Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes 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.
$29.70 with Wellpoint vs $326.00 with Aetna — 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 | $29.70 | — |
| Devoted Health Plan | MCR | $41.25 | — |
| Humana | ChoicecareMGMCR | $41.25 | — |
| HealthSpring | DualEligible | $41.25 | — |
| HealthSpring | MCRHMO | $41.25 | — |
| HealthSpring | MCRPOS | $41.25 | — |
| HealthSpring | MCRPPO | $41.25 | — |
| Odyssey Healthcare | COMM | $41.25 | — |
| Alive Hospice | COMM | $41.25 | — |
| Sarah Cannon Research | COMM | $41.25 | — |
| United | VACCN | $41.25 | — |
| Amerigroup | MGMCR | $41.25 | — |
| Aetna | MGMCRHMO | $41.67 | — |
| Aetna | MGMCRSNP | $41.67 | — |
| Aetna | MGMCRPPO | $41.67 | — |
| United | MGMCR | $42.08 | — |
| Bright Health | HIX | $42.22 | — |
| WellCare | MCR | $42.49 | — |
| Zing | MGMCR | $42.49 | — |
| BCBS | MCR | $42.49 | — |
| American Health Advantage | MCRPPO | $43.32 | — |
| American Health Advantage | MCRPOS | $43.32 | — |
| American Health Advantage | MCRHMO | $43.32 | — |
| Evergreen HMO | MCR | $43.32 | — |
| American Health Advantage | MCRPFFS | $43.32 | — |
| American Health Advantage | MCRSNP | $43.32 | — |
| Signature Advantage | MCR | $43.73 | — |
| ATRIO Golden Times | MCR | $45.38 | — |
| Oscar | HIX | $45.45 | — |
| Kentucky Labor Cabinet | WORKERSCOMP | $45.72 | — |
| NHC Advantage, Inc. | MCRHMO | $47.19 | — |
| Pruitt Health (AllyAlign) | MCR | $47.19 | — |
| Bright Health | MCRNarrow | $47.44 | — |
| Ambetter | CORE | $55.39 | — |
| BCBS | TENNCARE | $57.43 | — |
| Ambetter | Select | $57.62 | — |
| Prime Health | WORKERSCOMP | $59.41 | — |
| Bright Health | SmallGroup | $59.61 | — |
| NovaNET | WORKERSCOMP | $60.64 | — |
| CorVel Corporation | WORKERSCOMP | $60.64 | — |
| United | OptionsPPO | $61.35 | — |
| Humana | TRICARE | $62.09 | — |
| BCBS | COVERKIDS | $62.19 | — |
| Cigna | NewBusiness | $62.59 | — |
| Cigna | OAP | $71.03 | — |
| Cigna | PPO | $80.97 | — |
| BCBS | NetworkP | $101.20 | — |
| United | GlobalBenefitPlan | $111.77 | — |
| BCBS | BlueCare | $114.47 | — |
| BGFH SingleSource | DIRECTNETWORK | $124.19 | — |
| Aetna | NAP | $124.19 | — |
| Humana BH | COMM | $161.44 | — |
| Employers Health Network | COMM | $173.86 | — |
| Odom's TN Pride Sausage | WORKERSCOMP | $186.28 | — |
| MHNet | COMM | $186.28 | — |
| Multiplan | COMM | $203.66 | — |
| BGFH SingleSource | LEASEDNETWORK | $211.11 | — |
| Beech Street | COMM | $218.57 | — |
| Prime Health | COMMPPO | $218.57 | — |
| TriWest Healthcare | FED | $243.40 | — |
| Aetna | NewBusiness | $274.00 | — |
| Aetna | COMM | $326.00 | — |
Visitor-reported prices
Comments
Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $50.48 | $39.61 – $104.56 |
| CHI Memorial Hospital Hixson | Hixson | $63.35 | $42.80 – $189.52 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $90.53 | $44.94 – $189.52 |
| Johnson City Medical Center | JOHNSON CITY | $46.20 | $44.00 – $102.20 |
| Ascension Saint Thomas DeKalb | Smithville | $50.48 | $39.61 – $104.56 |
| Ascension Saint Thomas Highlands | Sparta | $50.48 | $39.61 – $104.56 |
| Ascension Saint Thomas River Park | McMinnville | $50.48 | $41.78 – $104.56 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $42.50 | $39.61 – $104.56 |