Dmd dup/delet analysis 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.
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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.
$125.55 with Wellpoint vs $1,116.00 with Humana — 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 |
|---|---|---|---|
| Wellpoint | MGMCD | $125.55 | — |
| BCBS | TENNCARE | $197.20 | — |
| BCBS | COVERKIDS | $213.25 | — |
| Aetna | COMM | $221.81 | — |
| Aetna | NewBusiness | $221.81 | — |
| HealthSpring | MCRPPO | $279.00 | — |
| Devoted Health Plan | MCR | $279.00 | — |
| Humana | ChoicecareMGMCR | $279.00 | — |
| HealthSpring | DualEligible | $279.00 | — |
| HealthSpring | MCRHMO | $279.00 | — |
| HealthSpring | MCRPOS | $279.00 | — |
| United | VACCN | $279.00 | — |
| United | AllPayerAppendix | $279.00 | — |
| United | CorePayer | $279.00 | — |
| United | HeritageSelect | $279.00 | — |
| Amerigroup | MGMCR | $279.00 | — |
| Bright Health | HIX | $279.00 | — |
| Bright Health | SmallGroup | $279.00 | — |
| BCBS | NetworkP | $279.00 | — |
| Sarah Cannon Research | COMM | $279.00 | — |
| Odyssey Healthcare | COMM | $279.00 | — |
| Aetna | MGMCRSNP | $281.79 | — |
| Aetna | MGMCRHMO | $281.79 | — |
| Aetna | MGMCRPPO | $281.79 | — |
| United | MGMCR | $284.58 | — |
| Zing | MGMCR | $287.37 | — |
| BCBS | MCR | $287.37 | — |
| WellCare | MCR | $287.37 | — |
| Ambetter | Select | $290.16 | — |
| American Health Advantage | MCRSNP | $292.95 | — |
| American Health Advantage | MCRPFFS | $292.95 | — |
| Evergreen HMO | MCR | $292.95 | — |
| American Health Advantage | MCRHMO | $292.95 | — |
| American Health Advantage | MCRPOS | $292.95 | — |
| American Health Advantage | MCRPPO | $292.95 | — |
| Signature Advantage | MCR | $295.74 | — |
| Ambetter | CORE | $301.32 | — |
| ATRIO Golden Times | MCR | $306.90 | — |
| Bright Health | MCRNarrow | $320.85 | — |
| BCBS | BlueCare | $331.34 | — |
| Prime Health | WORKERSCOMP | $401.76 | — |
| NovaNET | WORKERSCOMP | $410.13 | — |
| CorVel Corporation | WORKERSCOMP | $410.13 | — |
| Cigna | NewBusiness | $497.74 | — |
| Cigna | OAP | $565.27 | — |
| Oscar | HIX | $837.00 | — |
| Humana | NarrowExchangeNetwork | $1,116.00 | — |
| Humana | BroadNetwork | $1,116.00 | — |
| Humana | HumanaChoice | $1,116.00 | — |
| Humana | HumanaChoiceCare | $1,116.00 | — |
Visitor-reported prices
Comments
Dmd dup/delet analysis at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnson City Medical Center | JOHNSON CITY | $219.15 | $126.13 – $608.22 |
| Hancock County Hospital | SNEEDVILLE | $215.05 | $70.07 – $614.96 |
| Greeneville Community Hospital | GREENEVILLE | $219.15 | $50.45 – $608.22 |
| Bristol Regional Medical Center | BRISTOL | $219.15 | $84.08 – $669.60 |
| Franklin Woods Community Hospital | JOHNSON CITY | $219.15 | $126.13 – $608.22 |
| Holston Valley Medical Center | KINGSPORT | $219.15 | $84.08 – $669.60 |
| Indian Path Community Hospital | KINGSPORT | $219.15 | $126.13 – $669.60 |
| Hawkins County Memorial Hospital | ROGERSVILLE | $219.15 | $70.07 – $608.22 |