Athrectomy fem/pop/unilateral 37225 at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$4,121.25
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.
$27,475.00
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.
$3,678.00 with UNITED HEALTHCARE vs $27,475.00 with BLUE CROSS — 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 | $3,678.00 | ↓ -11% |
| SENTARA HEALTH | SENTARA HEALTH | $6,956.67 | ↑ +69% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $10,155.59 | ↑ +146% |
| CIGNA HEALTHCARE | CIGNA HMO | $11,457.08 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $11,457.08 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $11,457.08 | ↑ +178% |
| AETNA | AETNA | $11,731.83 | ↑ +185% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $11,813.00 | ↑ +187% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $12,347.00 | ↑ +200% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $12,748.40 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $13,075.35 | ↑ +217% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $14,386.57 | ↑ +249% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $14,386.57 | ↑ +249% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $14,400.53 | ↑ +249% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $14,526.24 | ↑ +252% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $14,665.92 | ↑ +256% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $20,054.00 | ↑ +387% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $24,727.50 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE SELECT | $27,475.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $27,475.00 | ↑ +567% |
Visitor-reported prices
Comments
Athrectomy fem/pop/unilateral 37225 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $4,121.25 | $10,155.59 – $14,665.92 |
| Russell County Hospital | LEBANON | $4,121.25 | $10,155.59 – $14,666.10 |
| Sentara Martha Jefferson Hospital | Charlottesville | $17,271.50 | $3,338.00 – $29,725.00 |
| Sentara Northern Virginia Medical Center | Woodbridge | $17,085.50 | $3,988.00 – $12,301.00 |
| Smyth County Community Hospital | MARION | $4,121.25 | $10,155.59 – $14,526.24 |
| Sentara Halifax Regional Hospital | South Boston | $19,592.50 | not published |
| Sentara Leigh Hospital | Norfolk | $17,085.50 | $5,220.00 – $31,497.00 |
| Sentara RMH Medical Center | Harrisonburg | $17,271.50 | not published |