Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$53.55
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.
$357.00
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.
$79.13 with BLUE CROSS vs $433.11 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 | BLUE CROSS BALLAD HEALTH EMPLOYEE | $79.13 | ↑ +48% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $79.90 | ↑ +49% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $79.90 | ↑ +49% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $83.09 | ↑ +55% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $83.10 | ↑ +55% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $88.92 | ↑ +66% |
| SENTARA HEALTH | SENTARA HEALTH | $99.32 | ↑ +85% |
| BLUE CROSS | BLUE CROSS E NETWORK | $105.76 | ↑ +97% |
| BLUE CROSS | BLUE CROSS P NETWORK | $105.76 | ↑ +97% |
| BLUE CROSS | BLUE CROSS S NETWORK | $105.76 | ↑ +97% |
| CIGNA HEALTHCARE | CIGNA HMO | $123.40 | ↑ +130% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $123.40 | ↑ +130% |
| CIGNA HEALTHCARE | CIGNA PPO | $123.40 | ↑ +130% |
| MEDCOST | MEDCOST VHN | $124.95 | ↑ +133% |
| BLUE CROSS | TENNCARE BLUE CARE | $130.67 | ↑ +144% |
| BLUE CROSS | TENNCARE BLUE SELECT | $130.67 | ↑ +144% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $165.65 | ↑ +209% |
| AMERIGROUP | AMERIGROUP | $172.12 | ↑ +221% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $198.67 | ↑ +271% |
| HUMANA | HUMANA MEDICARE | $198.67 | ↑ +271% |
| AETNA | AETNA HEALTHCARE MEDICARE | $198.67 | ↑ +271% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $198.67 | ↑ +271% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $198.67 | ↑ +271% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $198.67 | ↑ +271% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $198.67 | ↑ +271% |
| SENTARA HEALTH | SENTARA MEDICARE | $198.67 | ↑ +271% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $198.67 | ↑ +271% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $204.63 | ↑ +282% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $206.62 | ↑ +286% |
| BLUE CROSS | BLUE CROSS MEDICARE | $206.62 | ↑ +286% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $208.61 | ↑ +290% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $208.61 | ↑ +290% |
| NHC ADVANTAGE | NHC ADVANTAGE | $208.61 | ↑ +290% |
| WELLCARE | WELLCARE MEDICARE | $210.59 | ↑ +293% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $219.00 | ↑ +309% |
| AETNA | AETNA | $227.77 | ↑ +325% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $244.00 | ↑ +356% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $267.75 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $357.00 | ↑ +567% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $357.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $357.00 | ↑ +567% |
| AMBETTER | AMBETTER | $433.11 | ↑ +709% |
Visitor-reported prices
Comments
Inhalation aerosol pentamidine pneumocystis pneumonia treatment/prophylaxis at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $135.48 | $41.14 – $272.71 |
| CHI Memorial Hospital Hixson | Hixson | $388.65 | $75.80 – $919.10 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $555.40 | $75.80 – $919.10 |
| Johnson City Medical Center | JOHNSON CITY | $53.55 | $73.63 – $445.45 |
| Hancock County Hospital | SNEEDVILLE | $52.67 | $49.40 – $229.00 |
| Greeneville Community Hospital | GREENEVILLE | $53.55 | $35.57 – $445.45 |
| Bristol Regional Medical Center | BRISTOL | $53.55 | $59.28 – $452.86 |
| Franklin Woods Community Hospital | JOHNSON CITY | $53.55 | $79.13 – $433.43 |