M/phmtrc alys ishquant/semiq at Claiborne Medical Center
1850 Old Knoxville Rd, Tazewell, TN · Fsregional · · NPI 1942205166
$287.56
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.
$1,027.00
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.
$48.44 with United Healthcare vs $1,233.54 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 |
|---|---|---|---|
| United Healthcare | Tenncare | $48.44 | ↓ -83% |
| Wellpoint | Medicaid Tenncare | $143.31 | ↓ -50% |
| United Healthcare | All Other Plans | $143.50 | ↓ -50% |
| United Healthcare | Options PPO | $143.50 | ↓ -50% |
| United Healthcare | Heritage Select | $143.50 | ↓ -50% |
| Tricare | Humana Military | $165.55 | ↓ -42% |
| Optum | VA CCN | $165.55 | ↓ -42% |
| Humana | Medicare Advantage HMO | $170.52 | ↓ -41% |
| Humana | DSNP | $170.52 | ↓ -41% |
| Humana | Medicare Advantage PPO | $170.52 | ↓ -41% |
| United Healthcare | Medicare Advantage | $170.52 | ↓ -41% |
| United Healthcare | Community Plan DSNP | $170.52 | ↓ -41% |
| Farm Bureau | Medicare Advantage PPO | $172.17 | ↓ -40% |
| Farm Bureau | Medicare Advantage HMO | $172.17 | ↓ -40% |
| Blue Cross of TN | BlueEssential HMO | $173.83 | ↓ -40% |
| Devoted Health | HMO | $173.83 | ↓ -40% |
| Wellcare | Medicare Advantage | $173.83 | ↓ -40% |
| United Healthcare | DSNP | $173.83 | ↓ -40% |
| Devoted Health | PPO | $173.83 | ↓ -40% |
| HealthSpring | Medicare PPO | $173.83 | ↓ -40% |
| HealthSpring | Medicare HMO POS | $173.83 | ↓ -40% |
| Aetna | Medicare Advantage | $173.83 | ↓ -40% |
| Cigna | Medicare PPO | $173.83 | ↓ -40% |
| Cigna | Medicare HMO | $173.83 | ↓ -40% |
| Wellpoint | DSNP | $173.83 | ↓ -40% |
| Wellpoint | Medicare Advantage | $173.83 | ↓ -40% |
| Blue Cross of TN | Med Adv PPO | $173.83 | ↓ -40% |
| Blue Cross of TN | Med Adv Diamond | $173.83 | ↓ -40% |
| Blue Cross of TN | BlueEssential DSNP | $173.83 | ↓ -40% |
| Blue Cross of TN | Med Adv Sapphire | $173.83 | ↓ -40% |
| Blue Cross of TN | Med Adv Ruby | $173.83 | ↓ -40% |
| Cigna | Medicare HMO-POS | $173.83 | ↓ -40% |
| EHN | Network Lease | $322.20 | ↑ +12% |
| BCBS TN | Blue Care | $367.80 | ↑ +28% |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | $429.60 | ↑ +49% |
| Community Services Network | NonProfit Public Benefit | $465.40 | ↑ +62% |
| Aetna | Commercial | $486.25 | ↑ +69% |
| USA Managed Care Organization | PPO | $501.20 | ↑ +74% |
| NovaNet | Network Lease | $537.00 | ↑ +87% |
| BCBS TN | Commercial Network P | $559.06 | ↑ +94% |
| BCBS TN | Commercial Network S | $559.06 | ↑ +94% |
| National Provider Network | PPO | $572.80 | ↑ +99% |
| Direct Care America | PPO | $572.80 | ↑ +99% |
| MedSave USA | Commercial | $572.80 | ↑ +99% |
| CCN Managed Care | PPO | $608.60 | ↑ +112% |
| Beech Street | PPO | $608.60 | ↑ +112% |
| Initial Group | PPO | $630.08 | ↑ +119% |
| Galaxy Health Network | PPO | $644.40 | ↑ +124% |
| Cigna | IFP | $690.39 | ↑ +140% |
| Cigna | Local Plus | $693.40 | ↑ +141% |
| Cigna | OAP | $753.70 | ↑ +162% |
| Cigna | HMO | $753.70 | ↑ +162% |
| Cigna | POS | $753.70 | ↑ +162% |
| Ambetter | Exchange | $1,233.54 | ↑ +329% |
Visitor-reported prices
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M/phmtrc alys ishquant/semiq at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $600.21 | $108.14 – $1,098.46 |
| Johnson City Medical Center | JOHNSON CITY | $105.75 | $58.99 – $346.58 |
| Ascension Saint Thomas DeKalb | Smithville | $600.21 | $90.89 – $1,098.46 |
| Ascension Saint Thomas Highlands | Sparta | $600.21 | $90.89 – $1,098.46 |
| Ascension Saint Thomas River Park | McMinnville | $600.21 | $90.89 – $1,098.46 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $600.21 | $108.14 – $1,098.46 |
| Hancock County Hospital | SNEEDVILLE | $103.50 | $91.81 – $450.00 |
| Greeneville Community Hospital | GREENEVILLE | $105.75 | $53.09 – $346.58 |