Surgical pathology level 5 gross & microscopic examination at Johnson City Medical Center
400 N. STATE OF FRANKLIN RD, JOHNSON CITY, TN · Balladhealth · · NPI 1972606465
$235.20
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.
$1,568.00
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.
$34.65 with BLUE CROSS vs $1,568.00 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 | BLUE CROSS BALLAD HEALTH EMPLOYEE | $34.65 | ↓ -85% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $51.89 | ↓ -78% |
| AMERIGROUP | AMERIGROUP | $98.38 | ↓ -58% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $203.69 | ↓ -13% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $209.80 | ↓ -11% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $209.80 | ↓ -11% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $211.84 | ↓ -10% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $211.84 | ↓ -10% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $283.41 | ↑ +20% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $283.41 | ↑ +20% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $283.41 | ↑ +20% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $334.48 | ↑ +42% |
| AETNA | AETNA HEALTHCARE MEDICARE | $334.48 | ↑ +42% |
| HUMANA | HUMANA MEDICARE | $334.48 | ↑ +42% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $334.48 | ↑ +42% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $334.48 | ↑ +42% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $334.48 | ↑ +42% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $334.48 | ↑ +42% |
| SENTARA HEALTH | SENTARA MEDICARE | $334.48 | ↑ +42% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $334.48 | ↑ +42% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $334.48 | ↑ +42% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $344.52 | ↑ +46% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $344.52 | ↑ +46% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $347.86 | ↑ +48% |
| BLUE CROSS | BLUE CROSS MEDICARE | $347.86 | ↑ +48% |
| NHC ADVANTAGE | NHC ADVANTAGE | $351.21 | ↑ +49% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $351.21 | ↑ +49% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $351.21 | ↑ +49% |
| WELLCARE | WELLCARE MEDICARE | $354.55 | ↑ +51% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $432.63 | ↑ +84% |
| CIGNA HEALTHCARE | CIGNA PPO | $432.63 | ↑ +84% |
| CIGNA HEALTHCARE | CIGNA HMO | $432.63 | ↑ +84% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $451.42 | ↑ +92% |
| SENTARA HEALTH | SENTARA HEALTH | $547.08 | ↑ +133% |
| MEDCOST | MEDCOST VHN | $548.80 | ↑ +133% |
| AMBETTER | AMBETTER | $729.17 | ↑ +210% |
| BLUE CROSS | BLUE CROSS E NETWORK | $749.41 | ↑ +219% |
| BLUE CROSS | BLUE CROSS S NETWORK | $764.07 | ↑ +225% |
| BLUE CROSS | BLUE CROSS P NETWORK | $764.07 | ↑ +225% |
| AETNA | AETNA | $1,000.38 | ↑ +325% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,176.00 | ↑ +400% |
| WELLCARE | WELLCARE MEDICAID | $1,568.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,568.00 | ↑ +567% |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Franklin Woods Community Hospital | JOHNSON CITY | $235.20 | $34.65 – $709.48 |
| Ascension Saint Thomas Midtown | Nashville | $161.76 | $22.20 – $570.20 |
| CHI Memorial Hospital Hixson | Hixson | $294.82 | $33.04 – $697.20 |
| 62-1166050 BMH Carroll County | Huntingdon | $115.23 | $22.20 – $656.94 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $421.31 | $33.04 – $697.20 |
| Ascension Saint Thomas DeKalb | Smithville | $161.76 | $22.20 – $570.20 |
| Ascension Saint Thomas Highlands | Sparta | $161.76 | $22.20 – $570.20 |
| Ascension Saint Thomas River Park | McMinnville | $161.76 | $28.54 – $570.20 |