓ -32% |
| Ambetter | Individual Commercial | $130.95 | ↓ -27% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $140.26 | ↓ -22% |
| United Healthcare | IEX Commercial | $145.02 | ↓ -20% |
| Aetna | North Carolina Preferred Plus Commercial | $146.83 | ↓ -19% |
| Cigna | Commercial NB | $156.20 | ↓ -13% |
| Employers Health Network | Commercial | $159.45 | ↓ -12% |
| Aetna | Broad Network | $165.22 | ↓ -8% |
| United Healthcare | HMO-PPO Managed Care | $169.91 | ↓ -6% |
| Physician Reach Out | Plan P | $180.38 | ↑ +0% |
| Cigna | HMO-PPO Managed Care | $186.87 | ↑ +4% |
| MedCost | Ultra | $194.08 | ↑ +8% |
| MedCost | PPO | $215.73 | ↑ +20% |
| Magellan | Behavioral Health | $216.45 | ↑ +20% |
| GMMI | Commercial | $234.49 | ↑ +30% |
| Quik Trip | Commercial | $234.49 | ↑ +30% |
| Cigna | Commercial SAR | $243.51 | ↑ +35% |
| ChoiceCare | Commercial | $259.74 | ↑ +44% |
| Healthgram | Commercial | $288.60 | ↑ +60% |
| Provider Select | Commercial | $292.21 | ↑ +62% |
| Private Health Care Systems | Commercial | $295.82 | ↑ +64% |
| First Health | Commercial | $299.42 | ↑ +66% |
| Aetna First Health | Commercial | $299.42 | ↑ +66% |
| Beechstreet | Commercial | $324.68 | ↑ +80% |
| Multiplan | Commercial | $331.89 | ↑ +84% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Ot evaluation low complexity patient/family at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Behavioral Health Charlotte | Charlotte | $180.38 | $66.09 – $317.46 |
| Atrium Health Mercy | Charlotte | $180.38 | $51.53 – $331.89 |
| Atrium Health University City | Charlotte | $180.38 | $36.08 – $331.89 |
| Atrium Health Carolinas Medical Center | Charlotte | $180.38 | $51.53 – $324.68 |
| Carolinas Rehabilitation Charlotte | Charlotte | $180.38 | $66.09 – $331.89 |
| Atrium Health Anson | Wadesboro | $180.38 | $53.97 – $342.71 |
| Atrium Health Cabarrus | Concord | $180.38 | $44.26 – $342.71 |
| Atrium Health Cleveland | Shelby | $180.38 | $50.51 – $342.71 |