Pt evaluation low complexity patient/family at Atrium Health Pineville
10628 Park Rd, Charlotte, NC · Atrium Health · · NPI 1417432840
$202.08
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.
$404.15
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.
$40.42 with Partners vs $371.82 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 | $40.42 | ↓ -80% |
| Amerihealth Caritas | Managed Medicaid | $41.02 | ↓ -80% |
| Alliance | Behavioral Health | $41.43 | ↓ -79% |
| Carolina Complete Health | Managed Medicaid | $41.79 | ↓ -79% |
| Wellcare | Managed Medicaid | $41.79 | ↓ -79% |
| Healthy Blue | Managed Medicaid | $41.79 | ↓ -79% |
| Vaya | Managed Medicaid | $42.19 | ↓ -79% |
| Alliance | Managed Medicaid | $42.84 | ↓ -79% |
| Trillium | Managed Medicaid | $43.04 | ↓ -79% |
| United Healthcare | Managed Medicaid | $60.46 | ↓ -70% |
| Cigna Healthspring | Medicare Advantage | $94.11 | ↓ -53% |
| Humana | Medicare Advantage | $95.99 | ↓ -52% |
| Aetna | Medicare Advantage | $97.40 | ↓ -52% |
| United Healthcare | Medicare Advantage | $97.67 | ↓ -52% |
| Aetna | Connected North Carolina Individual HMO | $107.10 | ↓ -47% |
| Ambetter | CoBranded Commercial | $117.41 | ↓ -42% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $117.45 | ↓ -42% |
| Ortho Carolina | Commercial | $117.63 | ↓ -42% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $119.43 | ↓ -41% |
| Aetna | Whole Health HMO | $138.22 | ↓ -32% |
| Ambetter | Individual Commercial | $146.71 | ↓ -27% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $157.13 | ↓ -22% |
| United Healthcare | IEX Commercial | $162.47 | ↓ -20% |
| Aetna | North Carolina Preferred Plus Commercial | $164.49 | ↓ -19% |
| Cigna | Commercial NB | $175.00 | ↓ -13% |
| Employers Health Network | Commercial | $178.63 | ↓ -12% |
| Aetna | Broad Network | $185.10 | ↓ -8% |
| United Healthcare | HMO-PPO Managed Care | $190.35 | ↓ -6% |
| Physician Reach Out | Plan P | $202.08 | ↑ +0% |
| Cigna | HMO-PPO Managed Care | $209.35 | ↑ +4% |
| MedCost | Ultra | $217.43 | ↑ +8% |
| MedCost | PPO | $241.68 | ↑ +20% |
| Magellan | Behavioral Health | $242.49 | ↑ +20% |
| GMMI | Commercial | $262.70 | ↑ +30% |
| Quik Trip | Commercial | $262.70 | ↑ +30% |
| Cigna | Commercial SAR | $272.80 | ↑ +35% |
| ChoiceCare | Commercial | $290.99 | ↑ +44% |
| Healthgram | Commercial | $323.32 | ↑ +60% |
| Provider Select | Commercial | $327.36 | ↑ +62% |
| Private Health Care Systems | Commercial | $331.40 | ↑ +64% |
| First Health | Commercial | $335.44 | ↑ +66% |
| Aetna First Health | Commercial | $335.44 | ↑ +66% |
| Beechstreet | Commercial | $363.74 | ↑ +80% |
| Multiplan | Commercial | $371.82 | ↑ +84% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation low complexity patient/family at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Behavioral Health Charlotte | Charlotte | $202.08 | $68.13 – $355.65 |
| Atrium Health Mercy | Charlotte | $202.08 | $52.45 – $371.82 |
| Atrium Health University City | Charlotte | $202.08 | $40.42 – $371.82 |
| Atrium Health Carolinas Medical Center | Charlotte | $202.08 | $52.45 – $363.74 |
| Carolinas Rehabilitation Charlotte | Charlotte | $202.08 | $68.13 – $371.82 |
| Atrium Health Anson | Wadesboro | $202.08 | $60.46 – $383.94 |
| Atrium Health Cabarrus | Concord | $202.08 | $49.59 – $383.94 |
| Atrium Health Cleveland | Shelby | $202.08 | $56.58 – $383.94 |