Control oropharyngeal hemorr/simp 42960 at Johnson City Medical Center
400 N. STATE OF FRANKLIN RD, JOHNSON CITY, TN · Balladhealth · · NPI 1972606465
$211.95
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.
$1,413.00
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.
$161.00 with UNITED HEALTHCARE vs $1,876.95 with AETNA — 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 | $161.00 | ↓ -24% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $171.14 | ↓ -19% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $398.00 | ↑ +88% |
| SENTARA HEALTH | SENTARA HEALTH | $493.00 | ↑ +133% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $494.00 | ↑ +133% |
| MEDCOST | MEDCOST VHN | $494.55 | ↑ +133% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $503.27 | ↑ +137% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $503.27 | ↑ +137% |
| AETNA | AETNA HEALTHCARE MEDICARE | $503.27 | ↑ +137% |
| HUMANA | HUMANA MEDICARE | $503.27 | ↑ +137% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $503.27 | ↑ +137% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $503.27 | ↑ +137% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $503.27 | ↑ +137% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $503.27 | ↑ +137% |
| SENTARA HEALTH | SENTARA MEDICARE | $503.27 | ↑ +137% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $503.27 | ↑ +137% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $518.37 | ↑ +145% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $518.37 | ↑ +145% |
| BLUE CROSS | BLUE CROSS MEDICARE | $523.40 | ↑ +147% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $523.40 | ↑ +147% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $528.43 | ↑ +149% |
| NHC ADVANTAGE | NHC ADVANTAGE | $528.43 | ↑ +149% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $528.43 | ↑ +149% |
| WELLCARE | WELLCARE MEDICARE | $533.47 | ↑ +152% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $589.00 | ↑ +178% |
| AETNA | AETNA | $901.49 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,059.75 | ↑ +400% |
| AMBETTER | AMBETTER | $1,097.13 | ↑ +418% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $1,413.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $1,413.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,413.00 | ↑ +567% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $1,804.76 | ↑ +752% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $1,858.90 | ↑ +777% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $1,876.95 | ↑ +786% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $1,876.95 | ↑ +786% |
Visitor-reported prices
Comments
Control oropharyngeal hemorr/simp 42960 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Woods Community Hospital | JOHNSON CITY | $211.95 | $171.14 – $1,958.40 |
| 62-1166050 BMH Carroll County | Huntingdon | $162.15 | $404.56 – $930.02 |
| Hancock County Hospital | SNEEDVILLE | $207.92 | $171.14 – $2,056.32 |
| Greeneville Community Hospital | GREENEVILLE | $211.95 | $171.14 – $1,958.40 |
| Bristol Regional Medical Center | BRISTOL | $211.95 | $171.14 – $1,836.55 |
| Holston Valley Medical Center | KINGSPORT | $211.95 | $171.14 – $1,836.55 |
| 62-0123940 BMH Collierville | Collierville | $164.85 | $443.00 – $932.64 |
| Indian Path Community Hospital | KINGSPORT | $211.95 | $171.14 – $1,723.32 |