Dup scan/ue art/graft/bilat/comp 93930 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.
$167.94 with BCBS vs $2,113.94 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 |
|---|---|---|---|
| BCBS | TENNCARE | $167.94 | — |
| BCBS | COVERKIDS | $182.03 | — |
| BCBS | NetworkP | $301.01 | — |
| BCBS | BlueCare | $313.13 | — |
| Bright Health | HIX | $408.37 | — |
| Oscar | HIX | $439.60 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $442.25 | — |
| Apex Health | MCR | $456.42 | — |
| NHC Advantage, Inc. | MCRHMO | $456.42 | — |
| Pruitt Health (AllyAlign) | MCR | $456.42 | — |
| Cigna | NewBusiness | $508.13 | — |
| Ambetter | CORE | $535.69 | — |
| Ambetter | Select | $557.31 | — |
| Bright Health | SmallGroup | $576.53 | — |
| Cigna | OAP | $577.17 | — |
| Humana | TRICARE | $600.55 | — |
| United | OptionsPPO | $670.21 | — |
| Cigna | PPO | $783.12 | — |
| Centurion | PRISON | $989.71 | — |
| United | GlobalBenefitPlan | $1,080.99 | — |
| Aetna | NAP | $1,201.10 | — |
| BGFH SingleSource | DIRECTNETWORK | $1,201.10 | — |
| Aetna | NewBusiness | $1,264.00 | — |
| Aetna | COMM | $1,482.00 | — |
| Multiplan | COMM | $1,561.43 | — |
| Humana BH | COMM | $1,561.43 | — |
| Employers Health Network | COMM | $1,681.54 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $1,801.65 | — |
| ComPsych | COMM | $1,921.76 | — |
| Cigna Evernorth Behavioral Health | COMM | $1,921.76 | — |
| BGFH SingleSource | LEASEDNETWORK | $2,041.87 | — |
| Beech Street | COMM | $2,113.94 | — |
| Prime Health | COMMPPO | $2,113.94 | — |
Visitor-reported prices
Comments
Dup scan/ue art/graft/bilat/comp 93930 at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $384.66 | $108.35 – $451.97 |
| CHI Memorial Hospital Hixson | Hixson | $417.96 | $132.73 – $988.40 |
| 62-1166050 BMH Carroll County | Huntingdon | $458.16 | $108.35 – $441.44 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $597.28 | $132.73 – $988.40 |
| Johnson City Medical Center | JOHNSON CITY | $344.25 | $117.64 – $485.38 |
| Ascension Saint Thomas DeKalb | Smithville | $384.66 | $76.07 – $451.97 |
| Ascension Saint Thomas Highlands | Sparta | $384.66 | $76.07 – $451.97 |
| Ascension Saint Thomas River Park | McMinnville | $570.89 | $76.07 – $451.97 |