Ghs phenylketonurid at Claiborne Medical Center
1850 Old Knoxville Rd, Tazewell, TN · Fsregional · · NPI 1942205166
$47.32
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.
$169.00
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.
$2.48 with Wellpoint vs $152.10 with Galaxy Health Network — 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 | Medicaid Tenncare | $2.48 | ↓ -95% |
| United Healthcare | Tenncare | $3.52 | ↓ -93% |
| United Healthcare | Heritage Select | $5.50 | ↓ -88% |
| United Healthcare | Options PPO | $5.50 | ↓ -88% |
| United Healthcare | All Other Plans | $5.50 | ↓ -88% |
| Optum | VA CCN | $5.89 | ↓ -88% |
| Tricare | Humana Military | $5.89 | ↓ -88% |
| Humana | DSNP | $6.07 | ↓ -87% |
| Humana | Medicare Advantage PPO | $6.07 | ↓ -87% |
| Humana | Medicare Advantage HMO | $6.07 | ↓ -87% |
| United Healthcare | Community Plan DSNP | $6.07 | ↓ -87% |
| United Healthcare | Medicare Advantage | $6.07 | ↓ -87% |
| Farm Bureau | Medicare Advantage PPO | $6.13 | ↓ -87% |
| Farm Bureau | Medicare Advantage HMO | $6.13 | ↓ -87% |
| Devoted Health | PPO | $6.18 | ↓ -87% |
| HealthSpring | Medicare PPO | $6.18 | ↓ -87% |
| HealthSpring | Medicare HMO POS | $6.18 | ↓ -87% |
| Blue Cross of TN | Med Adv Sapphire | $6.18 | ↓ -87% |
| Aetna | Medicare Advantage | $6.18 | ↓ -87% |
| Wellcare | Medicare Advantage | $6.18 | ↓ -87% |
| Blue Cross of TN | Med Adv Ruby | $6.18 | ↓ -87% |
| Devoted Health | HMO | $6.18 | ↓ -87% |
| Cigna | Medicare PPO | $6.18 | ↓ -87% |
| Cigna | Medicare HMO | $6.18 | ↓ -87% |
| Blue Cross of TN | Med Adv PPO | $6.18 | ↓ -87% |
| Blue Cross of TN | Med Adv Diamond | $6.18 | ↓ -87% |
| Blue Cross of TN | BlueEssential HMO | $6.18 | ↓ -87% |
| Blue Cross of TN | BlueEssential DSNP | $6.18 | ↓ -87% |
| United Healthcare | DSNP | $6.18 | ↓ -87% |
| Cigna | Medicare HMO-POS | $6.18 | ↓ -87% |
| Wellpoint | DSNP | $6.18 | ↓ -87% |
| Wellpoint | Medicare Advantage | $6.18 | ↓ -87% |
| BCBS TN | Blue Care | $7.64 | ↓ -84% |
| Aetna | Commercial | $8.33 | ↓ -82% |
| Ambetter | Exchange | $9.96 | ↓ -79% |
| Cigna | IFP | $11.11 | ↓ -77% |
| Cigna | Local Plus | $11.16 | ↓ -76% |
| BCBS TN | Commercial Network S | $11.61 | ↓ -75% |
| BCBS TN | Commercial Network P | $11.61 | ↓ -75% |
| Cigna | POS | $12.13 | ↓ -74% |
| Cigna | OAP | $12.13 | ↓ -74% |
| Cigna | HMO | $12.13 | ↓ -74% |
| EHN | Network Lease | $76.05 | ↑ +61% |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | $101.40 | ↑ +114% |
| Community Services Network | NonProfit Public Benefit | $109.85 | ↑ +132% |
| USA Managed Care Organization | PPO | $118.30 | ↑ +150% |
| NovaNet | Network Lease | $126.75 | ↑ +168% |
| Direct Care America | PPO | $135.20 | ↑ +186% |
| MedSave USA | Commercial | $135.20 | ↑ +186% |
| National Provider Network | PPO | $135.20 | ↑ +186% |
| Beech Street | PPO | $143.65 | ↑ +204% |
| CCN Managed Care | PPO | $143.65 | ↑ +204% |
| Initial Group | PPO | $148.72 | ↑ +214% |
| Galaxy Health Network | PPO | $152.10 | ↑ +221% |
Visitor-reported prices
Comments
Ghs phenylketonurid at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| 62-1166050 BMH Carroll County | Huntingdon | $70.38 | $4.79 – $11.00 |
| Johnson City Medical Center | JOHNSON CITY | $9.60 | $2.75 – $11.99 |
| Greeneville Community Hospital | GREENEVILLE | $9.60 | $2.48 – $11.99 |
| Bristol Regional Medical Center | BRISTOL | $9.60 | $2.75 – $13.20 |
| Franklin Woods Community Hospital | JOHNSON CITY | $9.60 | $2.75 – $11.99 |
| Holston Valley Medical Center | KINGSPORT | $9.60 | $2.75 – $13.20 |
| Indian Path Community Hospital | KINGSPORT | $9.60 | $2.75 – $13.20 |
| Hawkins County Memorial Hospital | ROGERSVILLE | $9.60 | $2.75 – $11.99 |