Cell function assay w/stim at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$237.90
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.
$1,586.00
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.
$46.26 with OPTIMA HEALTH vs $1,586.00 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 |
|---|---|---|---|
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $46.26 | ↓ -81% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $46.26 | ↓ -81% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $48.11 | ↓ -80% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $48.11 | ↓ -80% |
| AMERIGROUP | AMERIGROUP | $67.93 | ↓ -71% |
| BLUE CROSS | TENNCARE BLUE SELECT | $91.70 | ↓ -61% |
| BLUE CROSS | TENNCARE BLUE CARE | $91.70 | ↓ -61% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $97.30 | ↓ -59% |
| HUMANA | HUMANA MEDICARE | $135.86 | ↓ -43% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $135.86 | ↓ -43% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $135.86 | ↓ -43% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $135.86 | ↓ -43% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $135.86 | ↓ -43% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $135.86 | ↓ -43% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $135.86 | ↓ -43% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $135.86 | ↓ -43% |
| SENTARA HEALTH | SENTARA MEDICARE | $135.86 | ↓ -43% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $135.86 | ↓ -43% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $135.86 | ↓ -43% |
| AETNA | AETNA HEALTHCARE MEDICARE | $135.86 | ↓ -43% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $139.94 | ↓ -41% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $141.29 | ↓ -41% |
| BLUE CROSS | BLUE CROSS MEDICARE | $141.29 | ↓ -41% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $142.65 | ↓ -40% |
| NHC ADVANTAGE | NHC ADVANTAGE | $142.65 | ↓ -40% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $142.65 | ↓ -40% |
| WELLCARE | WELLCARE MEDICARE | $144.01 | ↓ -39% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $173.19 | ↓ -27% |
| AMBETTER | AMBETTER | $296.17 | ↑ +24% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $299.54 | ↑ +26% |
| SENTARA HEALTH | SENTARA HEALTH | $441.23 | ↑ +85% |
| CIGNA HEALTHCARE | CIGNA PPO | $535.36 | ↑ +125% |
| CIGNA HEALTHCARE | CIGNA HMO | $535.36 | ↑ +125% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $535.36 | ↑ +125% |
| MEDCOST | MEDCOST VHN | $555.10 | ↑ +133% |
| BLUE CROSS | BLUE CROSS E NETWORK | $758.12 | ↑ +219% |
| BLUE CROSS | BLUE CROSS S NETWORK | $772.95 | ↑ +225% |
| BLUE CROSS | BLUE CROSS P NETWORK | $772.95 | ↑ +225% |
| AETNA | AETNA | $1,011.87 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,189.50 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $1,586.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,586.00 | ↑ +567% |
Visitor-reported prices
Comments
Cell function assay w/stim at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $460.08 | $48.91 – $526.00 |
| CHI Memorial Hospital Hixson | Hixson | $262.85 | $117.40 – $410.90 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $375.63 | $117.65 – $410.90 |
| Johnson City Medical Center | JOHNSON CITY | $237.90 | $42.63 – $296.17 |
| Ascension Saint Thomas DeKalb | Smithville | $460.08 | $79.05 – $526.00 |
| Ascension Saint Thomas Highlands | Sparta | $460.08 | $79.05 – $526.00 |
| Ascension Saint Thomas River Park | McMinnville | $460.08 | $95.26 – $526.00 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $460.08 | $79.05 – $526.00 |