Biopsy of rectum wall anal approach 45100 at Johnson County Community Hospital
1901 S. SHADY ST., MOUNTAIN CITY, TN · Balladhealth · · NPI 1497859789
$1,138.04
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.
$4,948.00
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 $4,948.00 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $171.00 | ↓ -85% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $257.73 | ↓ -77% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $398.00 | ↓ -65% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $455.00 | ↓ -60% |
| AMERIGROUP | AMERIGROUP | $543.00 | ↓ -52% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $589.00 | ↓ -48% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $1,434.92 | ↑ +26% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $1,434.92 | ↑ +26% |
| WELLCARE | WELLCARE MEDICARE | $1,434.92 | ↑ +26% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $1,434.92 | ↑ +26% |
| AETNA | AETNA HEALTHCARE MEDICARE | $1,434.92 | ↑ +26% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $1,434.92 | ↑ +26% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $1,434.92 | ↑ +26% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $1,434.92 | ↑ +26% |
| SENTARA HEALTH | SENTARA MEDICARE | $1,434.92 | ↑ +26% |
| HUMANA | HUMANA MEDICARE | $1,457.88 | ↑ +28% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $1,477.97 | ↑ +30% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $1,492.32 | ↑ +31% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $1,506.67 | ↑ +32% |
| NHC ADVANTAGE | NHC ADVANTAGE | $1,506.67 | ↑ +32% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $1,506.67 | ↑ +32% |
| AMBETTER | AMBETTER | $1,583.36 | ↑ +39% |
| SENTARA HEALTH | SENTARA HEALTH | $1,678.86 | ↑ +48% |
| MEDCOST | MEDCOST VHN | $1,731.80 | ↑ +52% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $2,025.66 | ↑ +78% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $2,086.43 | ↑ +83% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $2,086.43 | ↑ +83% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $2,106.69 | ↑ +85% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $2,106.69 | ↑ +85% |
| AETNA | AETNA | $3,156.82 | ↑ +177% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $3,711.00 | ↑ +226% |
| BLUE CROSS | BLUE CROSS MEDICARE | $3,723.86 | ↑ +227% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $4,948.00 | ↑ +335% |
Visitor-reported prices
Comments
Biopsy of rectum wall anal approach 45100 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 62-1166050 BMH Carroll County | Huntingdon | $765.67 | $2,178.59 – $5,008.26 |
| Johnson City Medical Center | JOHNSON CITY | $1,159.80 | $257.73 – $5,646.39 |
| Hancock County Hospital | SNEEDVILLE | $1,138.04 | $257.73 – $2,126.94 |
| Greeneville Community Hospital | GREENEVILLE | $1,159.80 | $257.73 – $5,646.39 |
| Bristol Regional Medical Center | BRISTOL | $1,159.80 | $257.73 – $6,319.52 |
| Franklin Woods Community Hospital | JOHNSON CITY | $1,159.80 | $257.73 – $5,493.94 |
| Holston Valley Medical Center | KINGSPORT | $1,159.80 | $257.73 – $6,319.52 |
| 62-0123940 BMH Collierville | Collierville | $772.38 | $832.24 – $5,022.42 |