Ghs i and d perirectal abscess 46040 at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$881.70
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.
$5,878.00
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.
$146.00 with UNITED HEALTHCARE vs $5,878.00 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $146.00 | ↓ -83% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $242.12 | ↓ -73% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $398.00 | ↓ -55% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $455.00 | ↓ -48% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $589.00 | ↓ -33% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $1,085.68 | ↑ +23% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $1,085.68 | ↑ +23% |
| SENTARA HEALTH | SENTARA MEDICARE | $1,085.68 | ↑ +23% |
| HUMANA | HUMANA MEDICARE | $1,085.68 | ↑ +23% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $1,085.68 | ↑ +23% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $1,085.68 | ↑ +23% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $1,085.68 | ↑ +23% |
| AETNA | AETNA HEALTHCARE MEDICARE | $1,085.68 | ↑ +23% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $1,085.68 | ↑ +23% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $1,118.25 | ↑ +27% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $1,129.11 | ↑ +28% |
| BLUE CROSS | BLUE CROSS MEDICARE | $1,129.11 | ↑ +28% |
| NHC ADVANTAGE | NHC ADVANTAGE | $1,139.97 | ↑ +29% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $1,139.97 | ↑ +29% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $1,139.97 | ↑ +29% |
| WELLCARE | WELLCARE MEDICARE | $1,150.82 | ↑ +31% |
| SENTARA HEALTH | SENTARA HEALTH | $1,635.26 | ↑ +85% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $2,025.66 | ↑ +130% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $2,025.66 | ↑ +130% |
| MEDCOST | MEDCOST VHN | $2,057.30 | ↑ +133% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $2,106.69 | ↑ +139% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $2,106.69 | ↑ +139% |
| AMBETTER | AMBETTER | $2,366.79 | ↑ +168% |
| AETNA | AETNA | $3,750.16 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $4,408.50 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $5,878.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $5,878.00 | ↑ +567% |
Visitor-reported prices
Comments
Ghs i and d perirectal abscess 46040 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 62-1166050 BMH Carroll County | Huntingdon | $806.84 | $936.68 – $2,153.28 |
| Johnson City Medical Center | JOHNSON CITY | $881.70 | $242.12 – $2,434.27 |
| Hancock County Hospital | SNEEDVILLE | $865.26 | $242.12 – $2,126.94 |
| Greeneville Community Hospital | GREENEVILLE | $881.70 | $242.12 – $2,434.27 |
| Bristol Regional Medical Center | BRISTOL | $881.70 | $242.12 – $2,724.47 |
| Franklin Woods Community Hospital | JOHNSON CITY | $881.70 | $242.12 – $2,368.55 |
| Holston Valley Medical Center | KINGSPORT | $881.70 | $242.12 – $2,724.47 |
| 62-0123940 BMH Collierville | Collierville | $736.68 | $1,025.70 – $2,159.36 |