Biopsy roof of mouth at Roane County Medical Center
8045 Roane Medical Center Dr, Harriman, TN · Fsregional · · NPI 1700036696
not published by hospital
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.
not published by hospital
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.
$989.00 with United Healthcare vs $2,945.00 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 |
|---|---|---|---|
| United Healthcare | Tenncare | $989.00 | — |
| Cigna | IFP | $1,250.00 | — |
| Ambetter | Exchange | $1,308.00 | — |
| Aetna | Commercial | $1,349.71 | — |
| Wellpoint | Medicaid Tenncare | $1,391.00 | — |
| Optum | VA CCN | $1,407.71 | — |
| Tricare | Humana Military | $1,407.71 | — |
| United Healthcare | Medicare Advantage | $1,449.94 | — |
| Humana | Medicare Advantage HMO | $1,449.94 | — |
| Humana | Medicare Advantage PPO | $1,449.94 | — |
| United Healthcare | Community Plan DSNP | $1,449.94 | — |
| Humana | DSNP | $1,449.94 | — |
| Farm Bureau | Medicare Advantage HMO | $1,464.02 | — |
| Farm Bureau | Medicare Advantage PPO | $1,464.02 | — |
| Wellpoint | Medicare Advantage | $1,478.10 | — |
| Blue Cross of TN | Med Adv Sapphire | $1,478.10 | — |
| United Healthcare | DSNP | $1,478.10 | — |
| Devoted Health | PPO | $1,478.10 | — |
| Devoted Health | HMO | $1,478.10 | — |
| HealthSpring | Medicare PPO | $1,478.10 | — |
| HealthSpring | Medicare HMO POS | $1,478.10 | — |
| Aetna | Medicare Advantage | $1,478.10 | — |
| Wellcare | Medicare Advantage | $1,478.10 | — |
| Cigna | Medicare PPO | $1,478.10 | — |
| Cigna | Medicare HMO | $1,478.10 | — |
| Cigna | Medicare HMO-POS | $1,478.10 | — |
| Wellpoint | DSNP | $1,478.10 | — |
| Blue Cross of TN | Med Adv Ruby | $1,478.10 | — |
| Blue Cross of TN | BlueEssential DSNP | $1,478.10 | — |
| Blue Cross of TN | BlueEssential HMO | $1,478.10 | — |
| Blue Cross of TN | Med Adv Diamond | $1,478.10 | — |
| Blue Cross of TN | Med Adv PPO | $1,478.10 | — |
| Cigna | Local Plus | $1,532.00 | — |
| BCBS TN | Blue Care | $1,575.00 | — |
| Cigna | HMO | $1,802.00 | — |
| Cigna | OAP | $1,802.00 | — |
| Cigna | POS | $1,802.00 | — |
| United Healthcare | All Other Plans | $1,894.00 | — |
| United Healthcare | Heritage Select | $2,227.00 | — |
| United Healthcare | Options PPO | $2,717.00 | — |
| BCBS TN | Commercial Network P | $2,945.00 | — |
| BCBS TN | Commercial Network S | $2,945.00 | — |
| USA Managed Care Organization | PPO | not published by hospital | — |
| National Provider Network | PPO | not published by hospital | — |
| Beech Street | PPO | not published by hospital | — |
| NovaNet | Network Lease | not published by hospital | — |
| Galaxy Health Network | PPO | not published by hospital | — |
| CCN Managed Care | PPO | not published by hospital | — |
| Community Services Network | NonProfit Public Benefit | not published by hospital | — |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | not published by hospital | — |
| Direct Care America | PPO | not published by hospital | — |
| EHN | Network Lease | not published by hospital | — |
| Initial Group | PPO | not published by hospital | — |
| MedSave USA | Commercial | not published by hospital | — |
Visitor-reported prices
Comments
Biopsy roof of mouth at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | not published | $733.50 – $1,534.53 |
| Ascension Saint Thomas DeKalb | Smithville | not published | $323.33 – $1,004.50 |
| Ascension Saint Thomas Highlands | Sparta | not published | $323.33 – $1,004.50 |
| Ascension Saint Thomas River Park | McMinnville | not published | $323.33 – $1,004.50 |
| Ascension Saint Thomas Rutherford | Murfreesboro | not published | $954.50 – $1,636.56 |
| Ascension Saint Thomas Hickman | Centerville | not published | $954.50 – $1,004.50 |
| 62-0123940 BMH Collierville | Collierville | not published | $1,288.59 – $2,712.82 |
| Parkwest Medical Center | Knoxville | not published | $168.31 – $1,478.10 |