Diphtheria-tetanus toxoids 0.5 ml (peds) at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$90.88
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.
$605.87
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.
$5.28 with BLUE CROSS vs $605.87 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 | $5.28 | ↓ -94% |
| BLUE CROSS | TENNCARE BLUE CARE | $9.42 | ↓ -90% |
| BLUE CROSS | TENNCARE BLUE SELECT | $9.42 | ↓ -90% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $35.05 | ↓ -61% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $35.05 | ↓ -61% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $36.45 | ↓ -60% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $36.46 | ↓ -60% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $130.28 | ↑ +43% |
| SENTARA HEALTH | SENTARA HEALTH | $168.55 | ↑ +85% |
| CIGNA HEALTHCARE | CIGNA PPO | $173.21 | ↑ +91% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $173.21 | ↑ +91% |
| CIGNA HEALTHCARE | CIGNA HMO | $173.21 | ↑ +91% |
| MEDCOST | MEDCOST VHN | $212.05 | ↑ +133% |
| AETNA | AETNA | $386.55 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $454.40 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $605.87 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $605.87 | ↑ +567% |
Visitor-reported prices
Comments
Diphtheria-tetanus toxoids 0.5 ml (peds) at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Hawkins County Memorial Hospital | ROGERSVILLE | $90.88 | $5.28 – $130.28 |
| SKYLINE MADISON CAMPUS | NASHVILLE | $153.20 | $11.77 – $91.79 |
| Ascension Saint Thomas Midtown | Nashville | not published | $8.12 – $113.99 |
| Ascension Saint Thomas DeKalb | Smithville | not published | $8.12 – $113.99 |
| Ascension Saint Thomas Highlands | Sparta | not published | $8.12 – $113.99 |
| Ascension Saint Thomas River Park | McMinnville | not published | $8.12 – $113.99 |
| Ascension Saint Thomas Rutherford | Murfreesboro | not published | $8.12 – $113.99 |
| Ascension Saint Thomas Hickman | Centerville | not published | $21.12 – $113.99 |