Calculus analysis qual at SKYLINE MADISON CAMPUS
3441 DICKERSON PIKE, NASHVILLE, TN · Tristarhealth · · NPI 1295780476
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.
$5.21 with Wellpoint vs $65.26 with BCBS — 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 | $5.21 | — |
| Aetna | COMM | $9.21 | — |
| Aetna | NewBusiness | $9.21 | — |
| Alive Hospice | COMM | $11.58 | — |
| Sarah Cannon Research | COMM | $11.58 | — |
| Bright Health | SmallGroup | $11.58 | — |
| Bright Health | HIX | $11.58 | — |
| HealthSpring | DualEligible | $11.58 | — |
| HealthSpring | MCRHMO | $11.58 | — |
| HealthSpring | MCRPOS | $11.58 | — |
| HealthSpring | MCRPPO | $11.58 | — |
| Devoted Health Plan | MCR | $11.58 | — |
| Odyssey Healthcare | COMM | $11.58 | — |
| Amerigroup | MGMCR | $11.58 | — |
| Humana | ChoicecareMGMCR | $11.58 | — |
| United | VACCN | $11.58 | — |
| United | AllPayerAppendix | $11.58 | — |
| United | CorePayer | $11.58 | — |
| United | HeritageSelect | $11.58 | — |
| Aetna | MGMCRPPO | $11.70 | — |
| Aetna | MGMCRSNP | $11.70 | — |
| Aetna | MGMCRHMO | $11.70 | — |
| United | MGMCR | $11.81 | — |
| Zing | MGMCR | $11.93 | — |
| WellCare | MCR | $11.93 | — |
| BCBS | MCR | $11.93 | — |
| Ambetter | Select | $12.04 | — |
| American Health Advantage | MCRSNP | $12.16 | — |
| American Health Advantage | MCRPFFS | $12.16 | — |
| American Health Advantage | MCRPPO | $12.16 | — |
| Evergreen HMO | MCR | $12.16 | — |
| American Health Advantage | MCRHMO | $12.16 | — |
| American Health Advantage | MCRPOS | $12.16 | — |
| Signature Advantage | MCR | $12.27 | — |
| Ambetter | CORE | $12.50 | — |
| ATRIO Golden Times | MCR | $12.74 | — |
| Bright Health | MCRNarrow | $13.32 | — |
| BCBS | NetworkP | $15.79 | — |
| Prime Health | WORKERSCOMP | $16.68 | — |
| CorVel Corporation | WORKERSCOMP | $17.02 | — |
| NovaNET | WORKERSCOMP | $17.02 | — |
| Cigna | NewBusiness | $20.76 | — |
| Cigna | OAP | $23.57 | — |
| BCBS | TENNCARE | $32.74 | — |
| Oscar | HIX | $34.74 | — |
| BCBS | COVERKIDS | $35.45 | — |
| Humana | HumanaChoice | $46.32 | — |
| Humana | HumanaChoiceCare | $46.32 | — |
| Humana | BroadNetwork | $46.32 | — |
| Humana | NarrowExchangeNetwork | $46.32 | — |
| BCBS | BlueCare | $65.26 | — |
Visitor-reported prices
Comments
Calculus analysis qual at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | not published | $4.17 – $45.14 |
| Ascension Saint Thomas DeKalb | Smithville | not published | $8.12 – $45.14 |
| Ascension Saint Thomas Highlands | Sparta | not published | $8.12 – $45.14 |
| Ascension Saint Thomas River Park | McMinnville | not published | $8.12 – $45.14 |
| Ascension Saint Thomas Rutherford | Murfreesboro | not published | $10.42 – $45.14 |
| Ascension Saint Thomas Hickman | Centerville | not published | $10.42 – $45.14 |
| CENTENNIAL MEDICAL CENTER AT ASHLAND CITY | Ashland City | not published | $5.21 – $34.74 |
| HENDERSONVILLE MEDICAL CENTER | HENDERSONVILLE | not published | $5.21 – $34.74 |