Biopsy of upper nose/throat at Atrium Health Lincoln
433 McAlister Rd, Lincolnton, NC · Atrium Health · · NPI 1730055054
$2,249.55
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.
$4,499.10
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.
$83.94 with Trillium vs $4,274.15 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 |
|---|---|---|---|
| Trillium | Managed Medicaid | $83.94 | ↓ -96% |
| Wellcare | Managed Medicaid | $84.78 | ↓ -96% |
| Partners | Managed Medicaid | $84.78 | ↓ -96% |
| United Healthcare | Managed Medicaid | $84.78 | ↓ -96% |
| Healthy Blue | Managed Medicaid | $84.78 | ↓ -96% |
| Carolina Complete Health | Managed Medicaid | $84.78 | ↓ -96% |
| Amerihealth Caritas | Managed Medicaid | $84.78 | ↓ -96% |
| Vaya | Managed Medicaid | $84.78 | ↓ -96% |
| Alliance | Managed Medicaid | $85.62 | ↓ -96% |
| Cigna Healthspring | Medicare Advantage | $113.29 | ↓ -95% |
| Humana | Medicare Advantage | $115.56 | ↓ -95% |
| Aetna | Medicare Advantage | $117.26 | ↓ -95% |
| United Healthcare | Medicare Advantage | $117.58 | ↓ -95% |
| OrthoCarolina | Commercial | $141.61 | ↓ -94% |
| United Healthcare | HMO-PPO Managed Care | $414.14 | ↓ -82% |
| Alliance | Behavioral Health | $512.45 | ↓ -77% |
| Aetna | Connected North Carolina Individual HMO | $1,192.26 | ↓ -47% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $1,289.89 | ↓ -43% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $1,359.63 | ↓ -40% |
| Ambetter | CoBranded Commercial | $1,471.66 | ↓ -35% |
| Ambetter | Individual Commercial | $1,673.67 | ↓ -26% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $1,697.51 | ↓ -25% |
| United Healthcare | IEX Commercial | $1,808.64 | ↓ -20% |
| Aetna | Whole Health HMO | $1,835.63 | ↓ -18% |
| Cigna | Commercial NB | $1,948.11 | ↓ -13% |
| Employers Health Network | Commercial | $1,988.60 | ↓ -12% |
| Aetna | North Carolina Preferred Plus | $2,092.08 | ↓ -7% |
| MedCost | Ultra | $2,119.08 | ↓ -6% |
| Physician Reach Out | Plan P | $2,249.55 | ↑ +0% |
| Aetna | Broad Network | $2,357.53 | ↑ +5% |
| Cigna | HMO-PPO Managed Care | $2,411.52 | ↑ +7% |
| Quik Trip | Commercial | $2,924.42 | ↑ +30% |
| GMMI | Commercial | $2,924.42 | ↑ +30% |
| MedCost | PPO | $2,942.41 | ↑ +31% |
| Cigna | Commercial SAR | $3,036.89 | ↑ +35% |
| ChoiceCare | Commercial | $3,689.26 | ↑ +64% |
| First Health | Commercial | $3,824.24 | ↑ +70% |
| Aetna First Health | Commercial | $3,824.24 | ↑ +70% |
| Private Health Care Systems | Commercial | $4,049.19 | ↑ +80% |
| Beechstreet | Commercial | $4,049.19 | ↑ +80% |
| Multiplan | Commercial | $4,274.15 | ↑ +90% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of upper nose/throat at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $2,249.55 | $83.94 – $4,274.15 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $2,249.55 | $84.78 – $3,959.21 |
| Atrium Health Cabarrus | Concord | $2,249.55 | $83.94 – $4,274.15 |
| Atrium Health Cleveland | Shelby | $2,249.55 | $83.94 – $4,274.15 |
| Atrium Health Mercy | Charlotte | $2,249.55 | $83.94 – $4,139.17 |
| Atrium Health Pineville | Charlotte | $2,249.55 | $83.94 – $4,139.17 |
| Atrium Health Stanly | Albermarle | $2,249.55 | $83.94 – $4,319.14 |
| Atrium Health Union | Monroe | $2,249.55 | $83.94 – $4,274.15 |