Bld prd mix at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$91.65
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.
$611.00
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.
$18.62 with BLUE CROSS vs $611.00 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 |
|---|---|---|---|
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $18.62 | ↓ -80% |
| BLUE CROSS | TENNCARE BLUE SELECT | $21.96 | ↓ -76% |
| BLUE CROSS | TENNCARE BLUE CARE | $21.96 | ↓ -76% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $22.38 | ↓ -76% |
| AMERIGROUP | AMERIGROUP | $57.36 | ↓ -37% |
| CIGNA HEALTHCARE | CIGNA PPO | $60.64 | ↓ -34% |
| CIGNA HEALTHCARE | CIGNA HMO | $60.64 | ↓ -34% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $60.64 | ↓ -34% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $67.85 | ↓ -26% |
| BLUE CROSS | BLUE CROSS E NETWORK | $84.21 | ↓ -8% |
| BLUE CROSS | BLUE CROSS P NETWORK | $85.86 | ↓ -6% |
| BLUE CROSS | BLUE CROSS S NETWORK | $85.86 | ↓ -6% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $118.38 | ↑ +29% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $118.38 | ↑ +29% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $123.11 | ↑ +34% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $123.12 | ↑ +34% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $143.50 | ↑ +57% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $143.50 | ↑ +57% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $143.50 | ↑ +57% |
| AETNA | AETNA HEALTHCARE MEDICARE | $154.57 | ↑ +69% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $154.57 | ↑ +69% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $154.57 | ↑ +69% |
| HUMANA | HUMANA MEDICARE | $154.57 | ↑ +69% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $154.57 | ↑ +69% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $154.57 | ↑ +69% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $154.57 | ↑ +69% |
| SENTARA HEALTH | SENTARA MEDICARE | $154.57 | ↑ +69% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $154.57 | ↑ +69% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $159.21 | ↑ +74% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $160.76 | ↑ +75% |
| BLUE CROSS | BLUE CROSS MEDICARE | $160.76 | ↑ +75% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $162.30 | ↑ +77% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $162.30 | ↑ +77% |
| NHC ADVANTAGE | NHC ADVANTAGE | $162.30 | ↑ +77% |
| WELLCARE | WELLCARE MEDICARE | $163.85 | ↑ +79% |
| SENTARA HEALTH | SENTARA HEALTH | $169.98 | ↑ +85% |
| MEDCOST | MEDCOST VHN | $213.85 | ↑ +133% |
| AMBETTER | AMBETTER | $336.97 | ↑ +268% |
| AETNA | AETNA | $389.82 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $458.25 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $611.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $611.00 | ↑ +567% |
Visitor-reported prices
Comments
Bld prd mix at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $79.34 | $18.93 – $229.75 |
| CHI Memorial Hospital Hixson | Hixson | $245.98 | $28.17 – $581.70 |
| 62-1166050 BMH Carroll County | Huntingdon | $21.62 | $18.93 – $312.94 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $351.52 | $28.17 – $581.70 |
| Johnson City Medical Center | JOHNSON CITY | $91.65 | $18.62 – $346.58 |
| Ascension Saint Thomas DeKalb | Smithville | $79.34 | $12.32 – $226.45 |
| Ascension Saint Thomas Highlands | Sparta | $101.01 | $12.32 – $226.45 |
| Ascension Saint Thomas River Park | McMinnville | $101.01 | $12.32 – $226.45 |