Consultation/report referred material w/preparation of slides at Claiborne Medical Center
1850 Old Knoxville Rd, Tazewell, TN · Fsregional · · NPI 1942205166
$86.80
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.
$310.00
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.
$30.28 with BCBS TN vs $359.07 with Ambetter — 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 |
|---|---|---|---|
| BCBS TN | Blue Care | $30.28 | ↓ -65% |
| Aetna | Commercial | $36.58 | ↓ -58% |
| EHN | Network Lease | $40.95 | ↓ -53% |
| BCBS TN | Commercial Network P | $46.02 | ↓ -47% |
| BCBS TN | Commercial Network S | $46.02 | ↓ -47% |
| United Healthcare | Tenncare | $48.44 | ↓ -44% |
| Wellpoint | Medicaid Tenncare | $49.40 | ↓ -43% |
| United Healthcare | All Other Plans | $49.47 | ↓ -43% |
| United Healthcare | Options PPO | $49.47 | ↓ -43% |
| United Healthcare | Heritage Select | $49.47 | ↓ -43% |
| Tricare | Humana Military | $50.64 | ↓ -42% |
| Optum | VA CCN | $50.64 | ↓ -42% |
| Humana | DSNP | $52.16 | ↓ -40% |
| Humana | Medicare Advantage HMO | $52.16 | ↓ -40% |
| United Healthcare | Medicare Advantage | $52.16 | ↓ -40% |
| Humana | Medicare Advantage PPO | $52.16 | ↓ -40% |
| United Healthcare | Community Plan DSNP | $52.16 | ↓ -40% |
| Farm Bureau | Medicare Advantage PPO | $52.67 | ↓ -39% |
| Farm Bureau | Medicare Advantage HMO | $52.67 | ↓ -39% |
| Blue Cross of TN | Med Adv Sapphire | $53.17 | ↓ -39% |
| Devoted Health | HMO | $53.17 | ↓ -39% |
| Wellcare | Medicare Advantage | $53.17 | ↓ -39% |
| United Healthcare | DSNP | $53.17 | ↓ -39% |
| Devoted Health | PPO | $53.17 | ↓ -39% |
| HealthSpring | Medicare PPO | $53.17 | ↓ -39% |
| HealthSpring | Medicare HMO POS | $53.17 | ↓ -39% |
| Aetna | Medicare Advantage | $53.17 | ↓ -39% |
| Cigna | Medicare PPO | $53.17 | ↓ -39% |
| Cigna | Medicare HMO | $53.17 | ↓ -39% |
| Cigna | Medicare HMO-POS | $53.17 | ↓ -39% |
| Wellpoint | DSNP | $53.17 | ↓ -39% |
| Wellpoint | Medicare Advantage | $53.17 | ↓ -39% |
| Blue Cross of TN | BlueEssential DSNP | $53.17 | ↓ -39% |
| Blue Cross of TN | BlueEssential HMO | $53.17 | ↓ -39% |
| Blue Cross of TN | Med Adv Diamond | $53.17 | ↓ -39% |
| Blue Cross of TN | Med Adv PPO | $53.17 | ↓ -39% |
| Blue Cross of TN | Med Adv Ruby | $53.17 | ↓ -39% |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | $54.60 | ↓ -37% |
| Cigna | IFP | $57.98 | ↓ -33% |
| Cigna | Local Plus | $58.24 | ↓ -33% |
| Community Services Network | NonProfit Public Benefit | $59.15 | ↓ -32% |
| Cigna | HMO | $63.30 | ↓ -27% |
| Cigna | POS | $63.30 | ↓ -27% |
| Cigna | OAP | $63.30 | ↓ -27% |
| USA Managed Care Organization | PPO | $63.70 | ↓ -27% |
| NovaNet | Network Lease | $68.25 | ↓ -21% |
| National Provider Network | PPO | $72.80 | ↓ -16% |
| MedSave USA | Commercial | $72.80 | ↓ -16% |
| Direct Care America | PPO | $72.80 | ↓ -16% |
| Beech Street | PPO | $77.35 | ↓ -11% |
| CCN Managed Care | PPO | $77.35 | ↓ -11% |
| Initial Group | PPO | $80.08 | ↓ -8% |
| Galaxy Health Network | PPO | $81.90 | ↓ -6% |
| Ambetter | Exchange | $359.07 | ↑ +314% |
Visitor-reported prices
Comments
Consultation/report referred material w/preparation of slides at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $29.60 | $9.57 – $104.50 |
| CHI Memorial Hospital Hixson | Hixson | $38.19 | $14.24 – $93.21 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $54.57 | $14.24 – $93.21 |
| Johnson City Medical Center | JOHNSON CITY | $68.40 | $11.10 – $121.50 |
| Ascension Saint Thomas DeKalb | Smithville | $29.60 | $9.57 – $113.47 |
| Ascension Saint Thomas Highlands | Sparta | $29.60 | $9.57 – $113.47 |
| Ascension Saint Thomas River Park | McMinnville | $29.60 | $14.30 – $113.47 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $29.60 | $9.57 – $113.47 |