Mayo factor v at Claiborne Medical Center
1850 Old Knoxville Rd, Tazewell, TN · Fsregional · · NPI 1942205166
$27.44
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.
?
What you pay up front if you don't use insurance.
$98.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$7.94 with Wellpoint vs $88.20 with Galaxy Health Network — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 | $7.94 | ↓ -71% |
| United Healthcare | Tenncare | $11.29 | ↓ -59% |
| United Healthcare | Heritage Select | $17.65 | ↓ -36% |
| United Healthcare | Options PPO | $17.65 | ↓ -36% |
| United Healthcare | All Other Plans | $17.65 | ↓ -36% |
| Optum | VA CCN | $18.90 | ↓ -31% |
| Tricare | Humana Military | $18.90 | ↓ -31% |
| Humana | DSNP | $19.47 | ↓ -29% |
| Humana | Medicare Advantage PPO | $19.47 | ↓ -29% |
| Humana | Medicare Advantage HMO | $19.47 | ↓ -29% |
| United Healthcare | Community Plan DSNP | $19.47 | ↓ -29% |
| United Healthcare | Medicare Advantage | $19.47 | ↓ -29% |
| Farm Bureau | Medicare Advantage PPO | $19.66 | ↓ -28% |
| Farm Bureau | Medicare Advantage HMO | $19.66 | ↓ -28% |
| Devoted Health | PPO | $19.85 | ↓ -28% |
| HealthSpring | Medicare PPO | $19.85 | ↓ -28% |
| HealthSpring | Medicare HMO POS | $19.85 | ↓ -28% |
| Blue Cross of TN | Med Adv Sapphire | $19.85 | ↓ -28% |
| Aetna | Medicare Advantage | $19.85 | ↓ -28% |
| Wellcare | Medicare Advantage | $19.85 | ↓ -28% |
| Blue Cross of TN | Med Adv Ruby | $19.85 | ↓ -28% |
| Devoted Health | HMO | $19.85 | ↓ -28% |
| Cigna | Medicare PPO | $19.85 | ↓ -28% |
| Cigna | Medicare HMO | $19.85 | ↓ -28% |
| Blue Cross of TN | Med Adv PPO | $19.85 | ↓ -28% |
| Blue Cross of TN | Med Adv Diamond | $19.85 | ↓ -28% |
| Blue Cross of TN | BlueEssential HMO | $19.85 | ↓ -28% |
| Blue Cross of TN | BlueEssential DSNP | $19.85 | ↓ -28% |
| United Healthcare | DSNP | $19.85 | ↓ -28% |
| Cigna | Medicare HMO-POS | $19.85 | ↓ -28% |
| Wellpoint | DSNP | $19.85 | ↓ -28% |
| Wellpoint | Medicare Advantage | $19.85 | ↓ -28% |
| BCBS TN | Blue Care | $24.51 | ↓ -11% |
| Aetna | Commercial | $26.75 | ↓ -3% |
| Ambetter | Exchange | $31.95 | ↑ +16% |
| Cigna | IFP | $36.07 | ↑ +31% |
| Cigna | Local Plus | $36.23 | ↑ +32% |
| BCBS TN | Commercial Network S | $37.26 | ↑ +36% |
| BCBS TN | Commercial Network P | $37.26 | ↑ +36% |
| Cigna | POS | $39.38 | ↑ +44% |
| Cigna | OAP | $39.38 | ↑ +44% |
| Cigna | HMO | $39.38 | ↑ +44% |
| EHN | Network Lease | $44.10 | ↑ +61% |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | $58.80 | ↑ +114% |
| Community Services Network | NonProfit Public Benefit | $63.70 | ↑ +132% |
| USA Managed Care Organization | PPO | $68.60 | ↑ +150% |
| NovaNet | Network Lease | $73.50 | ↑ +168% |
| Direct Care America | PPO | $78.40 | ↑ +186% |
| MedSave USA | Commercial | $78.40 | ↑ +186% |
| National Provider Network | PPO | $78.40 | ↑ +186% |
| Beech Street | PPO | $83.30 | ↑ +204% |
| CCN Managed Care | PPO | $83.30 | ↑ +204% |
| Initial Group | PPO | $86.24 | ↑ +214% |
| Galaxy Health Network | PPO | $88.20 | ↑ +221% |
Visitor-reported prices
Comments
Mayo factor v at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $165.96 | $6.35 – $68.87 |
| CHI Memorial Hospital Hixson | Hixson | $158.36 | $15.67 – $49.00 |
| 62-1166050 BMH Carroll County | Huntingdon | $26.22 | $15.36 – $35.30 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $226.31 | $14.70 – $49.00 |
| Johnson City Medical Center | JOHNSON CITY | $30.90 | $4.63 – $38.48 |
| Ascension Saint Thomas DeKalb | Smithville | $165.96 | $12.38 – $68.87 |
| Ascension Saint Thomas Highlands | Sparta | $165.96 | $12.38 – $68.87 |
| Ascension Saint Thomas River Park | McMinnville | $165.96 | $12.38 – $68.87 |