Ot evaluation moderate complexity patient/family at SUMMIT MEDICAL CENTER
100 SUMMIT BLVD, MT JULIET, TN · Tristarhealth · · NPI 1982650024
$460.90
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.
$460.90
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.
$75.98 with Wellpoint vs $405.59 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 |
|---|---|---|---|
| Wellpoint | MGMCD | $75.98 | ↓ -84% |
| Bright Health | HIX | $78.35 | ↓ -83% |
| Oscar | HIX | $84.34 | ↓ -82% |
| HealthSpring | MCRHMO | $84.43 | ↓ -82% |
| HealthSpring | MCRPOS | $84.43 | ↓ -82% |
| HealthSpring | MCRPPO | $84.43 | ↓ -82% |
| Humana | ChoicecareMGMCR | $84.43 | ↓ -82% |
| Devoted Health Plan | MCR | $84.43 | ↓ -82% |
| Sarah Cannon Research | COMM | $84.43 | ↓ -82% |
| Amerigroup | MGMCR | $84.43 | ↓ -82% |
| United | VACCN | $84.43 | ↓ -82% |
| Odyssey Healthcare | COMM | $84.43 | ↓ -82% |
| HealthSpring | DualEligible | $84.43 | ↓ -82% |
| Kentucky Labor Cabinet | WORKERSCOMP | $84.85 | ↓ -82% |
| Aetna | MGMCRSNP | $85.27 | ↓ -81% |
| Aetna | MGMCRPPO | $85.27 | ↓ -81% |
| Aetna | MGMCRHMO | $85.27 | ↓ -81% |
| United | MGMCR | $86.12 | ↓ -81% |
| Zing | MGMCR | $86.96 | ↓ -81% |
| WellCare | MCR | $86.96 | ↓ -81% |
| BCBS | MCR | $86.96 | ↓ -81% |
| NHC Advantage, Inc. | MCRHMO | $87.57 | ↓ -81% |
| Pruitt Health (AllyAlign) | MCR | $87.57 | ↓ -81% |
| Apex Health | MCR | $87.57 | ↓ -81% |
| American Health Advantage | MCRHMO | $88.65 | ↓ -81% |
| Evergreen HMO | MCR | $88.65 | ↓ -81% |
| American Health Advantage | MCRPFFS | $88.65 | ↓ -81% |
| American Health Advantage | MCRSNP | $88.65 | ↓ -81% |
| American Health Advantage | MCRPPO | $88.65 | ↓ -81% |
| American Health Advantage | MCRPOS | $88.65 | ↓ -81% |
| Signature Advantage | MCR | $89.49 | ↓ -81% |
| ATRIO Golden Times | MCR | $92.87 | ↓ -80% |
| Bright Health | MCRNarrow | $97.09 | ↓ -79% |
| BCBS | TENNCARE | $100.39 | ↓ -78% |
| Ambetter | CORE | $102.78 | ↓ -78% |
| Ambetter | Select | $106.93 | ↓ -77% |
| BCBS | COVERKIDS | $108.81 | ↓ -76% |
| Bright Health | SmallGroup | $110.62 | ↓ -76% |
| Humana | TRICARE | $115.22 | ↓ -75% |
| Cigna | NewBusiness | $116.15 | ↓ -75% |
| Prime Health | WORKERSCOMP | $121.57 | ↓ -74% |
| CorVel Corporation | WORKERSCOMP | $124.11 | ↓ -73% |
| NovaNET | WORKERSCOMP | $124.11 | ↓ -73% |
| United | OptionsPPO | $128.59 | ↓ -72% |
| Cigna | OAP | $131.82 | ↓ -71% |
| Cigna | PPO | $150.25 | ↓ -67% |
| BCBS | BlueCare | $187.19 | ↓ -59% |
| BCBS | NetworkP | $206.79 | ↓ -55% |
| United | GlobalBenefitPlan | $207.41 | ↓ -55% |
| Aetna | NAP | $230.45 | ↓ -50% |
| BGFH SingleSource | DIRECTNETWORK | $230.45 | ↓ -50% |
| Aetna | NewBusiness | $274.00 | ↓ -41% |
| Humana BH | COMM | $299.58 | ↓ -35% |
| Multiplan | COMM | $299.58 | ↓ -35% |
| Employers Health Network | COMM | $322.63 | ↓ -30% |
| Aetna | COMM | $326.00 | ↓ -29% |
| Odom's TN Pride Sausage | WORKERSCOMP | $345.68 | ↓ -25% |
| ComPsych | COMM | $368.72 | ↓ -20% |
| Cigna Evernorth Behavioral Health | COMM | $368.72 | ↓ -20% |
| BGFH SingleSource | LEASEDNETWORK | $391.76 | ↓ -15% |
| Prime Health | COMMPPO | $405.59 | ↓ -12% |
| Beech Street | COMM | $405.59 | ↓ -12% |
Visitor-reported prices
Comments
Ot evaluation moderate complexity patient/family at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $69.56 | $64.77 – $170.98 |
| CHI Memorial Hospital Hixson | Hixson | $135.28 | $70.00 – $319.90 |
| 62-1166050 BMH Carroll County | Huntingdon | $201.94 | $62.44 – $64.77 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $193.32 | $70.00 – $319.90 |
| Johnson City Medical Center | JOHNSON CITY | $75.45 | $44.00 – $323.96 |
| Ascension Saint Thomas DeKalb | Smithville | $129.60 | $64.77 – $170.98 |
| Ascension Saint Thomas Highlands | Sparta | $129.60 | $64.77 – $170.98 |
| Ascension Saint Thomas River Park | McMinnville | $123.42 | $83.87 – $170.98 |