Biopsy of salivary gland 42400 at Atrium Health Union
600 Hospital Dr, Monroe, NC · Atrium Health · · NPI 1396790325
$1,091.38
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.
$2,182.75
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.
$43.49 with Trillium vs $2,073.61 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 | $43.49 | ↓ -96% |
| Wellcare | Managed Medicaid | $43.92 | ↓ -96% |
| Partners | Managed Medicaid | $43.92 | ↓ -96% |
| Carolina Complete Health | Managed Medicaid | $43.92 | ↓ -96% |
| United Healthcare | Managed Medicaid | $43.92 | ↓ -96% |
| Amerihealth Caritas | Managed Medicaid | $43.92 | ↓ -96% |
| Healthy Blue | Managed Medicaid | $43.92 | ↓ -96% |
| Vaya | Managed Medicaid | $43.92 | ↓ -96% |
| Alliance | Managed Medicaid | $44.36 | ↓ -96% |
| Cigna Healthspring | Medicare Advantage | $48.90 | ↓ -96% |
| Humana | Medicare Advantage | $49.88 | ↓ -95% |
| Aetna | Medicare Advantage | $50.61 | ↓ -95% |
| United Healthcare | Medicare Advantage | $50.75 | ↓ -95% |
| Ortho Carolina | Commercial | $61.13 | ↓ -94% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $172.75 | ↓ -84% |
| Alliance | Behavioral Health | $337.67 | ↓ -69% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $349.02 | ↓ -68% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $468.20 | ↓ -57% |
| Aetna | Connected North Carolina Individual HMO | $578.43 | ↓ -47% |
| Ambetter | CoBranded Commercial | $650.68 | ↓ -40% |
| Ambetter | Individual Commercial | $792.34 | ↓ -27% |
| Aetna | Whole Health HMO | $866.55 | ↓ -21% |
| United Healthcare | IEX Commercial | $877.47 | ↓ -20% |
| Aetna | North Carolina Preferred Plus Commercial | $888.38 | ↓ -19% |
| Cigna | Commercial NB | $945.13 | ↓ -13% |
| Employers Health Network | Commercial | $964.78 | ↓ -12% |
| Aetna | Broad Network | $999.70 | ↓ -8% |
| United Healthcare | HMO-PPO Managed Care | $1,034.62 | ↓ -5% |
| Cigna | HMO-PPO Managed Care | $1,130.66 | ↑ +4% |
| MedCost | Ultra | $1,178.69 | ↑ +8% |
| Magellan | Behavioral Health | $1,309.65 | ↑ +20% |
| Aetna First Health | Commercial | $1,331.48 | ↑ +22% |
| GMMI | Commercial | $1,418.79 | ↑ +30% |
| Quik Trip | Commercial | $1,418.79 | ↑ +30% |
| MedCost | PPO | $1,418.79 | ↑ +30% |
| Cigna | Commercial SAR | $1,473.36 | ↑ +35% |
| Healthgram | Commercial | $1,746.20 | ↑ +60% |
| ChoiceCare | Commercial | $1,855.34 | ↑ +70% |
| First Health | Commercial | $1,855.34 | ↑ +70% |
| Private Health Care Systems | Commercial | $1,964.48 | ↑ +80% |
| Provider Select | Commercial | $1,964.48 | ↑ +80% |
| Beechstreet | Commercial | $1,964.48 | ↑ +80% |
| Multiplan | Commercial | $2,073.61 | ↑ +90% |
| Physician Reach Out | Plan P | not published by hospital | — |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $1,091.38 | $43.49 – $2,073.61 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $1,091.38 | $43.92 – $1,920.82 |
| Atrium Health Cabarrus | Concord | $1,091.38 | $43.49 – $2,073.61 |
| Atrium Health Cleveland | Shelby | $1,091.38 | $43.49 – $2,073.61 |
| Atrium Health Lincoln | Lincolnton | $1,091.38 | $43.49 – $2,073.61 |
| Atrium Health Mercy | Charlotte | $1,091.38 | $43.49 – $2,008.13 |
| Atrium Health Pineville | Charlotte | $1,091.38 | $43.49 – $2,008.13 |
| Atrium Health Stanly | Albermarle | $1,091.38 | $43.49 – $2,095.44 |