Coombs direct 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.
$2.43 with Wellpoint vs $24.80 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 | $2.43 | — |
| Aetna | COMM | $4.28 | — |
| Aetna | NewBusiness | $4.28 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $4.46 | — |
| NHC Advantage, Inc. | MCRHMO | $4.61 | — |
| Pruitt Health (AllyAlign) | MCR | $4.61 | — |
| HealthSpring | DualEligible | $5.39 | — |
| HealthSpring | MCRHMO | $5.39 | — |
| HealthSpring | MCRPOS | $5.39 | — |
| HealthSpring | MCRPPO | $5.39 | — |
| Odyssey Healthcare | COMM | $5.39 | — |
| Bright Health | SmallGroup | $5.39 | — |
| Amerigroup | MGMCR | $5.39 | — |
| United | HeritageSelect | $5.39 | — |
| Alive Hospice | COMM | $5.39 | — |
| Humana | ChoicecareMGMCR | $5.39 | — |
| Sarah Cannon Research | COMM | $5.39 | — |
| Devoted Health Plan | MCR | $5.39 | — |
| Bright Health | HIX | $5.39 | — |
| United | VACCN | $5.39 | — |
| United | AllPayerAppendix | $5.39 | — |
| United | CorePayer | $5.39 | — |
| Aetna | MGMCRPPO | $5.44 | — |
| Aetna | MGMCRSNP | $5.44 | — |
| Aetna | MGMCRHMO | $5.44 | — |
| United | MGMCR | $5.50 | — |
| BCBS | MCR | $5.55 | — |
| WellCare | MCR | $5.55 | — |
| Zing | MGMCR | $5.55 | — |
| Ambetter | Select | $5.61 | — |
| American Health Advantage | MCRHMO | $5.66 | — |
| American Health Advantage | MCRPOS | $5.66 | — |
| American Health Advantage | MCRSNP | $5.66 | — |
| American Health Advantage | MCRPPO | $5.66 | — |
| Evergreen HMO | MCR | $5.66 | — |
| American Health Advantage | MCRPFFS | $5.66 | — |
| Signature Advantage | MCR | $5.71 | — |
| Ambetter | CORE | $5.82 | — |
| ATRIO Golden Times | MCR | $5.93 | — |
| United | OptionsPPO | $5.99 | — |
| Humana | TRICARE | $6.06 | — |
| Bright Health | MCRNarrow | $6.20 | — |
| BCBS | NetworkP | $7.34 | — |
| Prime Health | WORKERSCOMP | $7.76 | — |
| Cigna | PPO | $7.91 | — |
| NovaNET | WORKERSCOMP | $7.92 | — |
| CorVel Corporation | WORKERSCOMP | $7.92 | — |
| Cigna | NewBusiness | $9.81 | — |
| Centurion | PRISON | $9.99 | — |
| United | GlobalBenefitPlan | $10.91 | — |
| Cigna | OAP | $11.14 | — |
| BGFH SingleSource | DIRECTNETWORK | $12.13 | — |
| Aetna | NAP | $12.13 | — |
| BCBS | TENNCARE | $12.44 | — |
| BCBS | COVERKIDS | $13.47 | — |
| Humana BH | COMM | $15.76 | — |
| Oscar | HIX | $16.17 | — |
| Employers Health Network | COMM | $16.98 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $18.19 | — |
| MHNet | COMM | $18.19 | — |
| Multiplan | COMM | $19.89 | — |
| BGFH SingleSource | LEASEDNETWORK | $20.61 | — |
| Prime Health | COMMPPO | $21.34 | — |
| Beech Street | COMM | $21.34 | — |
| Humana | NarrowExchangeNetwork | $21.56 | — |
| Humana | HumanaChoiceCare | $21.56 | — |
| Humana | HumanaChoice | $21.56 | — |
| Humana | BroadNetwork | $21.56 | — |
| TriWest Healthcare | FED | $23.77 | — |
| BCBS | BlueCare | $24.80 | — |
Visitor-reported prices
Comments
Coombs direct at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $53.81 | $4.85 – $79.65 |
| CHI Memorial Hospital Hixson | Hixson | $7.40 | $5.39 – $17.50 |
| 62-1166050 BMH Carroll County | Huntingdon | $39.79 | $8.58 – $108.48 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $10.58 | $5.25 – $17.50 |
| Johnson City Medical Center | JOHNSON CITY | $16.65 | $4.55 – $120.01 |
| Ascension Saint Thomas DeKalb | Smithville | $56.69 | $3.81 – $78.50 |
| Ascension Saint Thomas Highlands | Sparta | $56.69 | $3.81 – $78.50 |
| Ascension Saint Thomas River Park | McMinnville | $56.69 | $3.81 – $78.50 |