Bilirubin direct 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.
$2.26 with Wellpoint vs $320.32 with Prime Health — 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 | $2.26 | — |
| Aetna | NewBusiness | $4.00 | — |
| Aetna | COMM | $4.00 | — |
| Devoted Health Plan | MCR | $5.02 | — |
| Bright Health | SmallGroup | $5.02 | — |
| Bright Health | HIX | $5.02 | — |
| Amerigroup | MGMCR | $5.02 | — |
| HealthSpring | DualEligible | $5.02 | — |
| HealthSpring | MCRHMO | $5.02 | — |
| HealthSpring | MCRPOS | $5.02 | — |
| HealthSpring | MCRPPO | $5.02 | — |
| Odyssey Healthcare | COMM | $5.02 | — |
| United | HeritageSelect | $5.02 | — |
| United | VACCN | $5.02 | — |
| Sarah Cannon Research | COMM | $5.02 | — |
| Humana | ChoicecareMGMCR | $5.02 | — |
| United | CorePayer | $5.02 | — |
| United | AllPayerAppendix | $5.02 | — |
| Aetna | MGMCRPPO | $5.07 | — |
| Aetna | MGMCRSNP | $5.07 | — |
| Aetna | MGMCRHMO | $5.07 | — |
| United | MGMCR | $5.12 | — |
| BCBS | MCR | $5.17 | — |
| WellCare | MCR | $5.17 | — |
| Zing | MGMCR | $5.17 | — |
| Ambetter | Select | $5.22 | — |
| American Health Advantage | MCRHMO | $5.27 | — |
| American Health Advantage | MCRSNP | $5.27 | — |
| Evergreen HMO | MCR | $5.27 | — |
| American Health Advantage | MCRPFFS | $5.27 | — |
| American Health Advantage | MCRPOS | $5.27 | — |
| American Health Advantage | MCRPPO | $5.27 | — |
| Signature Advantage | MCR | $5.32 | — |
| Ambetter | CORE | $5.42 | — |
| ATRIO Golden Times | MCR | $5.52 | — |
| Bright Health | MCRNarrow | $5.77 | — |
| BCBS | NetworkP | $6.84 | — |
| Prime Health | WORKERSCOMP | $7.23 | — |
| NovaNET | WORKERSCOMP | $7.38 | — |
| CorVel Corporation | WORKERSCOMP | $7.38 | — |
| Cigna | NewBusiness | $9.23 | — |
| Cigna | OAP | $10.49 | — |
| BCBS | TENNCARE | $13.58 | — |
| BCBS | COVERKIDS | $14.72 | — |
| Oscar | HIX | $15.06 | — |
| Humana | BroadNetwork | $20.08 | — |
| Humana | NarrowExchangeNetwork | $20.08 | — |
| Humana | HumanaChoiceCare | $20.08 | — |
| Humana | HumanaChoice | $20.08 | — |
| BCBS | BlueCare | $25.32 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $67.01 | — |
| Pruitt Health (AllyAlign) | MCR | $69.16 | — |
| Apex Health | MCR | $69.16 | — |
| NHC Advantage, Inc. | MCRHMO | $69.16 | — |
| Humana | TRICARE | $91.00 | — |
| United | OptionsPPO | $101.56 | — |
| Cigna | PPO | $118.66 | — |
| Centurion | PRISON | $149.97 | — |
| United | GlobalBenefitPlan | $163.80 | — |
| BGFH SingleSource | DIRECTNETWORK | $182.00 | — |
| Aetna | NAP | $182.00 | — |
| Multiplan | COMM | $236.60 | — |
| Humana BH | COMM | $236.60 | — |
| Employers Health Network | COMM | $254.80 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $273.00 | — |
| Cigna Evernorth Behavioral Health | COMM | $291.20 | — |
| ComPsych | COMM | $291.20 | — |
| BGFH SingleSource | LEASEDNETWORK | $309.40 | — |
| Beech Street | COMM | $320.32 | — |
| Prime Health | COMMPPO | $320.32 | — |
Visitor-reported prices
Comments
Bilirubin direct at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $49.29 | $1.81 – $19.17 |
| CHI Memorial Hospital Hixson | Hixson | $75.48 | $4.46 – $178.50 |
| 62-1166050 BMH Carroll County | Huntingdon | $47.84 | $4.37 – $10.04 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $107.87 | $4.46 – $178.50 |
| Johnson City Medical Center | JOHNSON CITY | $8.85 | $2.51 – $10.94 |
| Ascension Saint Thomas DeKalb | Smithville | $49.31 | $3.51 – $19.17 |
| Ascension Saint Thomas Highlands | Sparta | $49.31 | $3.51 – $19.17 |
| Ascension Saint Thomas River Park | McMinnville | $49.31 | $3.51 – $19.17 |