Analysis tumor at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$47.40
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.
$316.00
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.
$18.41 with UNITED HEALTHCARE vs $362.38 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 UNITED HEALTHCARE | $18.41 | ↓ -61% |
| SENTARA HEALTH | SENTARA HEALTH | $80.01 | ↑ +69% |
| CIGNA HEALTHCARE | CIGNA HMO | $95.75 | ↑ +102% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $95.75 | ↑ +102% |
| CIGNA HEALTHCARE | CIGNA PPO | $95.75 | ↑ +102% |
| AETNA | AETNA | $134.93 | ↑ +185% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $135.73 | ↑ +186% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $143.50 | ↑ +203% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $143.50 | ↑ +203% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $149.24 | ↑ +215% |
| MEDCOST | MEDCOST VHN | $150.38 | ↑ +217% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $166.23 | ↑ +251% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $166.23 | ↑ +251% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $166.23 | ↑ +251% |
| SENTARA HEALTH | SENTARA MEDICARE | $166.23 | ↑ +251% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $166.23 | ↑ +251% |
| AETNA | AETNA HEALTHCARE MEDICARE | $166.23 | ↑ +251% |
| HUMANA | HUMANA MEDICARE | $166.23 | ↑ +251% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $166.23 | ↑ +251% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $171.21 | ↑ +261% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $171.21 | ↑ +261% |
| BLUE CROSS | BLUE CROSS MEDICARE | $172.88 | ↑ +265% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $174.54 | ↑ +268% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $174.54 | ↑ +268% |
| NHC ADVANTAGE | NHC ADVANTAGE | $174.54 | ↑ +268% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $174.54 | ↑ +268% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $174.54 | ↑ +268% |
| WELLCARE | WELLCARE MEDICARE | $176.20 | ↑ +272% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $192.43 | ↑ +306% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $210.35 | ↑ +344% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $210.35 | ↑ +344% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $210.55 | ↑ +344% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $212.39 | ↑ +348% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $214.43 | ↑ +352% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $284.40 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE CARE | $316.00 | ↑ +567% |
| BLUE CROSS | ANTHEM HMO | $316.00 | ↑ +567% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $316.00 | ↑ +567% |
| BLUE CROSS | ANTHEM EXCHANGE | $316.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $316.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS P NETWORK | $316.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS S NETWORK | $316.00 | ↑ +567% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $316.00 | ↑ +567% |
| AMBETTER | AMBETTER | $362.38 | ↑ +665% |
Visitor-reported prices
Comments
Analysis tumor at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $348.50 | $152.32 – $438.48 |
| Inova Fairfax Hospital | Falls Church | $348.50 | $152.32 – $438.48 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $348.50 | $152.32 – $438.48 |
| Inova Loudoun Hospital | Leesburg | $348.50 | $152.32 – $438.48 |
| Inova Mount Vernon Hospital | Alexandria | $348.50 | $152.32 – $438.48 |
| LEWISGALE MEDICAL CENTER | ROANOKE | $811.00 | $149.16 – $837.38 |
| LEWISGALE HOSPITAL-ALLEGHANY | LOW MOOR | not published | $149.16 – $842.01 |
| Sentara Martha Jefferson Hospital | Charlottesville | not published | $41.78 – $174.54 |