Immune complex assay at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$42.75
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.
$285.00
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.
$12.19 with AMERIGROUP vs $285.00 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 |
|---|---|---|---|
| AMERIGROUP | AMERIGROUP | $12.19 | ↓ -71% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $12.80 | ↓ -70% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $12.80 | ↓ -70% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $13.31 | ↓ -69% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $13.31 | ↓ -69% |
| SENTARA HEALTH | SENTARA MEDICARE | $24.37 | ↓ -43% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $24.37 | ↓ -43% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $24.37 | ↓ -43% |
| AETNA | AETNA HEALTHCARE MEDICARE | $24.37 | ↓ -43% |
| HUMANA | HUMANA MEDICARE | $24.37 | ↓ -43% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $24.37 | ↓ -43% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $24.37 | ↓ -43% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $24.37 | ↓ -43% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $24.37 | ↓ -43% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $24.37 | ↓ -43% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $24.37 | ↓ -43% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $24.37 | ↓ -43% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $25.10 | ↓ -41% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $25.34 | ↓ -41% |
| BLUE CROSS | BLUE CROSS MEDICARE | $25.34 | ↓ -41% |
| NHC ADVANTAGE | NHC ADVANTAGE | $25.59 | ↓ -40% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $25.59 | ↓ -40% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $25.59 | ↓ -40% |
| WELLCARE | WELLCARE MEDICARE | $25.83 | ↓ -40% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $31.07 | ↓ -27% |
| AMBETTER | AMBETTER | $53.13 | ↑ +24% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $53.41 | ↑ +25% |
| BLUE CROSS | TENNCARE BLUE CARE | $73.17 | ↑ +71% |
| BLUE CROSS | TENNCARE BLUE SELECT | $73.17 | ↑ +71% |
| SENTARA HEALTH | SENTARA HEALTH | $79.29 | ↑ +85% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $82.72 | ↑ +93% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $95.70 | ↑ +124% |
| CIGNA HEALTHCARE | CIGNA HMO | $95.70 | ↑ +124% |
| CIGNA HEALTHCARE | CIGNA PPO | $95.70 | ↑ +124% |
| MEDCOST | MEDCOST VHN | $99.75 | ↑ +133% |
| BLUE CROSS | BLUE CROSS E NETWORK | $135.99 | ↑ +218% |
| BLUE CROSS | BLUE CROSS S NETWORK | $138.65 | ↑ +224% |
| BLUE CROSS | BLUE CROSS P NETWORK | $138.65 | ↑ +224% |
| AETNA | AETNA | $181.83 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $213.75 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $285.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $285.00 | ↑ +567% |
Visitor-reported prices
Comments
Immune complex assay at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $86.81 | $8.77 – $94.83 |
| CHI Memorial Hospital Hixson | Hixson | $168.72 | $21.65 – $399.00 |
| 62-1166050 BMH Carroll County | Huntingdon | $167.90 | $21.20 – $48.74 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $241.11 | $21.65 – $399.00 |
| Johnson City Medical Center | JOHNSON CITY | $42.75 | $11.80 – $53.13 |
| Ascension Saint Thomas DeKalb | Smithville | $86.81 | $17.09 – $94.83 |
| Ascension Saint Thomas Highlands | Sparta | $86.81 | $17.09 – $94.83 |
| Ascension Saint Thomas River Park | McMinnville | $86.81 | $17.09 – $119.85 |