Biopsy of salivary gland 42400 at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$300.45
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.
$2,003.00
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.
$529.06 with AMERIGROUP vs $2,003.00 with WELLCARE — 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 |
|---|---|---|---|
| AMERIGROUP | AMERIGROUP | $529.06 | ↑ +76% |
| SENTARA HEALTH | SENTARA HEALTH | $557.23 | ↑ +85% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $642.47 | ↑ +114% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $642.47 | ↑ +114% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $642.47 | ↑ +114% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $642.47 | ↑ +114% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $642.47 | ↑ +114% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $642.47 | ↑ +114% |
| AETNA | AETNA HEALTHCARE MEDICARE | $642.47 | ↑ +114% |
| HUMANA | HUMANA MEDICARE | $642.47 | ↑ +114% |
| SENTARA HEALTH | SENTARA MEDICARE | $642.47 | ↑ +114% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $661.74 | ↑ +120% |
| BLUE CROSS | BLUE CROSS MEDICARE | $668.17 | ↑ +122% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $668.17 | ↑ +122% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $674.59 | ↑ +125% |
| NHC ADVANTAGE | NHC ADVANTAGE | $674.59 | ↑ +125% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $674.59 | ↑ +125% |
| WELLCARE | WELLCARE MEDICARE | $681.02 | ↑ +127% |
| MEDCOST | MEDCOST VHN | $701.05 | ↑ +133% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $704.00 | ↑ +134% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $758.00 | ↑ +152% |
| BLUE CROSS | TENNCARE BLUE CARE | $775.00 | ↑ +158% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $1,054.00 | ↑ +251% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $1,204.00 | ↑ +301% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $1,266.00 | ↑ +321% |
| CIGNA HEALTHCARE | CIGNA HMO | $1,266.00 | ↑ +321% |
| AETNA | AETNA | $1,277.91 | ↑ +325% |
| AMBETTER | AMBETTER | $1,400.59 | ↑ +366% |
| CIGNA HEALTHCARE | CIGNA PPO | $1,406.00 | ↑ +368% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $1,463.00 | ↑ +387% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,502.25 | ↑ +400% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $1,560.00 | ↑ +419% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $1,728.42 | ↑ +475% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $1,728.42 | ↑ +475% |
| BLUE CROSS | BLUE CROSS E NETWORK | $1,770.00 | ↑ +489% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $1,797.55 | ↑ +498% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $1,797.56 | ↑ +498% |
| BLUE CROSS | BLUE CROSS S NETWORK | $1,807.00 | ↑ +501% |
| BLUE CROSS | BLUE CROSS P NETWORK | $1,807.00 | ↑ +501% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $2,003.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $2,003.00 | ↑ +567% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $1,281.51 | $606.45 – $1,141.72 |
| CHI Memorial Hospital Hixson | Hixson | $148.00 | $100.00 – $350.00 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $211.50 | $105.00 – $350.00 |
| Johnson City Medical Center | JOHNSON CITY | $300.45 | $544.15 – $1,592.82 |
| Ascension Saint Thomas River Park | McMinnville | $996.54 | $243.67 – $1,004.50 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $1,281.51 | $606.45 – $1,217.22 |
| Greeneville Community Hospital | GREENEVILLE | $300.45 | $486.59 – $1,728.42 |
| Bristol Regional Medical Center | BRISTOL | $300.45 | $671.77 – $1,620.88 |