Pt evaluation high complexity patient/family at Atrium Health Cleveland
201 E Grover St, Shelby, NC · Atrium Health · · NPI 1669348991
$404.15
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.
$808.30
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.
$67.46 with Trillium vs $767.89 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 | $67.46 | ↓ -83% |
| Wellcare | Managed Medicaid | $68.13 | ↓ -83% |
| Partners | Managed Medicaid | $68.13 | ↓ -83% |
| United Healthcare | Managed Medicaid | $68.13 | ↓ -83% |
| Amerihealth Caritas | Managed Medicaid | $68.13 | ↓ -83% |
| Healthy Blue | Managed Medicaid | $68.13 | ↓ -83% |
| Carolina Complete Health | Managed Medicaid | $68.13 | ↓ -83% |
| Vaya | Managed Medicaid | $68.13 | ↓ -83% |
| Alliance | Managed Medicaid | $68.81 | ↓ -83% |
| Cigna Healthspring | Medicare Advantage | $94.11 | ↓ -77% |
| Humana | Medicare Advantage | $95.99 | ↓ -76% |
| Aetna | Medicare Advantage | $97.40 | ↓ -76% |
| United Healthcare | Medicare Advantage | $97.67 | ↓ -76% |
| Alliance | Behavioral Health | $135.31 | ↓ -67% |
| Aetna | Connected North Carolina Individual HMO | $214.20 | ↓ -47% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $251.22 | ↓ -38% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $251.62 | ↓ -38% |
| Ambetter | CoBranded Commercial | $258.17 | ↓ -36% |
| Ambetter | Individual Commercial | $293.41 | ↓ -27% |
| Aetna | Whole Health HMO | $297.45 | ↓ -26% |
| United Healthcare | IEX Commercial | $324.94 | ↓ -20% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $331.08 | ↓ -18% |
| Cigna | Commercial NB | $349.99 | ↓ -13% |
| Employers Health Network | Commercial | $357.27 | ↓ -12% |
| Aetna | North Carolina Preferred Plus Commercial | $375.86 | ↓ -7% |
| Physician Reach Out | Plan P | $404.15 | ↑ +0% |
| Cigna | HMO-PPO Managed Care | $418.70 | ↑ +4% |
| Aetna | Broad Network | $423.55 | ↑ +5% |
| United Healthcare | HMO-PPO Managed Care | $431.63 | ↑ +7% |
| MedCost | Ultra | $451.03 | ↑ +12% |
| Magellan | Behavioral Health | $484.98 | ↑ +20% |
| Quik Trip | Commercial | $525.40 | ↑ +30% |
| GMMI | Commercial | $525.40 | ↑ +30% |
| MedCost | PPO | $535.90 | ↑ +33% |
| Cigna | Commercial SAR | $545.60 | ↑ +35% |
| Carolina Behavioral Health | Employee Plan | $581.98 | ↑ +44% |
| Aetna First Health | Commercial | $622.39 | ↑ +54% |
| Cigna | Behavioral Health | $646.64 | ↑ +60% |
| Carolina Behavioral Health | Commercial | $646.64 | ↑ +60% |
| Healthgram | Commercial | $646.64 | ↑ +60% |
| ChoiceCare | Commercial | $662.81 | ↑ +64% |
| Lifesynch Community Choice Care | Behavioral Health | $687.06 | ↑ +70% |
| First Health | Commercial | $687.06 | ↑ +70% |
| Private Health Care Systems | Commercial | $727.47 | ↑ +80% |
| Beechstreet | Commercial | $743.64 | ↑ +84% |
| Multiplan | Commercial | $767.89 | ↑ +90% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation high complexity patient/family at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $404.15 | $67.46 – $767.89 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $404.15 | $68.13 – $711.30 |
| Atrium Health Cabarrus | Concord | $404.15 | $67.46 – $767.89 |
| Atrium Health Lincoln | Lincolnton | $404.15 | $67.46 – $767.89 |
| Atrium Health Mercy | Charlotte | $404.15 | $52.45 – $743.64 |
| Atrium Health Pineville | Charlotte | $404.15 | $67.46 – $743.64 |
| Atrium Health Stanly | Albermarle | $404.15 | $67.46 – $775.97 |
| Atrium Health Union | Monroe | $404.15 | $67.46 – $767.89 |