Lipoprotein blood quant 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.
$15.39 with Wellpoint vs $136.76 with Humana — 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 | $15.39 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $16.53 | — |
| NHC Advantage, Inc. | MCRHMO | $17.06 | — |
| Pruitt Health (AllyAlign) | MCR | $17.06 | — |
| United | OptionsPPO | $22.18 | — |
| Humana | TRICARE | $22.45 | — |
| Aetna | COMM | $27.18 | — |
| Aetna | NewBusiness | $27.18 | — |
| Cigna | PPO | $29.27 | — |
| HealthSpring | DualEligible | $34.19 | — |
| HealthSpring | MCRHMO | $34.19 | — |
| HealthSpring | MCRPOS | $34.19 | — |
| HealthSpring | MCRPPO | $34.19 | — |
| Sarah Cannon Research | COMM | $34.19 | — |
| Devoted Health Plan | MCR | $34.19 | — |
| Alive Hospice | COMM | $34.19 | — |
| Humana | ChoicecareMGMCR | $34.19 | — |
| Bright Health | HIX | $34.19 | — |
| United | CorePayer | $34.19 | — |
| United | HeritageSelect | $34.19 | — |
| Amerigroup | MGMCR | $34.19 | — |
| Bright Health | SmallGroup | $34.19 | — |
| United | VACCN | $34.19 | — |
| United | AllPayerAppendix | $34.19 | — |
| Odyssey Healthcare | COMM | $34.19 | — |
| Aetna | MGMCRHMO | $34.53 | — |
| Aetna | MGMCRPPO | $34.53 | — |
| Aetna | MGMCRSNP | $34.53 | — |
| United | MGMCR | $34.87 | — |
| BCBS | MCR | $35.22 | — |
| WellCare | MCR | $35.22 | — |
| Zing | MGMCR | $35.22 | — |
| Ambetter | Select | $35.55 | — |
| American Health Advantage | MCRPPO | $35.90 | — |
| American Health Advantage | MCRSNP | $35.90 | — |
| American Health Advantage | MCRHMO | $35.90 | — |
| American Health Advantage | MCRPOS | $35.90 | — |
| Evergreen HMO | MCR | $35.90 | — |
| American Health Advantage | MCRPFFS | $35.90 | — |
| Signature Advantage | MCR | $36.24 | — |
| Ambetter | CORE | $36.92 | — |
| Centurion | PRISON | $36.99 | — |
| ATRIO Golden Times | MCR | $37.61 | — |
| Bright Health | MCRNarrow | $39.32 | — |
| United | GlobalBenefitPlan | $40.41 | — |
| BCBS | NetworkP | $43.04 | — |
| BGFH SingleSource | DIRECTNETWORK | $44.90 | — |
| Aetna | NAP | $44.90 | — |
| Prime Health | WORKERSCOMP | $49.23 | — |
| NovaNET | WORKERSCOMP | $50.26 | — |
| CorVel Corporation | WORKERSCOMP | $50.26 | — |
| BCBS | TENNCARE | $51.94 | — |
| BCBS | COVERKIDS | $56.24 | — |
| Humana BH | COMM | $58.36 | — |
| Cigna | NewBusiness | $61.13 | — |
| Employers Health Network | COMM | $62.85 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $67.34 | — |
| MHNet | COMM | $67.34 | — |
| Cigna | OAP | $69.43 | — |
| Multiplan | COMM | $73.63 | — |
| BGFH SingleSource | LEASEDNETWORK | $76.32 | — |
| Beech Street | COMM | $79.02 | — |
| Prime Health | COMMPPO | $79.02 | — |
| TriWest Healthcare | FED | $87.99 | — |
| Oscar | HIX | $102.57 | — |
| BCBS | BlueCare | $103.52 | — |
| Humana | HumanaChoiceCare | $136.76 | — |
| Humana | HumanaChoice | $136.76 | — |
| Humana | BroadNetwork | $136.76 | — |
| Humana | NarrowExchangeNetwork | $136.76 | — |
Visitor-reported prices
Comments
Lipoprotein blood quant at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $28.82 | $12.31 – $121.90 |
| CHI Memorial Hospital Hixson | Hixson | $61.87 | $28.02 – $146.30 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $88.41 | $28.02 – $146.30 |
| Johnson City Medical Center | JOHNSON CITY | $55.35 | $17.10 – $74.53 |
| Ascension Saint Thomas DeKalb | Smithville | $28.82 | $22.13 – $121.90 |
| Ascension Saint Thomas Highlands | Sparta | $28.82 | $22.13 – $121.90 |
| Ascension Saint Thomas River Park | McMinnville | $28.82 | $22.13 – $121.90 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $28.82 | $30.77 – $121.90 |