Cdna analysis for variants at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$210.30
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.
$1,402.00
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.
$92.60 with AMERIGROUP vs $1,402.00 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 | $92.60 | ↓ -56% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $166.68 | ↓ -21% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $181.79 | ↓ -14% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $181.79 | ↓ -14% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $185.20 | ↓ -12% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $185.20 | ↓ -12% |
| SENTARA HEALTH | SENTARA MEDICARE | $185.20 | ↓ -12% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $185.20 | ↓ -12% |
| AETNA | AETNA HEALTHCARE MEDICARE | $185.20 | ↓ -12% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $185.20 | ↓ -12% |
| HUMANA | HUMANA MEDICARE | $185.20 | ↓ -12% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $185.20 | ↓ -12% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $185.20 | ↓ -12% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $185.20 | ↓ -12% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $185.20 | ↓ -12% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $185.20 | ↓ -12% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $189.06 | ↓ -10% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $189.06 | ↓ -10% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $190.76 | ↓ -9% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $192.61 | ↓ -8% |
| BLUE CROSS | BLUE CROSS MEDICARE | $192.61 | ↓ -8% |
| NHC ADVANTAGE | NHC ADVANTAGE | $194.46 | ↓ -8% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $194.46 | ↓ -8% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $194.46 | ↓ -8% |
| WELLCARE | WELLCARE MEDICARE | $196.31 | ↓ -7% |
| BLUE CROSS | TENNCARE BLUE CARE | $221.47 | ↑ +5% |
| BLUE CROSS | TENNCARE BLUE SELECT | $221.47 | ↑ +5% |
| SENTARA HEALTH | SENTARA HEALTH | $390.04 | ↑ +85% |
| AMBETTER | AMBETTER | $403.74 | ↑ +92% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $408.53 | ↑ +94% |
| MEDCOST | MEDCOST VHN | $490.70 | ↑ +133% |
| CIGNA HEALTHCARE | CIGNA HMO | $543.98 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $543.98 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA PPO | $677.17 | ↑ +222% |
| AETNA | AETNA | $894.48 | ↑ +325% |
| BLUE CROSS | BLUE CROSS E NETWORK | $961.15 | ↑ +357% |
| BLUE CROSS | BLUE CROSS S NETWORK | $979.95 | ↑ +366% |
| BLUE CROSS | BLUE CROSS P NETWORK | $979.95 | ↑ +366% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $981.40 | ↑ +367% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,051.50 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,402.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $1,402.00 | ↑ +567% |
Visitor-reported prices
Comments
Cdna analysis for variants at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Memorial Hospital Hixson | Hixson | $175.24 | $120.89 – $414.40 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $250.42 | $120.89 – $414.40 |
| Johnson City Medical Center | JOHNSON CITY | $210.30 | $92.60 – $403.74 |
| Hancock County Hospital | SNEEDVILLE | $206.31 | $92.60 – $408.53 |
| Greeneville Community Hospital | GREENEVILLE | $210.30 | $66.67 – $403.74 |
| Bristol Regional Medical Center | BRISTOL | $210.30 | $92.60 – $444.48 |
| Franklin Woods Community Hospital | JOHNSON CITY | $210.30 | $92.60 – $403.74 |
| Holston Valley Medical Center | KINGSPORT | $210.30 | $92.60 – $444.48 |