Established Patient Office Visit (level 5) at Hawkins County Memorial Hospital
851 LOCUST ST, ROGERSVILLE, TN · Balladhealth · · NPI 1174553598
$46.20
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.
$308.00
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.
$65.21 with UNITED HEALTHCARE vs $308.00 with SEVEN CORNERS, INC. — 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $65.21 | ↑ +41% |
| SENTARA HEALTH | SENTARA HEALTH | $79.49 | ↑ +72% |
| BLUE CROSS | TENNCARE BLUE SELECT | $88.39 | ↑ +91% |
| BLUE CROSS | TENNCARE BLUE CARE | $88.39 | ↑ +91% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $94.56 | ↑ +105% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $99.48 | ↑ +115% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $99.48 | ↑ +115% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $103.22 | ↑ +123% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $128.44 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA HMO | $128.44 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $128.44 | ↑ +178% |
| AETNA | AETNA | $131.52 | ↑ +185% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $142.91 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $146.58 | ↑ +217% |
| BLUE CROSS | ANTHEM HMO | $180.78 | ↑ +291% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $180.78 | ↑ +291% |
| BLUE CROSS | ANTHEM EXCHANGE | $180.78 | ↑ +291% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $277.20 | ↑ +500% |
| WELLCARE | WELLCARE MEDICAID | $308.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $308.00 | ↑ +567% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 5) at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| CHI Memorial Hospital Hixson | Hixson | $279.72 | $94.76 – $661.50 |
| 62-1166050 BMH Carroll County | Huntingdon | $136.85 | $76.20 – $116.84 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $399.74 | $94.76 – $661.50 |
| Johnson City Medical Center | JOHNSON CITY | $46.20 | $88.39 – $117.37 |
| Greeneville Community Hospital | GREENEVILLE | $46.20 | $46.95 – $88.39 |
| Bristol Regional Medical Center | BRISTOL | $46.20 | $78.25 – $88.39 |
| Franklin Woods Community Hospital | JOHNSON CITY | $46.20 | $103.22 – $114.58 |
| Holston Valley Medical Center | KINGSPORT | $46.20 | $78.25 – $88.39 |