Biopsy of salivary gland 42400 at Roane County Medical Center
8045 Roane Medical Center Dr, Harriman, TN · Fsregional · · NPI 1700036696
$358.05
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.
$1,085.00
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.
$488.25 with EHN vs $2,356.00 with BCBS TN — 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 |
|---|---|---|---|
| EHN | Network Lease | $488.25 | ↑ +36% |
| Tricare | Humana Military | $642.47 | ↑ +79% |
| Optum | VA CCN | $642.47 | ↑ +79% |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | $651.00 | ↑ +82% |
| Humana | Medicare Advantage HMO | $661.74 | ↑ +85% |
| United Healthcare | Community Plan DSNP | $661.74 | ↑ +85% |
| Humana | DSNP | $661.74 | ↑ +85% |
| Humana | Medicare Advantage PPO | $661.74 | ↑ +85% |
| United Healthcare | Medicare Advantage | $661.74 | ↑ +85% |
| Farm Bureau | Medicare Advantage HMO | $668.17 | ↑ +87% |
| Farm Bureau | Medicare Advantage PPO | $668.17 | ↑ +87% |
| Cigna | Medicare HMO-POS | $674.59 | ↑ +88% |
| Devoted Health | HMO | $674.59 | ↑ +88% |
| Wellcare | Medicare Advantage | $674.59 | ↑ +88% |
| United Healthcare | DSNP | $674.59 | ↑ +88% |
| Devoted Health | PPO | $674.59 | ↑ +88% |
| HealthSpring | Medicare PPO | $674.59 | ↑ +88% |
| HealthSpring | Medicare HMO POS | $674.59 | ↑ +88% |
| Aetna | Medicare Advantage | $674.59 | ↑ +88% |
| Wellpoint | DSNP | $674.59 | ↑ +88% |
| Blue Cross of TN | Med Adv Sapphire | $674.59 | ↑ +88% |
| Blue Cross of TN | Med Adv Ruby | $674.59 | ↑ +88% |
| Cigna | Medicare PPO | $674.59 | ↑ +88% |
| Cigna | Medicare HMO | $674.59 | ↑ +88% |
| Blue Cross of TN | Med Adv PPO | $674.59 | ↑ +88% |
| Blue Cross of TN | Med Adv Diamond | $674.59 | ↑ +88% |
| Blue Cross of TN | BlueEssential HMO | $674.59 | ↑ +88% |
| Blue Cross of TN | BlueEssential DSNP | $674.59 | ↑ +88% |
| Wellpoint | Medicare Advantage | $674.59 | ↑ +88% |
| Community Services Network | NonProfit Public Benefit | $705.25 | ↑ +97% |
| USA Managed Care Organization | PPO | $759.50 | ↑ +112% |
| United Healthcare | Tenncare | $787.00 | ↑ +120% |
| NovaNet | Network Lease | $813.75 | ↑ +127% |
| MedSave USA | Commercial | $868.00 | ↑ +142% |
| National Provider Network | PPO | $868.00 | ↑ +142% |
| Direct Care America | PPO | $868.00 | ↑ +142% |
| Beech Street | PPO | $922.25 | ↑ +158% |
| CCN Managed Care | PPO | $922.25 | ↑ +158% |
| Initial Group | PPO | $954.80 | ↑ +167% |
| Galaxy Health Network | PPO | $976.50 | ↑ +173% |
| United Healthcare | All Other Plans | $1,066.00 | ↑ +198% |
| Cigna | IFP | $1,250.00 | ↑ +249% |
| United Healthcare | Heritage Select | $1,254.00 | ↑ +250% |
| Wellpoint | Medicaid Tenncare | $1,259.81 | ↑ +252% |
| Ambetter | Exchange | $1,308.00 | ↑ +265% |
| Aetna | Commercial | $1,349.71 | ↑ +277% |
| United Healthcare | Options PPO | $1,526.00 | ↑ +326% |
| Cigna | Local Plus | $1,532.00 | ↑ +328% |
| BCBS TN | Blue Care | $1,575.00 | ↑ +340% |
| Cigna | HMO | $1,802.00 | ↑ +403% |
| Cigna | OAP | $1,802.00 | ↑ +403% |
| Cigna | POS | $1,802.00 | ↑ +403% |
| BCBS TN | Commercial Network P | $2,356.00 | ↑ +558% |
| BCBS TN | Commercial Network S | $2,356.00 | ↑ +558% |
Visitor-reported prices
Comments
Biopsy of salivary gland 42400 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $1,281.51 | $606.45 – $1,141.72 |
| CHI Memorial Hospital Hixson | Hixson | $148.00 | $100.00 – $350.00 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $211.50 | $105.00 – $350.00 |
| Johnson City Medical Center | JOHNSON CITY | $300.45 | $544.15 – $1,592.82 |
| Ascension Saint Thomas River Park | McMinnville | $996.54 | $243.67 – $1,004.50 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $1,281.51 | $606.45 – $1,217.22 |
| Greeneville Community Hospital | GREENEVILLE | $300.45 | $486.59 – $1,728.42 |
| Bristol Regional Medical Center | BRISTOL | $300.45 | $671.77 – $1,620.88 |