Pt evaluation moderate complexity patient/family at Atrium Health Cleveland
201 E Grover St, Shelby, NC · Atrium Health · · NPI 1669348991
$303.15
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.
?
What you pay up front if you don't use insurance.
$606.30
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.
?
The hospital's undiscounted list price — almost no one pays this.
$67.46 with Trillium vs $575.99 with Multiplan — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | ↓ -78% |
| Wellcare | Managed Medicaid | $68.13 | ↓ -78% |
| Partners | Managed Medicaid | $68.13 | ↓ -78% |
| United Healthcare | Managed Medicaid | $68.13 | ↓ -78% |
| Amerihealth Caritas | Managed Medicaid | $68.13 | ↓ -78% |
| Healthy Blue | Managed Medicaid | $68.13 | ↓ -78% |
| Carolina Complete Health | Managed Medicaid | $68.13 | ↓ -78% |
| Vaya | Managed Medicaid | $68.13 | ↓ -78% |
| Alliance | Managed Medicaid | $68.81 | ↓ -77% |
| Cigna Healthspring | Medicare Advantage | $94.11 | ↓ -69% |
| Humana | Medicare Advantage | $95.99 | ↓ -68% |
| Aetna | Medicare Advantage | $97.40 | ↓ -68% |
| United Healthcare | Medicare Advantage | $97.67 | ↓ -68% |
| Alliance | Behavioral Health | $101.49 | ↓ -67% |
| Aetna | Connected North Carolina Individual HMO | $160.67 | ↓ -47% |
| Blue Cross Blue Shield of North Carolina | Local Individual Commercial | $188.44 | ↓ -38% |
| Blue Cross Blue Shield of North Carolina | Local Group Commercial | $188.74 | ↓ -38% |
| Ambetter | CoBranded Commercial | $193.65 | ↓ -36% |
| Ambetter | Individual Commercial | $220.09 | ↓ -27% |
| Aetna | Whole Health HMO | $223.12 | ↓ -26% |
| United Healthcare | IEX Commercial | $243.73 | ↓ -20% |
| Blue Cross Blue Shield of North Carolina | HMO-PPO Managed Care | $248.34 | ↓ -18% |
| Cigna | Commercial NB | $262.53 | ↓ -13% |
| Employers Health Network | Commercial | $267.98 | ↓ -12% |
| Aetna | North Carolina Preferred Plus Commercial | $281.93 | ↓ -7% |
| Physician Reach Out | Plan P | $303.15 | ↑ +0% |
| Cigna | HMO-PPO Managed Care | $314.06 | ↑ +4% |
| Aetna | Broad Network | $317.70 | ↑ +5% |
| United Healthcare | HMO-PPO Managed Care | $323.76 | ↑ +7% |
| MedCost | Ultra | $338.32 | ↑ +12% |
| Magellan | Behavioral Health | $363.78 | ↑ +20% |
| Quik Trip | Commercial | $394.10 | ↑ +30% |
| GMMI | Commercial | $394.10 | ↑ +30% |
| MedCost | PPO | $401.98 | ↑ +33% |
| Cigna | Commercial SAR | $409.25 | ↑ +35% |
| Carolina Behavioral Health | Employee Plan | $436.54 | ↑ +44% |
| Aetna First Health | Commercial | $466.85 | ↑ +54% |
| Cigna | Behavioral Health | $485.04 | ↑ +60% |
| Carolina Behavioral Health | Commercial | $485.04 | ↑ +60% |
| Healthgram | Commercial | $485.04 | ↑ +60% |
| ChoiceCare | Commercial | $497.17 | ↑ +64% |
| Lifesynch Community Choice Care | Behavioral Health | $515.36 | ↑ +70% |
| First Health | Commercial | $515.36 | ↑ +70% |
| Private Health Care Systems | Commercial | $545.67 | ↑ +80% |
| Beechstreet | Commercial | $557.80 | ↑ +84% |
| Multiplan | Commercial | $575.99 | ↑ +90% |
| Broughton Cardinal Partners | Commercial | not published by hospital | — |
| Physician Reach Out | Plan H | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other North-carolina hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Atrium Health Anson | Wadesboro | $303.15 | $67.46 – $575.99 |
| Atrium Health Behavioral Health Charlotte | Charlotte | $303.15 | $68.13 – $533.54 |
| Atrium Health Cabarrus | Concord | $303.15 | $67.46 – $575.99 |
| Atrium Health Lincoln | Lincolnton | $303.15 | $67.46 – $575.99 |
| Atrium Health Mercy | Charlotte | $303.15 | $52.45 – $557.80 |
| Atrium Health Pineville | Charlotte | $303.15 | $60.63 – $557.80 |
| Atrium Health Stanly | Albermarle | $303.15 | $67.46 – $582.05 |
| Atrium Health Union | Monroe | $303.15 | $67.46 – $575.99 |