Established Patient Office Visit (level 3) 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.
$58.71 with BCBS vs $623.20 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 →
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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 | $58.71 | — |
| BCBS | COVERKIDS | $63.64 | — |
| Aetna | MGMCRHMO | $106.23 | — |
| Aetna | MGMCRSNP | $106.23 | — |
| Aetna | MGMCRPPO | $106.23 | — |
| BCBS | BlueCare | $109.47 | — |
| Oscar | HIX | $129.60 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $130.38 | — |
| Apex Health | MCR | $134.55 | — |
| NHC Advantage, Inc. | MCRHMO | $134.55 | — |
| Pruitt Health (AllyAlign) | MCR | $134.55 | — |
| Humana | TRICARE | $177.04 | — |
| United | OptionsPPO | $197.58 | — |
| Aetna | NewBusiness | $198.29 | — |
| Aetna | COMM | $233.70 | — |
| Centurion | PRISON | $291.77 | — |
| United | GlobalBenefitPlan | $318.68 | — |
| Aetna | NAP | $354.09 | — |
| Signature Advantage | MCR | $354.09 | — |
| BGFH SingleSource | DIRECTNETWORK | $354.09 | — |
| Multiplan | COMM | $460.32 | — |
| Humana BH | COMM | $460.32 | — |
| Employers Health Network | COMM | $495.73 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $531.13 | — |
| ComPsych | COMM | $566.54 | — |
| Cigna Evernorth Behavioral Health | COMM | $566.54 | — |
| BGFH SingleSource | LEASEDNETWORK | $601.95 | — |
| Prime Health | COMMPPO | $623.20 | — |
| Beech Street | COMM | $623.20 | — |
| BCBS | NetworkP | not published by hospital | — |
Visitor-reported prices
Comments
Established Patient Office Visit (level 3) at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Memorial Hospital Hixson | Hixson | $71.04 | $48.00 – $168.00 |
| 62-1166050 BMH Carroll County | Huntingdon | $112.01 | $37.88 – $53.73 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $101.52 | $50.40 – $168.00 |
| Johnson City Medical Center | JOHNSON CITY | $36.30 | $43.80 – $64.91 |
| Hancock County Hospital | SNEEDVILLE | $35.42 | $36.06 – $43.80 |
| Greeneville Community Hospital | GREENEVILLE | $36.30 | $25.96 – $43.80 |
| Bristol Regional Medical Center | BRISTOL | $36.30 | $43.27 – $43.80 |
| Franklin Woods Community Hospital | JOHNSON CITY | $36.30 | $43.80 – $64.91 |