Off/op cnsltj new/est mod 40 at Atrium Health Cleveland
201 E Grover St, Shelby, NC · Atrium Health · · NPI 1669348991
not published by hospital
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.
not published by hospital
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.
$148.71 with Trillium vs $560.62 with Aetna First Health — 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 | $148.71 | — |
| Wellcare | Managed Medicaid | $150.20 | — |
| United Healthcare | Managed Medicaid | $150.20 | — |
| Amerihealth Caritas | Managed Medicaid | $150.20 | — |
| Healthy Blue | Managed Medicaid | $150.20 | — |
| Carolina Complete Health | Managed Medicaid | $150.20 | — |
| Vaya | Managed Medicaid | $150.20 | — |
| Partners | Managed Medicaid | $150.20 | — |
| Alliance | Managed Medicaid | $151.68 | — |
| Humana | Medicare Advantage | $152.14 | — |
| Aetna | Medicare Advantage | $154.38 | — |
| Cigna Healthspring | Medicare Advantage | $156.62 | — |
| United Healthcare | Medicare Advantage | $157.08 | — |
| United Healthcare | IEX Commercial | $231.98 | — |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $258.34 | — |
| ChoiceCare | Commercial | $272.98 | — |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $272.98 | — |
| United Healthcare | HMO-PPO Managed Care | $301.80 | — |
| MedCost | PPO | $322.91 | — |
| MedCost | Ultra | $322.91 | — |
| Aetna | Whole Health HMO | $331.63 | — |
| Aetna | North Carolina Preferred Plus Commercial | $333.37 | — |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $339.91 | — |
| Aetna | Broad Network | $368.28 | — |
| Aetna First Health | Commercial | $560.62 | — |
Visitor-reported prices
Comments
Off/op cnsltj new/est mod 40 at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | not published | $148.71 – $560.62 |
| Atrium Health Behavioral Health Charlotte | Charlotte | not published | $124.91 – $409.88 |
| Atrium Health Cabarrus | Concord | not published | $148.71 – $560.62 |
| Atrium Health Lincoln | Lincolnton | not published | $148.71 – $560.62 |
| Atrium Health Mercy | Charlotte | not published | $148.71 – $560.62 |
| Atrium Health Pineville | Charlotte | not published | $148.71 – $560.62 |
| Atrium Health Stanly | Albermarle | not published | $148.71 – $560.62 |
| Atrium Health Union | Monroe | not published | $148.71 – $560.62 |