Diphenhydramine 12.5 mg/5 ml oral elixir at SUMMIT MEDICAL CENTER

100 SUMMIT BLVD, MT JULIET, TN · Tristarhealth · · NPI 1982650024

Source: hospital's published price file ↗ · Published Mar 1, 2026 · Ingested Sep 16, 2026

$76.08

Cash price

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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.

Full explanation →

What you pay up front if you don't use insurance.

$76.08

Gross charge

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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.

Full explanation →

The hospital's undiscounted list price — almost no one pays this.

$0.03 with Cigna vs $66.95 with Beech Street — 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 →

Payer
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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
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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
Cigna NewBusiness $0.03 ↓ -100%
Cigna OAP $0.03 ↓ -100%
United HeritageSelect $3.76 ↓ -95%
United AllPayerAppendix $3.76 ↓ -95%
United CorePayer $3.76 ↓ -95%
Aetna MGMCRHMO $11.41 ↓ -85%
Aetna MGMCRPPO $11.41 ↓ -85%
Aetna MGMCRSNP $11.41 ↓ -85%
Kentucky Labor Cabinet WORKERSCOMP $14.01 ↓ -82%
BCBS NetworkP $17.50 ↓ -77%
Ambetter Select $17.65 ↓ -77%
Humana TRICARE $19.02 ↓ -75%
United OptionsPPO $21.23 ↓ -72%
Cigna PPO $24.80 ↓ -67%
Centurion PRISON $31.34 ↓ -59%
United GlobalBenefitPlan $34.24 ↓ -55%
BGFH SingleSource DIRECTNETWORK $38.04 ↓ -50%
Signature Advantage MCR $38.04 ↓ -50%
Multiplan COMM $49.45 ↓ -35%
Humana BH COMM $49.45 ↓ -35%
Employers Health Network COMM $53.26 ↓ -30%
Odom's TN Pride Sausage WORKERSCOMP $57.06 ↓ -25%
Cigna Evernorth Behavioral Health COMM $60.86 ↓ -20%
BGFH SingleSource LEASEDNETWORK $64.67 ↓ -15%
Prime Health COMMPPO $66.95 ↓ -12%
Beech Street COMM $66.95 ↓ -12%

Visitor-reported prices

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Diphenhydramine 12.5 mg/5 ml oral elixir at other Tennessee hospitals

Hospital City Cash price Negotiated range
CHI Memorial Hospital Hixson Hixson $1.13 $0.32 – $2.67
62-1166050 BMH Carroll County Huntingdon $0.14 $0.02 – $0.02
CHI Memorial Hospital Chattanooga Chattanooga $1.62 $0.32 – $2.67
62-0123940 BMH Collierville Collierville $0.13 $0.02 – $0.02
62-1138045 BMH Union City Union City $0.12 $0.02 – $0.02
CENTENNIAL MEDICAL CENTER AT ASHLAND CITY Ashland City not published $0.03 – $3.76
HENDERSONVILLE MEDICAL CENTER HENDERSONVILLE not published $0.03 – $3.76
HORIZON MEDICAL CENTER DICKSON not published $0.03 – $3.76

All Tennessee hospitals for this procedure →