Tx closed tib fx proximal w/w/o manip w/skel trac at Sycamore Shoals Hospital
1501 W. ELK AVE., ELIZABETHTON, TN · Balladhealth · · NPI 1891801734
$1,394.10
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.
$9,294.00
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.
$669.87 with OPTIMA HEALTH vs $9,294.00 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 |
|---|---|---|---|
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $669.87 | ↓ -52% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $669.87 | ↓ -52% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $679.13 | ↓ -51% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $696.66 | ↓ -50% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $696.66 | ↓ -50% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $1,180.96 | ↓ -15% |
| AMERIGROUP | AMERIGROUP | $2,443.03 | ↑ +75% |
| SENTARA HEALTH | SENTARA HEALTH | $2,585.59 | ↑ +85% |
| SENTARA HEALTH | SENTARA MEDICARE | $2,968.60 | ↑ +113% |
| HUMANA | HUMANA MEDICARE | $2,968.60 | ↑ +113% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $2,968.60 | ↑ +113% |
| AETNA | AETNA HEALTHCARE MEDICARE | $2,968.60 | ↑ +113% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $2,968.60 | ↑ +113% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $2,968.60 | ↑ +113% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $2,968.60 | ↑ +113% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $2,968.60 | ↑ +113% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $2,968.60 | ↑ +113% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $3,057.66 | ↑ +119% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $3,087.35 | ↑ +121% |
| BLUE CROSS | BLUE CROSS MEDICARE | $3,087.35 | ↑ +121% |
| NHC ADVANTAGE | NHC ADVANTAGE | $3,117.03 | ↑ +124% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $3,117.03 | ↑ +124% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $3,117.03 | ↑ +124% |
| WELLCARE | WELLCARE MEDICARE | $3,146.72 | ↑ +126% |
| MEDCOST | MEDCOST VHN | $3,252.90 | ↑ +133% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $3,457.37 | ↑ +148% |
| CIGNA HEALTHCARE | CIGNA HMO | $3,606.07 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $3,606.07 | ↑ +159% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $3,633.95 | ↑ +161% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $3,633.95 | ↑ +161% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $4,312.42 | ↑ +209% |
| CIGNA HEALTHCARE | CIGNA PPO | $4,489.00 | ↑ +222% |
| AETNA | AETNA | $5,929.57 | ↑ +325% |
| AMBETTER | AMBETTER | $6,471.55 | ↑ +364% |
| BLUE CROSS | BLUE CROSS S NETWORK | $6,691.68 | ↑ +380% |
| BLUE CROSS | BLUE CROSS P NETWORK | $6,691.68 | ↑ +380% |
| BLUE CROSS | BLUE CROSS E NETWORK | $6,691.68 | ↑ +380% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $6,970.50 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $9,294.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $9,294.00 | ↑ +567% |
Visitor-reported prices
Comments
Tx closed tib fx proximal w/w/o manip w/skel trac at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 62-1166050 BMH Carroll County | Huntingdon | $1,996.40 | $2,364.00 – $5,925.44 |
| Johnson City Medical Center | JOHNSON CITY | $1,394.10 | $617.32 – $6,656.07 |
| Franklin Woods Community Hospital | JOHNSON CITY | $1,394.10 | $669.87 – $6,476.36 |
| 62-0123940 BMH Collierville | Collierville | $1,822.80 | $2,822.54 – $5,942.18 |
| Indian Path Community Hospital | KINGSPORT | $1,394.10 | $589.46 – $7,124.65 |
| 62-1138045 BMH Union City | Union City | $1,736.00 | $2,577.57 – $5,925.44 |
| Ascension Saint Thomas Midtown | Nashville | not published | $733.50 – $1,141.72 |
| Ascension Saint Thomas DeKalb | Smithville | not published | $656.09 – $1,004.50 |