ER Visit (level 4) at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$300.30
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.
$2,002.00
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.
$50.00 with UNITED HEALTHCARE vs $2,002.00 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 | $50.00 | ↓ -83% |
| AMERIGROUP | AMERIGROUP | $60.00 | ↓ -80% |
| BLUE CROSS | TENNCARE BLUE SELECT | $134.00 | ↓ -55% |
| BLUE CROSS | TENNCARE BLUE CARE | $134.00 | ↓ -55% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $378.57 | ↑ +26% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $378.57 | ↑ +26% |
| AETNA | AETNA HEALTHCARE MEDICARE | $378.57 | ↑ +26% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $378.57 | ↑ +26% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $378.57 | ↑ +26% |
| SENTARA HEALTH | SENTARA MEDICARE | $378.57 | ↑ +26% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $378.57 | ↑ +26% |
| HUMANA | HUMANA MEDICARE | $378.57 | ↑ +26% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $378.57 | ↑ +26% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $389.93 | ↑ +30% |
| BLUE CROSS | BLUE CROSS MEDICARE | $393.71 | ↑ +31% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $393.71 | ↑ +31% |
| NHC ADVANTAGE | NHC ADVANTAGE | $397.50 | ↑ +32% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $397.50 | ↑ +32% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $397.50 | ↑ +32% |
| WELLCARE | WELLCARE MEDICARE | $401.29 | ↑ +34% |
| SENTARA HEALTH | SENTARA HEALTH | $556.96 | ↑ +85% |
| BLUE CROSS | BLUE CROSS E NETWORK | $665.00 | ↑ +121% |
| BLUE CROSS | BLUE CROSS S NETWORK | $679.00 | ↑ +126% |
| BLUE CROSS | BLUE CROSS P NETWORK | $679.00 | ↑ +126% |
| MEDCOST | MEDCOST VHN | $700.70 | ↑ +133% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $806.00 | ↑ +168% |
| AMBETTER | AMBETTER | $825.29 | ↑ +175% |
| AETNA | AETNA | $1,277.28 | ↑ +325% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $1,491.00 | ↑ +397% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,501.50 | ↑ +400% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $1,587.00 | ↑ +428% |
| CIGNA HEALTHCARE | CIGNA HMO | $1,587.00 | ↑ +428% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $1,702.00 | ↑ +467% |
| CIGNA HEALTHCARE | CIGNA PPO | $1,760.00 | ↑ +486% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $1,834.00 | ↑ +511% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $2,002.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $2,002.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $2,002.00 | ↑ +567% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | not published by hospital | — |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | not published by hospital | — |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | not published by hospital | — |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | not published by hospital | — |
Visitor-reported prices
Comments
ER Visit (level 4) at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $945.00 | $107.34 – $3,788.00 |
| CHI Memorial Hospital Hixson | Hixson | $529.25 | $171.17 – $1,222.00 |
| 62-1166050 BMH Carroll County | Huntingdon | $691.15 | $93.67 – $777.64 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $756.33 | $171.17 – $1,222.00 |
| Johnson City Medical Center | JOHNSON CITY | $300.30 | $389.37 – $848.82 |
| Ascension Saint Thomas DeKalb | Smithville | $945.00 | $107.34 – $3,788.00 |
| Ascension Saint Thomas Highlands | Sparta | $945.00 | $107.34 – $3,788.00 |
| Ascension Saint Thomas River Park | McMinnville | $945.00 | $107.34 – $3,788.00 |