Aco cont gluc mnt phys/qhp eqp 95250aco at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$94.35
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.
$629.00
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.
$47.63 with BLUE CROSS vs $629.00 with SEVEN CORNERS, INC. — 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 |
|---|---|---|---|
| BLUE CROSS | TENNCARE BLUE SELECT | $47.63 | ↓ -50% |
| BLUE CROSS | TENNCARE BLUE CARE | $47.63 | ↓ -50% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $52.50 | ↓ -44% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $80.82 | ↓ -14% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $80.82 | ↓ -14% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $84.05 | ↓ -11% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $84.05 | ↓ -11% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $95.00 | ↑ +1% |
| AMERIGROUP | AMERIGROUP | $105.00 | ↑ +11% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $110.00 | ↑ +17% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $117.37 | ↑ +24% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $120.79 | ↑ +28% |
| HUMANA | HUMANA MEDICARE | $120.79 | ↑ +28% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $120.79 | ↑ +28% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $120.79 | ↑ +28% |
| SENTARA HEALTH | SENTARA MEDICARE | $120.79 | ↑ +28% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $120.79 | ↑ +28% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $120.79 | ↑ +28% |
| AETNA | AETNA HEALTHCARE MEDICARE | $120.79 | ↑ +28% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $120.79 | ↑ +28% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $124.41 | ↑ +32% |
| BLUE CROSS | BLUE CROSS MEDICARE | $125.62 | ↑ +33% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $125.62 | ↑ +33% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $126.83 | ↑ +34% |
| NHC ADVANTAGE | NHC ADVANTAGE | $126.83 | ↑ +34% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $126.83 | ↑ +34% |
| WELLCARE | WELLCARE MEDICARE | $128.04 | ↑ +36% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $141.00 | ↑ +49% |
| SENTARA HEALTH | SENTARA HEALTH | $174.99 | ↑ +85% |
| MEDCOST | MEDCOST VHN | $220.15 | ↑ +133% |
| AMBETTER | AMBETTER | $263.32 | ↑ +179% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $291.86 | ↑ +209% |
| AETNA | AETNA | $401.30 | ↑ +325% |
| CIGNA HEALTHCARE | CIGNA PPO | $439.26 | ↑ +366% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $439.26 | ↑ +366% |
| CIGNA HEALTHCARE | CIGNA HMO | $439.26 | ↑ +366% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $471.75 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $629.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS S NETWORK | $629.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS P NETWORK | $629.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS E NETWORK | $629.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $629.00 | ↑ +567% |
Visitor-reported prices
Comments
Aco cont gluc mnt phys/qhp eqp 95250aco at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnson City Medical Center | JOHNSON CITY | $94.35 | $47.63 – $270.83 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $273.98 | $41.06 – $324.51 |
| Greeneville Community Hospital | GREENEVILLE | $94.35 | $46.95 – $270.83 |
| Bristol Regional Medical Center | BRISTOL | $94.35 | $47.63 – $303.12 |
| Franklin Woods Community Hospital | JOHNSON CITY | $94.35 | $52.50 – $263.52 |
| Holston Valley Medical Center | KINGSPORT | $94.35 | $47.63 – $303.12 |
| Indian Path Community Hospital | KINGSPORT | $94.35 | $47.63 – $289.90 |
| Hawkins County Memorial Hospital | ROGERSVILLE | $94.35 | $47.63 – $263.32 |