Breast punct aspir cyst, bil at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$282.00
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.
$1,880.00
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.
$23.55 with BLUE CROSS vs $1,880.00 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 | TENNCARE BLUE SELECT | $23.55 | ↓ -92% |
| BLUE CROSS | TENNCARE BLUE CARE | $23.55 | ↓ -92% |
| SENTARA HEALTH | SENTARA HEALTH | $523.02 | ↑ +85% |
| AMERIGROUP | AMERIGROUP | $529.06 | ↑ +88% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $642.47 | ↑ +128% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $642.47 | ↑ +128% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $642.47 | ↑ +128% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $642.47 | ↑ +128% |
| AETNA | AETNA HEALTHCARE MEDICARE | $642.47 | ↑ +128% |
| HUMANA | HUMANA MEDICARE | $642.47 | ↑ +128% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $642.47 | ↑ +128% |
| SENTARA HEALTH | SENTARA MEDICARE | $642.47 | ↑ +128% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $642.47 | ↑ +128% |
| MEDCOST | MEDCOST VHN | $658.00 | ↑ +133% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $661.74 | ↑ +135% |
| BLUE CROSS | BLUE CROSS MEDICARE | $668.17 | ↑ +137% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $668.17 | ↑ +137% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $674.59 | ↑ +139% |
| NHC ADVANTAGE | NHC ADVANTAGE | $674.59 | ↑ +139% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $674.59 | ↑ +139% |
| WELLCARE | WELLCARE MEDICARE | $681.02 | ↑ +141% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $758.00 | ↑ +169% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $948.00 | ↑ +236% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $1,054.00 | ↑ +274% |
| AETNA | AETNA | $1,199.44 | ↑ +325% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $1,204.00 | ↑ +327% |
| CIGNA HEALTHCARE | CIGNA HMO | $1,266.00 | ↑ +349% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $1,266.00 | ↑ +349% |
| AMBETTER | AMBETTER | $1,400.59 | ↑ +397% |
| CIGNA HEALTHCARE | CIGNA PPO | $1,406.00 | ↑ +399% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,410.00 | ↑ +400% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $1,463.00 | ↑ +419% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $1,560.00 | ↑ +453% |
| BLUE CROSS | BLUE CROSS E NETWORK | $1,770.00 | ↑ +528% |
| BLUE CROSS | BLUE CROSS S NETWORK | $1,807.00 | ↑ +541% |
| BLUE CROSS | BLUE CROSS P NETWORK | $1,807.00 | ↑ +541% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,880.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $1,880.00 | ↑ +567% |
Visitor-reported prices
Comments
Breast punct aspir cyst, bil at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $690.03 | $20.30 – $998.50 |
| Johnson City Medical Center | JOHNSON CITY | $282.00 | $23.55 – $1,440.52 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $690.03 | $20.30 – $1,004.50 |
| Greeneville Community Hospital | GREENEVILLE | $282.00 | $23.55 – $1,440.52 |
| Bristol Regional Medical Center | BRISTOL | $282.00 | $23.55 – $1,612.25 |
| Franklin Woods Community Hospital | JOHNSON CITY | $282.00 | $28.62 – $1,401.63 |
| Holston Valley Medical Center | KINGSPORT | $282.00 | $23.55 – $1,612.25 |
| 62-0123940 BMH Collierville | Collierville | $259.56 | $34.40 – $1,288.56 |