Bx of breast open 19101 at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$1,397.10
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.
$9,314.00
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.
$948.00 with BLUE CROSS vs $9,314.00 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 | $948.00 | ↓ -32% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $1,031.00 | ↓ -26% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $1,738.38 | ↑ +24% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $1,738.38 | ↑ +24% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $1,740.07 | ↑ +25% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $1,755.26 | ↑ +26% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $1,772.14 | ↑ +27% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $1,956.00 | ↑ +40% |
| SENTARA HEALTH | SENTARA HEALTH | $2,358.30 | ↑ +69% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $2,436.00 | ↑ +74% |
| CIGNA HEALTHCARE | CIGNA PPO | $2,488.00 | ↑ +78% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $2,547.00 | ↑ +82% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $2,588.00 | ↑ +85% |
| CIGNA HEALTHCARE | CIGNA HMO | $2,588.00 | ↑ +85% |
| SENTARA HEALTH | SENTARA MEDICARE | $3,820.23 | ↑ +173% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $3,820.23 | ↑ +173% |
| AETNA | AETNA HEALTHCARE MEDICARE | $3,820.23 | ↑ +173% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $3,820.23 | ↑ +173% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $3,820.23 | ↑ +173% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $3,820.23 | ↑ +173% |
| HUMANA | HUMANA MEDICARE | $3,820.23 | ↑ +173% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $3,820.23 | ↑ +173% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $3,934.84 | ↑ +182% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $3,934.84 | ↑ +182% |
| BLUE CROSS | BLUE CROSS MEDICARE | $3,973.04 | ↑ +184% |
| AETNA | AETNA | $3,977.08 | ↑ +185% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $4,011.24 | ↑ +187% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $4,011.24 | ↑ +187% |
| NHC ADVANTAGE | NHC ADVANTAGE | $4,011.24 | ↑ +187% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $4,011.24 | ↑ +187% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $4,011.24 | ↑ +187% |
| WELLCARE | WELLCARE MEDICARE | $4,049.44 | ↑ +190% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $4,296.00 | ↑ +207% |
| MEDCOST | MEDCOST VHN | $4,432.53 | ↑ +217% |
| AMBETTER | AMBETTER | $8,328.10 | ↑ +496% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $8,382.60 | ↑ +500% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $9,168.55 | ↑ +556% |
| BLUE CROSS | BLUE CROSS P NETWORK | $9,314.00 | ↑ +567% |
| BLUE CROSS | ANTHEM EXCHANGE | $9,314.00 | ↑ +567% |
| BLUE CROSS | BLUE CROSS S NETWORK | $9,314.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $9,314.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $9,314.00 | ↑ +567% |
| BLUE CROSS | ANTHEM HMO | $9,314.00 | ↑ +567% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $9,314.00 | ↑ +567% |
Visitor-reported prices
Comments
Bx of breast open 19101 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $12,284.00 | $1,909.84 – $4,413.00 |
| Inova Fairfax Hospital | Falls Church | $12,284.00 | $1,909.84 – $4,413.00 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $12,284.00 | $1,909.84 – $4,413.00 |
| Inova Loudoun Hospital | Leesburg | $12,284.00 | $1,909.84 – $4,413.00 |
| Inova Mount Vernon Hospital | Alexandria | $12,284.00 | $1,909.84 – $4,413.00 |
| Sentara Martha Jefferson Hospital | Charlottesville | $4,745.50 | $1,571.00 – $5,978.00 |
| Sentara Northern Virginia Medical Center | Woodbridge | $5,077.00 | $3,231.00 – $4,011.24 |
| Sentara Halifax Regional Hospital | South Boston | $6,358.00 | $3,927.48 – $4,042.99 |