New Patient Office Visit (level 4) 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.
?
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.
?
The hospital's undiscounted list price — almost no one pays this.
$92.11 with Aetna vs $601.82 with TriWest Healthcare — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| Aetna | MGMCRPPO | $92.11 | — |
| Aetna | MGMCRHMO | $92.11 | — |
| Aetna | MGMCRSNP | $92.11 | — |
| Oscar | HIX | $112.38 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $113.06 | — |
| NHC Advantage, Inc. | MCRHMO | $116.68 | — |
| Pruitt Health (AllyAlign) | MCR | $116.68 | — |
| BCBS | TENNCARE | $121.08 | — |
| BCBS | COVERKIDS | $131.09 | — |
| United | OptionsPPO | $151.68 | — |
| Humana | TRICARE | $153.53 | — |
| Aetna | NewBusiness | $171.95 | — |
| Aetna | COMM | $202.65 | — |
| BCBS | BlueCare | $241.31 | — |
| Centurion | PRISON | $253.01 | — |
| United | GlobalBenefitPlan | $276.35 | — |
| Aetna | NAP | $307.05 | — |
| Signature Advantage | MCR | $307.05 | — |
| BGFH SingleSource | DIRECTNETWORK | $307.05 | — |
| Humana BH | COMM | $399.17 | — |
| Employers Health Network | COMM | $429.87 | — |
| MHNet | COMM | $460.57 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $460.57 | — |
| Multiplan | COMM | $503.56 | — |
| BGFH SingleSource | LEASEDNETWORK | $521.99 | — |
| Prime Health | COMMPPO | $540.41 | — |
| Beech Street | COMM | $540.41 | — |
| TriWest Healthcare | FED | $601.82 | — |
| BCBS | NetworkP | not published by hospital | — |
Visitor-reported prices
Comments
New Patient Office Visit (level 4) at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | not published | $83.50 – $118.41 |
| CHI Memorial Hospital Hixson | Hixson | $226.44 | $94.76 – $535.50 |
| 62-1166050 BMH Carroll County | Huntingdon | $112.01 | $83.50 – $108.16 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $323.60 | $94.76 – $535.50 |
| Johnson City Medical Center | JOHNSON CITY | $51.00 | $96.86 – $117.37 |
| Hancock County Hospital | SNEEDVILLE | $50.14 | $65.21 – $96.86 |
| Greeneville Community Hospital | GREENEVILLE | $51.00 | $46.95 – $96.86 |
| Bristol Regional Medical Center | BRISTOL | $51.00 | $78.25 – $96.86 |