Egd/insert intraluminal tube/cath 43241 at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$806.40
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.
$5,376.00
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.
$775.00 with BLUE CROSS vs $5,376.00 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 |
|---|---|---|---|
| BLUE CROSS | TENNCARE BLUE CARE | $775.00 | ↓ -4% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $948.00 | ↑ +18% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $954.00 | ↑ +18% |
| AMERIGROUP | AMERIGROUP | $1,318.28 | ↑ +63% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $1,383.32 | ↑ +72% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $1,383.32 | ↑ +72% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $1,438.65 | ↑ +78% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $1,438.65 | ↑ +78% |
| SENTARA HEALTH | SENTARA HEALTH | $1,495.60 | ↑ +85% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $1,621.00 | ↑ +101% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $1,695.00 | ↑ +110% |
| CIGNA HEALTHCARE | CIGNA HMO | $1,695.00 | ↑ +110% |
| HUMANA | HUMANA MEDICARE | $1,740.98 | ↑ +116% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $1,740.98 | ↑ +116% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $1,740.98 | ↑ +116% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $1,740.98 | ↑ +116% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $1,740.98 | ↑ +116% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $1,740.98 | ↑ +116% |
| AETNA | AETNA HEALTHCARE MEDICARE | $1,740.98 | ↑ +116% |
| SENTARA HEALTH | SENTARA MEDICARE | $1,740.98 | ↑ +116% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $1,740.98 | ↑ +116% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $1,793.21 | ↑ +122% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $1,810.61 | ↑ +125% |
| BLUE CROSS | BLUE CROSS MEDICARE | $1,810.61 | ↑ +125% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $1,828.02 | ↑ +127% |
| NHC ADVANTAGE | NHC ADVANTAGE | $1,828.02 | ↑ +127% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $1,828.02 | ↑ +127% |
| WELLCARE | WELLCARE MEDICARE | $1,845.43 | ↑ +129% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $1,850.00 | ↑ +129% |
| MEDCOST | MEDCOST VHN | $1,881.60 | ↑ +133% |
| CIGNA HEALTHCARE | CIGNA PPO | $1,882.00 | ↑ +133% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $1,956.00 | ↑ +143% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $2,397.00 | ↑ +197% |
| BLUE CROSS | BLUE CROSS E NETWORK | $3,229.00 | ↑ +300% |
| BLUE CROSS | BLUE CROSS S NETWORK | $3,297.00 | ↑ +309% |
| BLUE CROSS | BLUE CROSS P NETWORK | $3,297.00 | ↑ +309% |
| AETNA | AETNA | $3,429.89 | ↑ +325% |
| AMBETTER | AMBETTER | $3,795.33 | ↑ +371% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $4,032.00 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $5,376.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $5,376.00 | ↑ +567% |
Visitor-reported prices
Comments
Egd/insert intraluminal tube/cath 43241 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $1,093.16 | $1,185.00 – $1,534.53 |
| Johnson City Medical Center | JOHNSON CITY | $806.40 | $1,274.80 – $3,903.54 |
| Ascension Saint Thomas DeKalb | Smithville | $1,093.16 | $372.80 – $1,246.50 |
| Ascension Saint Thomas Highlands | Sparta | $1,093.16 | $372.80 – $1,246.50 |
| Ascension Saint Thomas River Park | McMinnville | $1,093.16 | $372.80 – $1,246.50 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $1,093.16 | $1,185.00 – $1,636.56 |
| Greeneville Community Hospital | GREENEVILLE | $806.40 | $1,212.46 – $3,903.54 |
| Bristol Regional Medical Center | BRISTOL | $806.40 | $1,295.99 – $4,368.90 |