Biopsy of nail unit 11755 at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$293.70
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.
$1,958.00
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.
$92.93 with BLUE CROSS vs $1,958.00 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 |
|---|---|---|---|
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $92.93 | ↓ -68% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $189.28 | ↓ -36% |
| SENTARA HEALTH | SENTARA HEALTH | $495.77 | ↑ +69% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $565.37 | ↑ +92% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $565.37 | ↑ +92% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $565.92 | ↑ +93% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $570.86 | ↑ +94% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $576.35 | ↑ +96% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $690.91 | ↑ +135% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $690.91 | ↑ +135% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $690.91 | ↑ +135% |
| SENTARA HEALTH | SENTARA MEDICARE | $690.91 | ↑ +135% |
| AETNA | AETNA HEALTHCARE MEDICARE | $690.91 | ↑ +135% |
| HUMANA | HUMANA MEDICARE | $690.91 | ↑ +135% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $690.91 | ↑ +135% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $690.91 | ↑ +135% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $711.64 | ↑ +142% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $711.64 | ↑ +142% |
| BLUE CROSS | BLUE CROSS MEDICARE | $718.55 | ↑ +145% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $725.46 | ↑ +147% |
| NHC ADVANTAGE | NHC ADVANTAGE | $725.46 | ↑ +147% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $725.46 | ↑ +147% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $725.46 | ↑ +147% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $725.46 | ↑ +147% |
| WELLCARE | WELLCARE MEDICARE | $732.37 | ↑ +149% |
| CIGNA HEALTHCARE | CIGNA HMO | $816.49 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $816.49 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $816.49 | ↑ +178% |
| AETNA | AETNA | $836.07 | ↑ +185% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $908.51 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $931.81 | ↑ +217% |
| AMBETTER | AMBETTER | $1,506.19 | ↑ +413% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,658.19 | ↑ +465% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,762.20 | ↑ +500% |
| BLUE CROSS | ANTHEM EXCHANGE | $1,958.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $1,958.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $1,958.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS P NETWORK | $1,958.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS S NETWORK | $1,958.00 | ↑ +567% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $1,958.00 | ↑ +567% |
| BLUE CROSS | ANTHEM HMO | $1,958.00 | ↑ +567% |
Visitor-reported prices
Comments
Biopsy of nail unit 11755 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $293.70 | $92.93 – $1,506.19 |
| Russell County Hospital | LEBANON | $293.70 | $92.93 – $853.69 |
| Smyth County Community Hospital | MARION | $293.70 | $92.93 – $853.69 |
| Dickenson Community Hospital | CLINTWOOD | $288.42 | $92.93 – $815.81 |
| Lee County Community Hospital | PENNINGTON GAP | $288.42 | $92.93 – $815.81 |
| Sentara Martha Jefferson Hospital | Charlottesville | not published | $704.73 – $1,547.00 |
| Sentara Northern Virginia Medical Center | Woodbridge | not published | $704.73 – $2,603.00 |
| Sentara Halifax Regional Hospital | South Boston | not published | $710.31 – $731.20 |