App topical fluoride varnish at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$5.85
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.
$39.00
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.
$5.22 with UNITED HEALTHCARE vs $181.57 with MOLINA 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 |
|---|---|---|---|
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $5.22 | ↓ -11% |
| SENTARA HEALTH | SENTARA HEALTH | $9.87 | ↑ +69% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $11.97 | ↑ +105% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $12.60 | ↑ +115% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $12.60 | ↑ +115% |
| CIGNA HEALTHCARE | CIGNA HMO | $16.26 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $16.26 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $16.26 | ↑ +178% |
| AETNA | AETNA | $16.65 | ↑ +185% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $18.10 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $18.56 | ↑ +217% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $27.30 | ↑ +367% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $35.10 | ↑ +500% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $39.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $39.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $39.00 | ↑ +567% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $178.11 | ↑ +2945% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $178.28 | ↑ +2948% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $179.83 | ↑ +2974% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $181.57 | ↑ +3004% |