Apl(pml-rara) quant - sendout at SUMMIT MEDICAL CENTER
100 SUMMIT BLVD, MT JULIET, TN · Tristarhealth · · NPI 1982650024
not published by hospital
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.
not published by hospital
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.
$93.29 with Wellpoint vs $829.24 with Humana — 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 |
|---|---|---|---|
| Wellpoint | MGMCD | $93.29 | — |
| BCBS | TENNCARE | $154.89 | — |
| Aetna | COMM | $164.81 | — |
| Aetna | NewBusiness | $164.81 | — |
| BCBS | COVERKIDS | $167.88 | — |
| HealthSpring | MCRPPO | $207.31 | — |
| Devoted Health Plan | MCR | $207.31 | — |
| Humana | ChoicecareMGMCR | $207.31 | — |
| HealthSpring | DualEligible | $207.31 | — |
| HealthSpring | MCRHMO | $207.31 | — |
| HealthSpring | MCRPOS | $207.31 | — |
| United | VACCN | $207.31 | — |
| United | AllPayerAppendix | $207.31 | — |
| United | CorePayer | $207.31 | — |
| United | HeritageSelect | $207.31 | — |
| Amerigroup | MGMCR | $207.31 | — |
| Bright Health | HIX | $207.31 | — |
| Bright Health | SmallGroup | $207.31 | — |
| Sarah Cannon Research | COMM | $207.31 | — |
| Odyssey Healthcare | COMM | $207.31 | — |
| Aetna | MGMCRHMO | $209.38 | — |
| Aetna | MGMCRSNP | $209.38 | — |
| Aetna | MGMCRPPO | $209.38 | — |
| United | MGMCR | $211.46 | — |
| Zing | MGMCR | $213.53 | — |
| WellCare | MCR | $213.53 | — |
| BCBS | MCR | $213.53 | — |
| Ambetter | Select | $215.61 | — |
| American Health Advantage | MCRSNP | $217.68 | — |
| American Health Advantage | MCRPFFS | $217.68 | — |
| Evergreen HMO | MCR | $217.68 | — |
| American Health Advantage | MCRHMO | $217.68 | — |
| American Health Advantage | MCRPOS | $217.68 | — |
| American Health Advantage | MCRPPO | $217.68 | — |
| Signature Advantage | MCR | $219.75 | — |
| Ambetter | CORE | $223.90 | — |
| ATRIO Golden Times | MCR | $228.04 | — |
| Bright Health | MCRNarrow | $238.41 | — |
| BCBS | NetworkP | $282.83 | — |
| BCBS | BlueCare | $288.80 | — |
| Prime Health | WORKERSCOMP | $298.53 | — |
| CorVel Corporation | WORKERSCOMP | $304.75 | — |
| NovaNET | WORKERSCOMP | $304.75 | — |
| Cigna | NewBusiness | $369.70 | — |
| Cigna | OAP | $419.86 | — |
| Oscar | HIX | $621.93 | — |
| Humana | HumanaChoiceCare | $829.24 | — |
| Humana | NarrowExchangeNetwork | $829.24 | — |
| Humana | BroadNetwork | $829.24 | — |
| Humana | HumanaChoice | $829.24 | — |
Visitor-reported prices
Comments
Apl(pml-rara) quant - sendout at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $429.53 | $74.63 – $802.56 |
| Johnson City Medical Center | JOHNSON CITY | $363.00 | $103.66 – $451.94 |
| Ascension Saint Thomas DeKalb | Smithville | $429.53 | $99.93 – $802.56 |
| Ascension Saint Thomas Highlands | Sparta | $429.53 | $99.93 – $802.56 |
| Ascension Saint Thomas River Park | McMinnville | $429.53 | $140.01 – $802.56 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $429.53 | $99.93 – $802.56 |
| Hancock County Hospital | SNEEDVILLE | $356.27 | $115.92 – $456.89 |
| Greeneville Community Hospital | GREENEVILLE | $363.00 | $93.29 – $451.94 |