CMS Price Transparency Data

Review of medical records for care

Facility: Blount Memorial Hospital

Billing Code: 90889 (CPT)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: 90889
Insurance Median: $146
Cash Discount Price: $58
vs. Medicare Baseline: N/A Medicare

The contracted insurance negotiated median rate for a Review of medical records for care at Blount Memorial Hospital is $146. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $58. Compared to the federal Medicare reimbursement reference rate of N/A, this hospital’s rate is N/A the Medicare baseline. Located in 907 E Lamar Alexander Parkway, Maryville, TN.

Cash / Self-Pay

$58

Average discount available for prompt cash payment at this facility.

Insurance Median

$146

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

N/A

Standard federal government reimbursement rate for this code.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
Medicaid / KanCare	$29	N/A
UnitedHealthcare	$29 - $334	N/A
Prisma Health Seniorcare Pace - Midlands [5400]	$44	N/A
Prisma Health Seniorcare Pace-Upstate [5200]	$44	N/A
Promise Health Plan Contracted [2401]	$66 - $113	N/A
Orangeburg Senior Helping Center Pace [5401]	$75	N/A
Cigna	$90 - $103	N/A
Mvp Health Care [3037]	$90	N/A
Blue Cross Blue Shield	$105	N/A
Bob Jones Univ-Pai [821]	$113	N/A
Preferred Administrators Contracted [2839]	$132	N/A
Medcost [2940]	$139 - $156	N/A
Atlantic Packaging Contracted [4833]	$141	N/A
Aps Healthcare System [2981]	$150	N/A
Companion Benefit Alternatives [2983]	$162	N/A
Multiplan/Phcs Contracted [2950]	$167	N/A
Aetna	$169	N/A
Meritain Health Contracted [2200]	$169	N/A
Nippon [2300]	$169	N/A
Vsp Vision Care [2986]	$169	N/A
Carelon Behavioral Health [3180]	$175	N/A
First Health Contracted [2952]	$175	N/A
Furman Int/Allen University Student [2951]	$175	N/A
Quiktrip-First Health [3067]	$175	N/A
Golden Rule Insurance Company [2991]	$334	N/A
Oxford Health Plans [2992]	$334	N/A

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $58.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify CPT Code matches exactly: 90889.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Blount Memorial Hospital is fully in-network.
Ask your insurer if "Prior Authorization" is required for CPT code 90889.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.