Interrog&prgrmg ipnss at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$47.55
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.
$317.00
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.
$49.44 with OPTIMA HEALTH vs $317.00 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 |
|---|---|---|---|
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $49.44 | ↑ +4% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $49.44 | ↑ +4% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $51.42 | ↑ +8% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $51.42 | ↑ +8% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $83.01 | ↑ +75% |
| SENTARA HEALTH | SENTARA MEDICARE | $86.26 | ↑ +81% |
| AETNA | AETNA HEALTHCARE MEDICARE | $86.26 | ↑ +81% |
| HUMANA | HUMANA MEDICARE | $86.26 | ↑ +81% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $86.26 | ↑ +81% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $86.26 | ↑ +81% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $86.26 | ↑ +81% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $86.26 | ↑ +81% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $86.26 | ↑ +81% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $86.26 | ↑ +81% |
| SENTARA HEALTH | SENTARA HEALTH | $88.19 | ↑ +85% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $88.84 | ↑ +87% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $89.71 | ↑ +89% |
| BLUE CROSS | BLUE CROSS MEDICARE | $89.71 | ↑ +89% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $90.57 | ↑ +90% |
| NHC ADVANTAGE | NHC ADVANTAGE | $90.57 | ↑ +90% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $90.57 | ↑ +90% |
| WELLCARE | WELLCARE MEDICARE | $91.43 | ↑ +92% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $95.00 | ↑ +100% |
| AMERIGROUP | AMERIGROUP | $106.38 | ↑ +124% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $110.00 | ↑ +131% |
| MEDCOST | MEDCOST VHN | $110.95 | ↑ +133% |
| CIGNA HEALTHCARE | CIGNA HMO | $123.00 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $123.00 | ↑ +159% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $141.00 | ↑ +197% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $147.09 | ↑ +209% |
| CIGNA HEALTHCARE | CIGNA PPO | $153.11 | ↑ +222% |
| AMBETTER | AMBETTER | $188.04 | ↑ +295% |
| AETNA | AETNA | $202.25 | ↑ +325% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $221.90 | ↑ +367% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $237.75 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $317.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS S NETWORK | $317.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS P NETWORK | $317.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS E NETWORK | $317.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $317.00 | ↑ +567% |
Visitor-reported prices
Comments
Interrog&prgrmg ipnss at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnson City Medical Center | JOHNSON CITY | $47.55 | $45.56 – $193.40 |
| Hancock County Hospital | SNEEDVILLE | $46.69 | $46.12 – $162.02 |
| Greeneville Community Hospital | GREENEVILLE | $47.55 | $33.20 – $193.40 |
| Bristol Regional Medical Center | BRISTOL | $47.55 | $46.32 – $216.45 |
| Franklin Woods Community Hospital | JOHNSON CITY | $47.55 | $49.44 – $188.18 |
| Holston Valley Medical Center | KINGSPORT | $47.55 | $44.97 – $216.45 |
| 62-0123940 BMH Collierville | Collierville | $54.60 | $79.85 – $168.10 |
| Indian Path Community Hospital | KINGSPORT | $47.55 | $43.51 – $207.01 |