Pt evaluation high complexity patient/family at Franklin Woods Community Hospital
300 MED TECH PKWY., JOHNSON CITY, TN · Balladhealth · · NPI 1114033628
$81.75
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.
$545.00
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.
$46.00 with UNITED HEALTHCARE vs $545.00 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $46.00 | ↓ -44% |
| AMERIGROUP | AMERIGROUP | $87.91 | ↑ +8% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $93.52 | ↑ +14% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $93.52 | ↑ +14% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $93.52 | ↑ +14% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $93.52 | ↑ +14% |
| SENTARA HEALTH | SENTARA MEDICARE | $93.52 | ↑ +14% |
| AETNA | AETNA HEALTHCARE MEDICARE | $93.52 | ↑ +14% |
| HUMANA | HUMANA MEDICARE | $93.52 | ↑ +14% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $93.52 | ↑ +14% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $93.52 | ↑ +14% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $93.52 | ↑ +14% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $93.52 | ↑ +14% |
| BLUE CROSS | TENNCARE BLUE SELECT | $94.10 | ↑ +15% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $96.33 | ↑ +18% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $97.26 | ↑ +19% |
| BLUE CROSS | BLUE CROSS MEDICARE | $97.26 | ↑ +19% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $98.20 | ↑ +20% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $98.20 | ↑ +20% |
| NHC ADVANTAGE | NHC ADVANTAGE | $98.20 | ↑ +20% |
| WELLCARE | WELLCARE MEDICARE | $99.13 | ↑ +21% |
| BLUE CROSS | TENNCARE BLUE CARE | $102.78 | ↑ +26% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $116.00 | ↑ +42% |
| SENTARA HEALTH | SENTARA HEALTH | $157.89 | ↑ +93% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $188.00 | ↑ +130% |
| AMBETTER | AMBETTER | $203.87 | ↑ +149% |
| CIGNA HEALTHCARE | CIGNA HMO | $211.46 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $211.46 | ↑ +159% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $215.00 | ↑ +163% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $252.88 | ↑ +209% |
| CIGNA HEALTHCARE | CIGNA PPO | $263.24 | ↑ +222% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $279.00 | ↑ +241% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $320.84 | ↑ +292% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $320.84 | ↑ +292% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $333.67 | ↑ +308% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $333.67 | ↑ +308% |
| AETNA | AETNA | $347.71 | ↑ +325% |
| BLUE CROSS | BLUE CROSS E NETWORK | $362.32 | ↑ +343% |
| BLUE CROSS | BLUE CROSS P NETWORK | $362.32 | ↑ +343% |
| BLUE CROSS | BLUE CROSS S NETWORK | $362.32 | ↑ +343% |
| MEDCOST | MEDCOST VHN | $463.25 | ↑ +467% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $545.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $545.00 | ↑ +567% |
Visitor-reported prices
Comments
Pt evaluation high complexity patient/family at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnson City Medical Center | JOHNSON CITY | $81.75 | $44.00 – $295.67 |
| Ascension Saint Thomas Midtown | Nashville | $69.56 | $66.74 – $176.18 |
| CHI Memorial Hospital Hixson | Hixson | $197.44 | $70.00 – $392.70 |
| 62-1166050 BMH Carroll County | Huntingdon | $205.85 | $64.31 – $66.74 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $282.15 | $70.00 – $392.70 |
| Ascension Saint Thomas DeKalb | Smithville | $129.60 | $66.74 – $176.18 |
| Ascension Saint Thomas Highlands | Sparta | $129.60 | $66.74 – $176.18 |
| Ascension Saint Thomas River Park | McMinnville | $123.42 | $83.29 – $176.18 |