Consultation pathology during surgery at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$52.05
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.
$347.00
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.
$15.37 with UNITED HEALTHCARE vs $347.00 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $15.37 | ↓ -70% |
| AMERIGROUP | AMERIGROUP | $24.85 | ↓ -52% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $33.43 | ↓ -36% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $33.43 | ↓ -36% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $33.43 | ↓ -36% |
| BLUE CROSS | TENNCARE BLUE CARE | $36.97 | ↓ -29% |
| BLUE CROSS | TENNCARE BLUE SELECT | $36.97 | ↓ -29% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $53.05 | ↑ +2% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $53.52 | ↑ +3% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $53.52 | ↑ +3% |
| AETNA | AETNA HEALTHCARE MEDICARE | $53.52 | ↑ +3% |
| SENTARA HEALTH | SENTARA MEDICARE | $53.52 | ↑ +3% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $53.52 | ↑ +3% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $53.52 | ↑ +3% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $53.52 | ↑ +3% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $53.52 | ↑ +3% |
| HUMANA | HUMANA MEDICARE | $53.52 | ↑ +3% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $55.13 | ↑ +6% |
| BLUE CROSS | BLUE CROSS MEDICARE | $55.66 | ↑ +7% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $55.66 | ↑ +7% |
| NHC ADVANTAGE | NHC ADVANTAGE | $56.20 | ↑ +8% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $56.20 | ↑ +8% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $56.20 | ↑ +8% |
| WELLCARE | WELLCARE MEDICARE | $56.73 | ↑ +9% |
| SENTARA HEALTH | SENTARA HEALTH | $96.54 | ↑ +85% |
| CIGNA HEALTHCARE | CIGNA HMO | $101.33 | ↑ +95% |
| CIGNA HEALTHCARE | CIGNA PPO | $101.33 | ↑ +95% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $101.33 | ↑ +95% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $108.84 | ↑ +109% |
| AMBETTER | AMBETTER | $116.68 | ↑ +124% |
| MEDCOST | MEDCOST VHN | $121.45 | ↑ +133% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $131.85 | ↑ +153% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $131.85 | ↑ +153% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $137.12 | ↑ +163% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $137.12 | ↑ +163% |
| AETNA | AETNA | $221.39 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $260.25 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $347.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $347.00 | ↑ +567% |
Visitor-reported prices
Comments
Consultation pathology during surgery at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnson City Medical Center | JOHNSON CITY | $52.05 | $15.37 – $121.50 |
| Hancock County Hospital | SNEEDVILLE | $51.06 | $8.54 – $138.44 |
| Greeneville Community Hospital | GREENEVILLE | $52.05 | $6.15 – $131.85 |
| Bristol Regional Medical Center | BRISTOL | $52.05 | $10.25 – $134.31 |
| Franklin Woods Community Hospital | JOHNSON CITY | $52.05 | $15.37 – $131.85 |
| Holston Valley Medical Center | KINGSPORT | $52.05 | $10.25 – $134.31 |
| Indian Path Community Hospital | KINGSPORT | $52.05 | $15.37 – $128.45 |
| Hawkins County Memorial Hospital | ROGERSVILLE | $52.05 | $8.54 – $135.94 |