healthcosts.net
Prolng off/op e/m ea 15 min 99417 at Atrium Health Pineville
10628 Park Rd, Charlotte, NC · Atrium Health · · NPI 1417432840
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.
$29.25 with Humana vs $122.46 with Alliance — 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 |
|---|---|---|---|
| Humana | Medicare Advantage | $29.25 | — |
| Aetna | Medicare Advantage | $29.68 | — |
| Cigna Healthspring | Medicare Advantage | $30.11 | — |
| United Healthcare | Medicare Advantage | $30.20 | — |
| Ortho Carolina | Commercial | $35.85 | — |
| United Healthcare | IEX Commercial | $49.19 | — |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $55.66 | — |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $58.81 | — |
| ChoiceCare | Commercial | $58.81 | — |
| Aetna | North Carolina Preferred Plus Commercial | $59.59 | — |
| United Healthcare | HMO-PPO Managed Care | $63.99 | — |
| Aetna | Broad Network | $65.83 | — |
| MedCost | PPO | $67.01 | — |
| MedCost | Ultra | $67.01 | — |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $73.23 | — |
| Trillium | Managed Medicaid | $120.06 | — |
| United Healthcare | Managed Medicaid | $121.26 | — |
| Wellcare | Managed Medicaid | $121.26 | — |
| Carolina Complete Health | Managed Medicaid | $121.26 | — |
| Partners | Managed Medicaid | $121.26 | — |
| Amerihealth Caritas | Managed Medicaid | $121.26 | — |
| Healthy Blue | Managed Medicaid | $121.26 | — |
| Vaya | Managed Medicaid | $121.26 | — |
| Alliance | Managed Medicaid | $122.46 | — |
Visitor-reported prices
Comments
Prolng off/op e/m ea 15 min 99417 at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Behavioral Health Charlotte | Charlotte | not published | $67.01 – $121.26 |
| Atrium Health Mercy | Charlotte | not published | $29.25 – $122.46 |
| Atrium Health University City | Charlotte | not published | $29.25 – $122.46 |
| Atrium Health Carolinas Medical Center | Charlotte | not published | $29.25 – $122.46 |
| Carolinas Rehabilitation Charlotte | Charlotte | not published | $29.25 – $121.26 |
| Atrium Health Anson | Wadesboro | not published | $29.25 – $122.46 |
| Atrium Health Cabarrus | Concord | not published | $29.25 – $122.46 |
| Atrium Health Cleveland | Shelby | not published | $29.25 – $122.46 |