Fundus photography with i&r 92250 at Franklin Woods Community Hospital
300 MED TECH PKWY., JOHNSON CITY, TN · Balladhealth · · NPI 1114033628
$54.75
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.
$365.00
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.
$7.44 with BLUE CROSS vs $365.00 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 |
|---|---|---|---|
| BLUE CROSS | TENNCARE BLUE SELECT | $7.44 | ↓ -86% |
| BLUE CROSS | TENNCARE BLUE CARE | $8.13 | ↓ -85% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $24.05 | ↓ -56% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $40.45 | ↓ -26% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $80.15 | ↑ +46% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $80.15 | ↑ +46% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $83.35 | ↑ +52% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $83.36 | ↑ +52% |
| AMERIGROUP | AMERIGROUP | $87.75 | ↑ +60% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $95.00 | ↑ +74% |
| SENTARA HEALTH | SENTARA HEALTH | $105.74 | ↑ +93% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $110.00 | ↑ +101% |
| HUMANA | HUMANA MEDICARE | $120.80 | ↑ +121% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $120.80 | ↑ +121% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $120.80 | ↑ +121% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $120.80 | ↑ +121% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $120.80 | ↑ +121% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $120.80 | ↑ +121% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $120.80 | ↑ +121% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $120.80 | ↑ +121% |
| AETNA | AETNA HEALTHCARE MEDICARE | $120.80 | ↑ +121% |
| SENTARA HEALTH | SENTARA MEDICARE | $120.80 | ↑ +121% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $120.80 | ↑ +121% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $124.43 | ↑ +127% |
| BLUE CROSS | BLUE CROSS MEDICARE | $125.63 | ↑ +129% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $125.63 | ↑ +129% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $126.84 | ↑ +132% |
| NHC ADVANTAGE | NHC ADVANTAGE | $126.84 | ↑ +132% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $126.84 | ↑ +132% |
| WELLCARE | WELLCARE MEDICARE | $128.05 | ↑ +134% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $141.00 | ↑ +158% |
| CIGNA HEALTHCARE | CIGNA HMO | $141.62 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $141.62 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $169.36 | ↑ +209% |
| CIGNA HEALTHCARE | CIGNA PPO | $176.30 | ↑ +222% |
| BLUE CROSS | BLUE CROSS P NETWORK | $232.15 | ↑ +324% |
| BLUE CROSS | BLUE CROSS S NETWORK | $232.15 | ↑ +324% |
| BLUE CROSS | BLUE CROSS E NETWORK | $232.15 | ↑ +324% |
| AETNA | AETNA | $232.87 | ↑ +325% |
| AMBETTER | AMBETTER | $263.35 | ↑ +381% |
| MEDCOST | MEDCOST VHN | $310.25 | ↑ +467% |
| WELLCARE | WELLCARE MEDICAID | $365.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $365.00 | ↑ +567% |
Visitor-reported prices
Comments
Fundus photography with i&r 92250 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnson City Medical Center | JOHNSON CITY | $54.75 | $6.12 – $270.65 |
| Ascension Saint Thomas Midtown | Nashville | $127.26 | $5.28 – $172.83 |
| Greeneville Community Hospital | GREENEVILLE | $54.75 | $6.12 – $270.65 |
| Bristol Regional Medical Center | BRISTOL | $54.75 | $6.12 – $302.92 |
| Holston Valley Medical Center | KINGSPORT | $54.75 | $6.12 – $302.92 |
| 62-0123940 BMH Collierville | Collierville | $30.87 | $5.28 – $236.06 |
| Indian Path Community Hospital | KINGSPORT | $54.75 | $6.12 – $289.71 |
| Hawkins County Memorial Hospital | ROGERSVILLE | $54.75 | $6.12 – $263.15 |