Avul nail plate addl at Johnson County Community Hospital
1901 S. SHADY ST., MOUNTAIN CITY, TN · Balladhealth · · NPI 1497859789
$40.25
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.
$175.00
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.
$33.13 with BLUE CROSS vs $175.00 with UNITED HEALTHCARE — 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 | $33.13 | ↓ -18% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $50.75 | ↑ +26% |
| SENTARA HEALTH | SENTARA MEDICARE | $50.75 | ↑ +26% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $50.75 | ↑ +26% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $50.75 | ↑ +26% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $50.75 | ↑ +26% |
| WELLCARE | WELLCARE MEDICARE | $50.75 | ↑ +26% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $50.75 | ↑ +26% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $50.75 | ↑ +26% |
| AETNA | AETNA HEALTHCARE MEDICARE | $50.75 | ↑ +26% |
| HUMANA | HUMANA MEDICARE | $51.56 | ↑ +28% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $52.27 | ↑ +30% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $52.78 | ↑ +31% |
| NHC ADVANTAGE | NHC ADVANTAGE | $53.29 | ↑ +32% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $53.29 | ↑ +32% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $53.29 | ↑ +32% |
| AMBETTER | AMBETTER | $56.00 | ↑ +39% |
| SENTARA HEALTH | SENTARA HEALTH | $59.38 | ↑ +48% |
| MEDCOST | MEDCOST VHN | $61.25 | ↑ +52% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $91.44 | ↑ +127% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $94.18 | ↑ +134% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $94.18 | ↑ +134% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $95.10 | ↑ +136% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $95.10 | ↑ +136% |
| AETNA | AETNA | $111.65 | ↑ +177% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $131.25 | ↑ +226% |
| BLUE CROSS | BLUE CROSS MEDICARE | $131.71 | ↑ +227% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $171.00 | ↑ +325% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $175.00 | ↑ +335% |
| AMERIGROUP | AMERIGROUP | $175.00 | ↑ +335% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $175.00 | ↑ +335% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $175.00 | ↑ +335% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $175.00 | ↑ +335% |
Visitor-reported prices
Comments
Avul nail plate addl at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Memorial Hospital Hixson | Hixson | $96.20 | $65.00 – $227.50 |
| 62-1166050 BMH Carroll County | Huntingdon | $22.31 | $13.73 – $98.00 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $137.48 | $68.25 – $227.50 |
| Johnson City Medical Center | JOHNSON CITY | $41.10 | $33.13 – $87.64 |
| Hancock County Hospital | SNEEDVILLE | $40.25 | $33.13 – $96.01 |
| Greeneville Community Hospital | GREENEVILLE | $41.10 | $33.13 – $91.44 |
| Bristol Regional Medical Center | BRISTOL | $41.10 | $33.13 – $87.33 |
| Franklin Woods Community Hospital | JOHNSON CITY | $41.10 | $33.13 – $95.10 |