Adh-sendout at SOUTHERN HILLS MEDICAL CENTER
2127 CENTURY FARMS PKWY, ANTIOCH, TN · Tristarhealth · · NPI 1720032345
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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$15.27 with Wellpoint vs $1,320.48 with Beech Street — 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 |
|---|---|---|---|
| Wellpoint | MGMCD | $15.27 | — |
| Aetna | NewBusiness | $26.99 | — |
| Aetna | COMM | $26.99 | — |
| Humana | ChoicecareMGMCR | $33.94 | — |
| Devoted Health Plan | MCR | $33.94 | — |
| Bright Health | SmallGroup | $33.94 | — |
| Bright Health | HIX | $33.94 | — |
| HealthSpring | DualEligible | $33.94 | — |
| HealthSpring | MCRHMO | $33.94 | — |
| HealthSpring | MCRPOS | $33.94 | — |
| HealthSpring | MCRPPO | $33.94 | — |
| United | CorePayer | $33.94 | — |
| Odyssey Healthcare | COMM | $33.94 | — |
| Sarah Cannon Research | COMM | $33.94 | — |
| Amerigroup | MGMCR | $33.94 | — |
| United | VACCN | $33.94 | — |
| United | AllPayerAppendix | $33.94 | — |
| United | HeritageSelect | $33.94 | — |
| Aetna | MGMCRPPO | $34.28 | — |
| Aetna | MGMCRSNP | $34.28 | — |
| Aetna | MGMCRHMO | $34.28 | — |
| United | MGMCR | $34.62 | — |
| Zing | MGMCR | $34.96 | — |
| WellCare | MCR | $34.96 | — |
| BCBS | MCR | $34.96 | — |
| Ambetter | Select | $35.30 | — |
| Evergreen HMO | MCR | $35.64 | — |
| American Health Advantage | MCRHMO | $35.64 | — |
| American Health Advantage | MCRPOS | $35.64 | — |
| American Health Advantage | MCRPPO | $35.64 | — |
| American Health Advantage | MCRSNP | $35.64 | — |
| American Health Advantage | MCRPFFS | $35.64 | — |
| Signature Advantage | MCR | $35.98 | — |
| Ambetter | CORE | $36.65 | — |
| ATRIO Golden Times | MCR | $37.33 | — |
| Bright Health | MCRNarrow | $39.03 | — |
| BCBS | NetworkP | $46.31 | — |
| Prime Health | WORKERSCOMP | $48.87 | — |
| CorVel Corporation | WORKERSCOMP | $49.89 | — |
| NovaNET | WORKERSCOMP | $49.89 | — |
| Cigna | NewBusiness | $60.56 | — |
| Cigna | OAP | $68.77 | — |
| Oscar | HIX | $101.82 | — |
| BCBS | TENNCARE | $114.66 | — |
| BCBS | COVERKIDS | $123.99 | — |
| Humana | HumanaChoice | $135.76 | — |
| Humana | NarrowExchangeNetwork | $135.76 | — |
| Humana | HumanaChoiceCare | $135.76 | — |
| Humana | BroadNetwork | $135.76 | — |
| BCBS | BlueCare | $192.65 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $276.25 | — |
| Apex Health | MCR | $285.10 | — |
| Pruitt Health (AllyAlign) | MCR | $285.10 | — |
| NHC Advantage, Inc. | MCRHMO | $285.10 | — |
| Humana | TRICARE | $375.14 | — |
| United | OptionsPPO | $445.66 | — |
| Cigna | PPO | $489.18 | — |
| Centurion | PRISON | $618.23 | — |
| United | GlobalBenefitPlan | $675.25 | — |
| Aetna | NAP | $750.27 | — |
| BGFH SingleSource | DIRECTNETWORK | $750.27 | — |
| Multiplan | COMM | $870.32 | — |
| Employers Health Network | COMM | $1,050.38 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $1,125.41 | — |
| BGFH SingleSource | LEASEDNETWORK | $1,275.47 | — |
| Prime Health | COMMPPO | $1,320.48 | — |
| Beech Street | COMM | $1,320.48 | — |
Visitor-reported prices
Comments
Adh-sendout at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $109.16 | $12.22 – $130.95 |
| CHI Memorial Hospital Hixson | Hixson | $47.36 | $30.15 – $112.00 |
| 62-1166050 BMH Carroll County | Huntingdon | $65.09 | $29.53 – $67.88 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $67.68 | $30.15 – $112.00 |
| Johnson City Medical Center | JOHNSON CITY | $30.75 | $16.97 – $73.99 |
| Ascension Saint Thomas DeKalb | Smithville | $109.16 | $23.80 – $130.95 |
| Ascension Saint Thomas Highlands | Sparta | $109.16 | $23.80 – $130.95 |
| Ascension Saint Thomas River Park | McMinnville | $109.16 | $23.80 – $130.95 |