Biopsy of rectum wall anal approach 45100 at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$1,159.80
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.
$7,732.00
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.
$146.00 with UNITED HEALTHCARE vs $7,732.00 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $146.00 | ↓ -87% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $257.73 | ↓ -78% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $398.00 | ↓ -66% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $455.00 | ↓ -61% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $589.00 | ↓ -49% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $2,025.66 | ↑ +75% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $2,025.66 | ↑ +75% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $2,106.69 | ↑ +82% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $2,106.69 | ↑ +82% |
| SENTARA HEALTH | SENTARA HEALTH | $2,151.04 | ↑ +85% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $2,518.29 | ↑ +117% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $2,518.29 | ↑ +117% |
| SENTARA HEALTH | SENTARA MEDICARE | $2,518.29 | ↑ +117% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $2,518.29 | ↑ +117% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $2,518.29 | ↑ +117% |
| AETNA | AETNA HEALTHCARE MEDICARE | $2,518.29 | ↑ +117% |
| HUMANA | HUMANA MEDICARE | $2,518.29 | ↑ +117% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $2,518.29 | ↑ +117% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $2,518.29 | ↑ +117% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $2,593.83 | ↑ +124% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $2,619.02 | ↑ +126% |
| BLUE CROSS | BLUE CROSS MEDICARE | $2,619.02 | ↑ +126% |
| NHC ADVANTAGE | NHC ADVANTAGE | $2,644.20 | ↑ +128% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $2,644.20 | ↑ +128% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $2,644.20 | ↑ +128% |
| WELLCARE | WELLCARE MEDICARE | $2,669.38 | ↑ +130% |
| MEDCOST | MEDCOST VHN | $2,706.20 | ↑ +133% |
| AETNA | AETNA | $4,933.02 | ↑ +325% |
| AMBETTER | AMBETTER | $5,489.86 | ↑ +373% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $5,799.00 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $7,732.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $7,732.00 | ↑ +567% |
Visitor-reported prices
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Biopsy of rectum wall anal approach 45100 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 62-1166050 BMH Carroll County | Huntingdon | $765.67 | $2,178.59 – $5,008.26 |
| Johnson City Medical Center | JOHNSON CITY | $1,159.80 | $257.73 – $5,646.39 |
| Hancock County Hospital | SNEEDVILLE | $1,138.04 | $257.73 – $2,126.94 |
| Greeneville Community Hospital | GREENEVILLE | $1,159.80 | $257.73 – $5,646.39 |
| Bristol Regional Medical Center | BRISTOL | $1,159.80 | $257.73 – $6,319.52 |
| Franklin Woods Community Hospital | JOHNSON CITY | $1,159.80 | $257.73 – $5,493.94 |
| Holston Valley Medical Center | KINGSPORT | $1,159.80 | $257.73 – $6,319.52 |
| 62-0123940 BMH Collierville | Collierville | $772.38 | $832.24 – $5,022.42 |