Incision of breast lesion at Holston Valley Medical Center
130 W. RAVINE RD., KINGSPORT, TN · Balladhealth · · NPI 1487690400
$757.65
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.
$5,051.00
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.
$171.00 with UNITED HEALTHCARE vs $5,051.00 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 | $171.00 | ↓ -77% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $224.48 | ↓ -70% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $471.00 | ↓ -38% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $491.00 | ↓ -35% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $847.00 | ↑ +12% |
| SENTARA HEALTH | SENTARA HEALTH | $1,303.66 | ↑ +72% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $1,566.79 | ↑ +107% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $1,566.79 | ↑ +107% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $1,566.79 | ↑ +107% |
| AETNA | AETNA HEALTHCARE MEDICARE | $1,566.79 | ↑ +107% |
| HUMANA | HUMANA MEDICARE | $1,566.79 | ↑ +107% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $1,566.79 | ↑ +107% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $1,566.79 | ↑ +107% |
| SENTARA HEALTH | SENTARA MEDICARE | $1,566.79 | ↑ +107% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $1,598.13 | ↑ +111% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $1,629.46 | ↑ +115% |
| BLUE CROSS | BLUE CROSS MEDICARE | $1,629.46 | ↑ +115% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $1,645.13 | ↑ +117% |
| NHC ADVANTAGE | NHC ADVANTAGE | $1,645.13 | ↑ +117% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $1,645.13 | ↑ +117% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $1,645.13 | ↑ +117% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $1,645.13 | ↑ +117% |
| WELLCARE | WELLCARE MEDICARE | $1,660.80 | ↑ +119% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $1,661.48 | ↑ +119% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $1,711.32 | ↑ +126% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $1,712.99 | ↑ +126% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $1,727.94 | ↑ +128% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $1,744.55 | ↑ +130% |
| AETNA | AETNA | $2,156.78 | ↑ +185% |
| MEDCOST | MEDCOST VHN | $2,403.77 | ↑ +217% |
| BLUE CROSS | ANTHEM EXCHANGE | $3,217.85 | ↑ +325% |
| AMBETTER | AMBETTER | $3,415.60 | ↑ +351% |
| BLUE CROSS | ANTHEM HMO | $3,418.86 | ↑ +351% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $3,760.30 | ↑ +396% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $3,889.27 | ↑ +413% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $4,022.09 | ↑ +431% |
| WELLCARE | WELLCARE MEDICAID | $5,051.00 | ↑ +567% |
Visitor-reported prices
Comments
Incision of breast lesion at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 62-1166050 BMH Carroll County | Huntingdon | $1,015.91 | $1,287.14 – $2,958.94 |
| Greeneville Community Hospital | GREENEVILLE | $757.65 | $224.48 – $3,359.76 |
| Bristol Regional Medical Center | BRISTOL | $757.65 | $224.48 – $3,760.30 |
| 62-0123940 BMH Collierville | Collierville | $968.31 | $1,115.49 – $2,967.30 |
| 62-1138045 BMH Union City | Union City | $862.00 | $1,287.14 – $2,958.94 |
| Hawkins County Memorial Hospital | ROGERSVILLE | $757.65 | $224.48 – $3,266.63 |
| Ascension Saint Thomas Midtown | Nashville | not published | $1,185.00 – $1,534.53 |
| Ascension Saint Thomas DeKalb | Smithville | not published | $817.89 – $1,246.50 |