Oth resp proc, group at Claiborne Medical Center
1850 Old Knoxville Rd, Tazewell, TN · Fsregional · · NPI 1942205166
$31.08
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.
$111.00
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.
$13.48 with BCBS TN vs $232.00 with United Healthcare — 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 | $13.48 | ↓ -57% |
| United Healthcare | Tenncare | $14.19 | ↓ -54% |
| Wellpoint | Medicaid Tenncare | $33.38 | ↑ +7% |
| Tricare | Humana Military | $36.29 | ↑ +17% |
| Optum | VA CCN | $36.29 | ↑ +17% |
| United Healthcare | Medicare Advantage | $37.38 | ↑ +20% |
| Humana | DSNP | $37.38 | ↑ +20% |
| Humana | Medicare Advantage PPO | $37.38 | ↑ +20% |
| Humana | Medicare Advantage HMO | $37.38 | ↑ +20% |
| United Healthcare | Community Plan DSNP | $37.38 | ↑ +20% |
| Farm Bureau | Medicare Advantage PPO | $37.74 | ↑ +21% |
| Farm Bureau | Medicare Advantage HMO | $37.74 | ↑ +21% |
| Blue Cross of TN | BlueEssential DSNP | $38.10 | ↑ +23% |
| Devoted Health | HMO | $38.10 | ↑ +23% |
| Wellcare | Medicare Advantage | $38.10 | ↑ +23% |
| United Healthcare | DSNP | $38.10 | ↑ +23% |
| Devoted Health | PPO | $38.10 | ↑ +23% |
| HealthSpring | Medicare PPO | $38.10 | ↑ +23% |
| HealthSpring | Medicare HMO POS | $38.10 | ↑ +23% |
| Aetna | Medicare Advantage | $38.10 | ↑ +23% |
| Cigna | Medicare HMO-POS | $38.10 | ↑ +23% |
| Wellpoint | DSNP | $38.10 | ↑ +23% |
| Wellpoint | Medicare Advantage | $38.10 | ↑ +23% |
| Blue Cross of TN | BlueEssential HMO | $38.10 | ↑ +23% |
| Cigna | Medicare PPO | $38.10 | ↑ +23% |
| Cigna | Medicare HMO | $38.10 | ↑ +23% |
| Blue Cross of TN | Med Adv Sapphire | $38.10 | ↑ +23% |
| Blue Cross of TN | Med Adv Ruby | $38.10 | ↑ +23% |
| Blue Cross of TN | Med Adv PPO | $38.10 | ↑ +23% |
| Blue Cross of TN | Med Adv Diamond | $38.10 | ↑ +23% |
| Aetna | Commercial | $44.40 | ↑ +43% |
| EHN | Network Lease | $49.95 | ↑ +61% |
| Ambetter | Exchange | $66.60 | ↑ +114% |
| Correctional Medical Services | Correctional Facilities - Inmate Claims | $66.60 | ↑ +114% |
| BCBS TN | Commercial Network P | $68.82 | ↑ +121% |
| BCBS TN | Commercial Network S | $68.82 | ↑ +121% |
| Community Services Network | NonProfit Public Benefit | $72.15 | ↑ +132% |
| USA Managed Care Organization | PPO | $77.70 | ↑ +150% |
| NovaNet | Network Lease | $83.25 | ↑ +168% |
| MedSave USA | Commercial | $88.80 | ↑ +186% |
| National Provider Network | PPO | $88.80 | ↑ +186% |
| Direct Care America | PPO | $88.80 | ↑ +186% |
| CCN Managed Care | PPO | $94.35 | ↑ +204% |
| Beech Street | PPO | $94.35 | ↑ +204% |
| Initial Group | PPO | $97.68 | ↑ +214% |
| Galaxy Health Network | PPO | $99.90 | ↑ +221% |
| Cigna | IFP | $141.00 | ↑ +354% |
| United Healthcare | All Other Plans | $162.00 | ↑ +421% |
| Cigna | Local Plus | $162.00 | ↑ +421% |
| Cigna | HMO | $190.00 | ↑ +511% |
| Cigna | OAP | $190.00 | ↑ +511% |
| Cigna | POS | $190.00 | ↑ +511% |
| United Healthcare | Heritage Select | $191.00 | ↑ +515% |
| United Healthcare | Options PPO | $232.00 | ↑ +646% |
Visitor-reported prices
Comments
Oth resp proc, group at other Tennessee hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Ascension Saint Thomas Midtown | Nashville | $69.30 | $10.30 – $26.34 |
| CHI Memorial Hospital Hixson | Hixson | $35.23 | $15.33 – $189.52 |
| 62-1166050 BMH Carroll County | Huntingdon | $24.84 | $10.30 – $71.68 |
| CHI Memorial Hospital Chattanooga | Chattanooga | $50.34 | $15.33 – $189.52 |
| Johnson City Medical Center | JOHNSON CITY | $79.05 | $11.49 – $75.98 |
| Ascension Saint Thomas DeKalb | Smithville | $102.12 | $10.30 – $26.34 |
| Ascension Saint Thomas River Park | McMinnville | $102.12 | $14.86 – $26.34 |
| Ascension Saint Thomas Rutherford | Murfreesboro | $69.30 | $10.30 – $26.34 |