Aco cmplx chron care without pt visit, 60 min 99487aco at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$39.45
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.
$263.00
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.
$66.59 with SENTARA HEALTH vs $377.53 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 |
|---|---|---|---|
| SENTARA HEALTH | SENTARA HEALTH | $66.59 | ↑ +69% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $76.19 | ↑ +93% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $76.19 | ↑ +93% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $76.27 | ↑ +93% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $76.93 | ↑ +95% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $77.68 | ↑ +97% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $80.74 | ↑ +105% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $84.95 | ↑ +115% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $84.95 | ↑ +115% |
| CIGNA HEALTHCARE | CIGNA HMO | $109.67 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $109.67 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $109.67 | ↑ +178% |
| AETNA | AETNA | $112.30 | ↑ +185% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $122.03 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $125.16 | ↑ +217% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $173.18 | ↑ +339% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $173.18 | ↑ +339% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $173.18 | ↑ +339% |
| AETNA | AETNA HEALTHCARE MEDICARE | $173.18 | ↑ +339% |
| HUMANA | HUMANA MEDICARE | $173.18 | ↑ +339% |
| SENTARA HEALTH | SENTARA MEDICARE | $173.18 | ↑ +339% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $173.18 | ↑ +339% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $173.18 | ↑ +339% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $178.38 | ↑ +352% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $178.38 | ↑ +352% |
| BLUE CROSS | BLUE CROSS MEDICARE | $180.11 | ↑ +357% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $181.84 | ↑ +361% |
| NHC ADVANTAGE | NHC ADVANTAGE | $181.84 | ↑ +361% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $181.84 | ↑ +361% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $181.84 | ↑ +361% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $181.84 | ↑ +361% |
| WELLCARE | WELLCARE MEDICARE | $183.57 | ↑ +365% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $184.10 | ↑ +367% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $236.70 | ↑ +500% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $263.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS S NETWORK | $263.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $263.00 | ↑ +567% |
| BLUE CROSS | ANTHEM EXCHANGE | $263.00 | ↑ +567% |
| BLUE CROSS | ANTHEM HMO | $263.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $263.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $263.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS P NETWORK | $263.00 | ↑ +567% |
| AMBETTER | AMBETTER | $377.53 | ↑ +857% |
Visitor-reported prices
Comments
Aco cmplx chron care without pt visit, 60 min 99487aco at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sentara Martha Jefferson Hospital | Charlottesville | $98.50 | not published |
| Sentara Northern Virginia Medical Center | Woodbridge | $103.00 | not published |
| Sentara Halifax Regional Hospital | South Boston | $112.00 | $178.04 – $183.28 |
| Sentara Leigh Hospital | Norfolk | $103.00 | not published |
| Sentara RMH Medical Center | Harrisonburg | $98.50 | $176.64 – $181.84 |
| Sentara CarePlex Hospital | Hampton | $103.00 | not published |
| Sentara Norfolk General Hospital | Norfolk | $103.00 | not published |
| Sentara Princess Anne Hospital | Virginia Beach | $103.00 | not published |