Surgical pathology level 5 gross & microscopic examination 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.
$38.18 with BCBS vs $622.12 with Beech Street — 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 |
|---|---|---|---|
| BCBS | TENNCARE | $38.18 | — |
| BCBS | COVERKIDS | $41.29 | — |
| BCBS | BlueCare | $64.16 | — |
| Bright Health | HIX | $120.18 | — |
| Oscar | HIX | $129.37 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $130.15 | — |
| Apex Health | MCR | $134.32 | — |
| NHC Advantage, Inc. | MCRHMO | $134.32 | — |
| Pruitt Health (AllyAlign) | MCR | $134.32 | — |
| Ambetter | CORE | $157.65 | — |
| Ambetter | Select | $164.01 | — |
| Bright Health | SmallGroup | $169.67 | — |
| Humana | TRICARE | $176.74 | — |
| BCBS | NetworkP | $183.23 | — |
| Aetna | COMM | $209.74 | — |
| Aetna | NewBusiness | $209.74 | — |
| United | OptionsPPO | $209.96 | — |
| Cigna | PPO | $230.47 | — |
| United | HeritageSelect | $291.26 | — |
| United | AllPayerAppendix | $291.26 | — |
| Centurion | PRISON | $291.26 | — |
| United | CorePayer | $291.26 | — |
| Humana | NarrowExchangeNetwork | $315.44 | — |
| Humana | BroadNetwork | $315.44 | — |
| Humana | HumanaChoice | $315.44 | — |
| Humana | HumanaChoiceCare | $315.44 | — |
| United | GlobalBenefitPlan | $318.13 | — |
| BGFH SingleSource | DIRECTNETWORK | $353.48 | — |
| Aetna | NAP | $353.48 | — |
| Cigna | NewBusiness | $358.42 | — |
| Cigna | OAP | $407.05 | — |
| Multiplan | COMM | $410.03 | — |
| Employers Health Network | COMM | $494.87 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $530.21 | — |
| BGFH SingleSource | LEASEDNETWORK | $600.91 | — |
| Prime Health | COMMPPO | $622.12 | — |
| Beech Street | COMM | $622.12 | — |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $161.76 | $22.20 – $570.20 |
| CHI Memorial Hospital Hixson | Hixson | $294.82 | $33.04 – $697.20 |
| 62-1166050 BMH Carroll County | Huntingdon | $115.23 | $22.20 – $656.94 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $421.31 | $33.04 – $697.20 |
| Johnson City Medical Center | JOHNSON CITY | $235.20 | $34.65 – $729.17 |
| Ascension Saint Thomas DeKalb | Smithville | $161.76 | $22.20 – $570.20 |
| Ascension Saint Thomas Highlands | Sparta | $161.76 | $22.20 – $570.20 |
| Ascension Saint Thomas River Park | McMinnville | $161.76 | $28.54 – $570.20 |