Pt re-evaluation patient/family at Johnson County Community Hospital
1901 S. SHADY ST., MOUNTAIN CITY, TN · Balladhealth · · NPI 1497859789
$47.61
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.
$207.00
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.
$46.00 with UNITED HEALTHCARE vs $333.67 with AETNA — 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 | $46.00 | ↓ -3% |
| BLUE CROSS | TENNCARE BLUE SELECT | $52.36 | ↑ +10% |
| BLUE CROSS | TENNCARE BLUE CARE | $52.36 | ↑ +10% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $60.03 | ↑ +26% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $60.03 | ↑ +26% |
| WELLCARE | WELLCARE MEDICARE | $60.03 | ↑ +26% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $60.03 | ↑ +26% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $60.03 | ↑ +26% |
| AETNA | AETNA HEALTHCARE MEDICARE | $60.03 | ↑ +26% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $60.03 | ↑ +26% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $60.03 | ↑ +26% |
| SENTARA HEALTH | SENTARA MEDICARE | $60.03 | ↑ +26% |
| HUMANA | HUMANA MEDICARE | $60.99 | ↑ +28% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $61.83 | ↑ +30% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $62.43 | ↑ +31% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $63.03 | ↑ +32% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $63.03 | ↑ +32% |
| NHC ADVANTAGE | NHC ADVANTAGE | $63.03 | ↑ +32% |
| AMBETTER | AMBETTER | $66.24 | ↑ +39% |
| SENTARA HEALTH | SENTARA HEALTH | $70.24 | ↑ +48% |
| MEDCOST | MEDCOST VHN | $72.45 | ↑ +52% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $80.52 | ↑ +69% |
| CIGNA HEALTHCARE | CIGNA HMO | $80.52 | ↑ +69% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $96.05 | ↑ +102% |
| CIGNA HEALTHCARE | CIGNA PPO | $99.98 | ↑ +110% |
| AMERIGROUP | AMERIGROUP | $108.68 | ↑ +128% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $116.00 | ↑ +144% |
| AETNA | AETNA | $132.07 | ↑ +177% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $155.25 | ↑ +226% |
| BLUE CROSS | BLUE CROSS MEDICARE | $155.79 | ↑ +227% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $188.00 | ↑ +295% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $207.00 | ↑ +335% |
| BLUE CROSS | BLUE CROSS E NETWORK | $207.00 | ↑ +335% |
| BLUE CROSS | BLUE CROSS P NETWORK | $207.00 | ↑ +335% |
| BLUE CROSS | BLUE CROSS S NETWORK | $207.00 | ↑ +335% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $207.00 | ↑ +335% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $207.00 | ↑ +335% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $207.00 | ↑ +335% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $320.84 | ↑ +574% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $330.46 | ↑ +594% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $333.67 | ↑ +601% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $333.67 | ↑ +601% |
Visitor-reported prices
Comments
Pt re-evaluation patient/family at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $46.65 | $45.14 – $119.16 |
| CHI Memorial Hospital Hixson | Hixson | $46.48 | $31.40 – $189.52 |
| 62-1166050 BMH Carroll County | Huntingdon | $103.96 | $43.76 – $45.14 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $66.42 | $32.97 – $189.52 |
| Johnson City Medical Center | JOHNSON CITY | $48.60 | $44.00 – $295.67 |
| Ascension Saint Thomas DeKalb | Smithville | $48.26 | $45.14 – $119.16 |
| Ascension Saint Thomas Highlands | Sparta | $48.26 | $45.14 – $119.16 |
| Ascension Saint Thomas River Park | McMinnville | $45.95 | $57.22 – $119.16 |