Ins/rplc spi npg/rcvr pocket at Atrium Health Cleveland
201 E Grover St, Shelby, NC · Atrium Health · · NPI 1669348991
$7,784.10
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.
$15,568.20
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.
$291.68 with Trillium vs $14,789.79 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 | $291.68 | ↓ -96% |
| Wellcare | Managed Medicaid | $294.60 | ↓ -96% |
| Carolina Complete Health | Managed Medicaid | $294.60 | ↓ -96% |
| Vaya | Managed Medicaid | $294.60 | ↓ -96% |
| United Healthcare | Managed Medicaid | $294.60 | ↓ -96% |
| Partners | Managed Medicaid | $294.60 | ↓ -96% |
| Amerihealth Caritas | Managed Medicaid | $294.60 | ↓ -96% |
| Healthy Blue | Managed Medicaid | $294.60 | ↓ -96% |
| Alliance | Managed Medicaid | $297.51 | ↓ -96% |
| Cigna Healthspring | Medicare Advantage | $311.47 | ↓ -96% |
| Humana | Medicare Advantage | $317.70 | ↓ -96% |
| Aetna | Medicare Advantage | $322.37 | ↓ -96% |
| United Healthcare | Medicare Advantage | $323.26 | ↓ -96% |
| Alliance | Behavioral Health | $2,606.12 | ↓ -67% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $2,811.62 | ↓ -64% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $3,633.62 | ↓ -53% |
| Aetna | Connected North Carolina Individual HMO | $4,125.57 | ↓ -47% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $4,780.99 | ↓ -39% |
| Ambetter | CoBranded Commercial | $4,972.48 | ↓ -36% |
| Ambetter | Individual Commercial | $5,651.26 | ↓ -27% |
| Aetna | Whole Health HMO | $5,729.10 | ↓ -26% |
| United Healthcare | IEX Commercial | $6,258.42 | ↓ -20% |
| Cigna | Commercial NB | $6,741.03 | ↓ -13% |
| Employers Health Network | Commercial | $6,881.14 | ↓ -12% |
| Aetna | North Carolina Preferred Plus Commercial | $7,239.21 | ↓ -7% |
| Physician Reach Out | Plan P | $7,784.10 | ↑ +0% |
| Cigna | HMO-PPO Managed Care | $8,064.33 | ↑ +4% |
| Aetna | Broad Network | $8,157.74 | ↑ +5% |
| United Healthcare | HMO-PPO Managed Care | $8,313.42 | ↑ +7% |
| MedCost | Ultra | $8,687.06 | ↑ +12% |
| Magellan | Behavioral Health | $9,340.92 | ↑ +20% |
| Quik Trip | Commercial | $10,119.33 | ↑ +30% |
| GMMI | Commercial | $10,119.33 | ↑ +30% |
| MedCost | PPO | $10,321.72 | ↑ +33% |
| Cigna | Commercial SAR | $10,508.54 | ↑ +35% |
| Carolina Behavioral Health | Employee Plan | $11,209.10 | ↑ +44% |
| Aetna First Health | Commercial | $11,987.51 | ↑ +54% |
| Carolina Behavioral Health | Commercial | $12,454.56 | ↑ +60% |
| Healthgram | Commercial | $12,454.56 | ↑ +60% |
| Cigna | Behavioral Health | $12,454.56 | ↑ +60% |
| ChoiceCare | Commercial | $12,765.92 | ↑ +64% |
| First Health | Commercial | $13,232.97 | ↑ +70% |
| Lifesynch Community Choice Care | Behavioral Health | $13,232.97 | ↑ +70% |
| Private Health Care Systems | Commercial | $14,011.38 | ↑ +80% |
| Beechstreet | Commercial | $14,322.74 | ↑ +84% |
| Multiplan | Commercial | $14,789.79 | ↑ +90% |
| Physician Reach Out | Plan H | not published by hospital | — |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Ins/rplc spi npg/rcvr pocket at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $7,784.10 | $291.68 – $14,789.79 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $7,784.10 | $294.60 – $13,700.02 |
| Atrium Health Cabarrus | Concord | $7,784.10 | $291.68 – $14,789.79 |
| Atrium Health Lincoln | Lincolnton | $7,784.10 | $291.68 – $14,789.79 |
| Atrium Health Mercy | Charlotte | $7,784.10 | $291.68 – $14,322.74 |
| Atrium Health Pineville | Charlotte | $7,784.10 | $291.68 – $14,322.74 |
| Atrium Health Stanly | Albermarle | $7,784.10 | $291.68 – $14,945.47 |
| Atrium Health Union | Monroe | $7,784.10 | $291.68 – $14,789.79 |