Control oropharyngeal hemorr/simp 42960 at Atrium Health Cleveland
201 E Grover St, Shelby, NC · Atrium Health · · NPI 1669348991
$308.60
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.
$617.20
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.
$86.41 with Partners vs $586.34 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 | $86.41 | ↓ -72% |
| Amerihealth Caritas | Managed Medicaid | $87.09 | ↓ -72% |
| Carolina Complete Health | Managed Medicaid | $88.75 | ↓ -71% |
| Wellcare | Managed Medicaid | $88.75 | ↓ -71% |
| Healthy Blue | Managed Medicaid | $88.75 | ↓ -71% |
| Vaya | Managed Medicaid | $89.62 | ↓ -71% |
| Trillium | Managed Medicaid | $91.41 | ↓ -70% |
| Alliance | Managed Medicaid | $91.59 | ↓ -70% |
| Alliance | Behavioral Health | $103.32 | ↓ -67% |
| United Healthcare | Managed Medicaid | $126.60 | ↓ -59% |
| Cigna Healthspring | Medicare Advantage | $149.51 | ↓ -52% |
| Humana | Medicare Advantage | $152.50 | ↓ -51% |
| Aetna | Medicare Advantage | $154.74 | ↓ -50% |
| United Healthcare | Medicare Advantage | $155.17 | ↓ -50% |
| Aetna | Connected North Carolina Individual HMO | $163.56 | ↓ -47% |
| Ambetter | CoBranded Commercial | $197.13 | ↓ -36% |
| United Healthcare | IEX Commercial | $199.36 | ↓ -35% |
| Ambetter | Individual Commercial | $224.04 | ↓ -27% |
| Aetna | Whole Health HMO | $227.13 | ↓ -26% |
| Cigna | Commercial NB | $267.25 | ↓ -13% |
| Employers Health Network | Commercial | $272.80 | ↓ -12% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $286.26 | ↓ -7% |
| Aetna | North Carolina Preferred Plus Commercial | $287.00 | ↓ -7% |
| Physician Reach Out | Plan P | $308.60 | ↑ +0% |
| Aetna | Broad Network | $323.41 | ↑ +5% |
| United Healthcare | HMO-PPO Managed Care | $329.58 | ↑ +7% |
| MedCost | Ultra | $344.40 | ↑ +12% |
| Cigna | HMO-PPO Managed Care | $348.72 | ↑ +13% |
| Magellan | Behavioral Health | $370.32 | ↑ +20% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $376.68 | ↑ +22% |
| Quik Trip | Commercial | $401.18 | ↑ +30% |
| GMMI | Commercial | $401.18 | ↑ +30% |
| MedCost | PPO | $409.20 | ↑ +33% |
| Cigna | Commercial SAR | $416.61 | ↑ +35% |
| Carolina Behavioral Health | Employee Plan | $444.38 | ↑ +44% |
| Aetna First Health | Commercial | $475.24 | ↑ +54% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $482.34 | ↑ +56% |
| Carolina Behavioral Health | Commercial | $493.76 | ↑ +60% |
| Cigna | Behavioral Health | $493.76 | ↑ +60% |
| Healthgram | Commercial | $493.76 | ↑ +60% |
| ChoiceCare | Commercial | $506.10 | ↑ +64% |
| Lifesynch Community Choice Care | Behavioral Health | $524.62 | ↑ +70% |
| First Health | Commercial | $524.62 | ↑ +70% |
| Private Health Care Systems | Commercial | $555.48 | ↑ +80% |
| Beechstreet | Commercial | $567.82 | ↑ +84% |
| Multiplan | Commercial | $586.34 | ↑ +90% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Control oropharyngeal hemorr/simp 42960 at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $308.60 | $92.33 – $586.34 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $308.60 | $115.42 – $543.14 |
| Atrium Health Cabarrus | Concord | $308.60 | $75.73 – $586.34 |
| Atrium Health Lincoln | Lincolnton | $308.60 | $69.62 – $586.34 |
| Atrium Health Mercy | Charlotte | $308.60 | $75.38 – $567.82 |
| Atrium Health Pineville | Charlotte | $308.60 | $61.72 – $567.82 |
| Atrium Health Stanly | Albermarle | $308.60 | $74.06 – $592.51 |
| Atrium Health Union | Monroe | $308.60 | $80.24 – $586.34 |