Ot evaluation high complexity patient/family at Johnson City Medical Center
400 N. STATE OF FRANKLIN RD, JOHNSON CITY, TN · Balladhealth · · NPI 1972606465
$79.20
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.
$528.00
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.
$44.00 with UNITED HEALTHCARE vs $528.00 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 | $44.00 | ↓ -44% |
| BLUE CROSS | TENNCARE BLUE CARE | $75.13 | ↓ -5% |
| BLUE CROSS | TENNCARE BLUE SELECT | $75.13 | ↓ -5% |
| SENTARA HEALTH | SENTARA MEDICARE | $95.94 | ↑ +21% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $95.94 | ↑ +21% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $95.94 | ↑ +21% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $95.94 | ↑ +21% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $95.94 | ↑ +21% |
| AETNA | AETNA HEALTHCARE MEDICARE | $95.94 | ↑ +21% |
| HUMANA | HUMANA MEDICARE | $95.94 | ↑ +21% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $95.94 | ↑ +21% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $95.94 | ↑ +21% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $95.94 | ↑ +21% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $98.82 | ↑ +25% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $98.82 | ↑ +25% |
| BLUE CROSS | BLUE CROSS MEDICARE | $99.78 | ↑ +26% |
| AMERIGROUP | AMERIGROUP | $99.78 | ↑ +26% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $99.78 | ↑ +26% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $100.74 | ↑ +27% |
| NHC ADVANTAGE | NHC ADVANTAGE | $100.74 | ↑ +27% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $100.74 | ↑ +27% |
| WELLCARE | WELLCARE MEDICARE | $101.70 | ↑ +28% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $116.00 | ↑ +46% |
| SENTARA HEALTH | SENTARA HEALTH | $184.22 | ↑ +133% |
| MEDCOST | MEDCOST VHN | $184.80 | ↑ +133% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $188.00 | ↑ +137% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $204.86 | ↑ +159% |
| CIGNA HEALTHCARE | CIGNA HMO | $204.86 | ↑ +159% |
| AMBETTER | AMBETTER | $209.15 | ↑ +164% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $234.00 | ↑ +195% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $244.99 | ↑ +209% |
| CIGNA HEALTHCARE | CIGNA PPO | $255.02 | ↑ +222% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $279.00 | ↑ +252% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $323.96 | ↑ +309% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $333.68 | ↑ +321% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $333.68 | ↑ +321% |
| AETNA | AETNA | $336.86 | ↑ +325% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $336.92 | ↑ +325% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $336.92 | ↑ +325% |
| BLUE CROSS | BLUE CROSS P NETWORK | $351.63 | ↑ +344% |
| BLUE CROSS | BLUE CROSS S NETWORK | $351.63 | ↑ +344% |
| BLUE CROSS | BLUE CROSS E NETWORK | $351.63 | ↑ +344% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $396.00 | ↑ +400% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $528.00 | ↑ +567% |
| WELLCARE | WELLCARE MEDICAID | $528.00 | ↑ +567% |
Visitor-reported prices
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Ot evaluation high complexity patient/family at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Woods Community Hospital | JOHNSON CITY | $79.20 | $46.00 – $351.54 |
| Ascension Saint Thomas Midtown | Nashville | $69.56 | $64.77 – $170.98 |
| CHI Memorial Hospital Hixson | Hixson | $156.88 | $70.00 – $371.00 |
| 62-1166050 BMH Carroll County | Huntingdon | $201.94 | $62.44 – $64.77 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $224.19 | $70.00 – $371.00 |
| Ascension Saint Thomas DeKalb | Smithville | $129.60 | $64.77 – $170.98 |
| Ascension Saint Thomas Highlands | Sparta | $129.60 | $64.77 – $170.98 |
| Ascension Saint Thomas River Park | McMinnville | $123.42 | $83.87 – $170.98 |