Exc benign tal 0.5 < cm 11400 at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$176.40
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.
$1,176.00
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.
$26.68 with BLUE CROSS vs $1,400.59 with AMBETTER — 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 SELECT | $26.68 | ↓ -85% |
| BLUE CROSS | TENNCARE BLUE CARE | $26.68 | ↓ -85% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $71.20 | ↓ -60% |
| SENTARA HEALTH | SENTARA HEALTH | $327.16 | ↑ +85% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $340.70 | ↑ +93% |
| MEDCOST | MEDCOST VHN | $411.60 | ↑ +133% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $437.47 | ↑ +148% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $456.29 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA HMO | $456.29 | ↑ +159% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $459.82 | ↑ +161% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $459.82 | ↑ +161% |
| AMERIGROUP | AMERIGROUP | $529.06 | ↑ +200% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $545.66 | ↑ +209% |
| CIGNA HEALTHCARE | CIGNA PPO | $559.78 | ↑ +217% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $594.07 | ↑ +237% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $594.07 | ↑ +237% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $617.83 | ↑ +250% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $617.83 | ↑ +250% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $642.47 | ↑ +264% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $642.47 | ↑ +264% |
| HUMANA | HUMANA MEDICARE | $642.47 | ↑ +264% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $642.47 | ↑ +264% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $642.47 | ↑ +264% |
| AETNA | AETNA HEALTHCARE MEDICARE | $642.47 | ↑ +264% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $642.47 | ↑ +264% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $642.47 | ↑ +264% |
| SENTARA HEALTH | SENTARA MEDICARE | $642.47 | ↑ +264% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $661.74 | ↑ +275% |
| BLUE CROSS | BLUE CROSS MEDICARE | $668.17 | ↑ +279% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $668.17 | ↑ +279% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $674.59 | ↑ +282% |
| NHC ADVANTAGE | NHC ADVANTAGE | $674.59 | ↑ +282% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $674.59 | ↑ +282% |
| WELLCARE | WELLCARE MEDICARE | $681.02 | ↑ +286% |
| AETNA | AETNA | $750.29 | ↑ +325% |
| BLUE CROSS | BLUE CROSS E NETWORK | $846.72 | ↑ +380% |
| BLUE CROSS | BLUE CROSS S NETWORK | $846.72 | ↑ +380% |
| BLUE CROSS | BLUE CROSS P NETWORK | $846.72 | ↑ +380% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $882.00 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,176.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $1,176.00 | ↑ +567% |
| AMBETTER | AMBETTER | $1,400.59 | ↑ +694% |
Visitor-reported prices
Comments
Exc benign tal 0.5 < cm 11400 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Memorial Hospital Hixson | Hixson | $721.95 | $34.23 – $1,707.30 |
| 62-1166050 BMH Carroll County | Huntingdon | $254.84 | $558.94 – $1,284.92 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $1,031.70 | $34.23 – $1,707.30 |
| Johnson City Medical Center | JOHNSON CITY | $176.40 | $26.68 – $1,440.52 |
| Hancock County Hospital | SNEEDVILLE | $173.19 | $26.68 – $753.00 |
| Greeneville Community Hospital | GREENEVILLE | $176.40 | $26.68 – $1,440.52 |
| Bristol Regional Medical Center | BRISTOL | $176.40 | $26.68 – $1,464.46 |
| Franklin Woods Community Hospital | JOHNSON CITY | $176.40 | $32.43 – $1,401.63 |