Clsd tx trimall ankle fx without manip 27816 at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$229.20
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.
$1,528.00
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.
$106.00 with UNITED HEALTHCARE vs $1,528.00 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 | $106.00 | ↓ -54% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $240.67 | ↑ +5% |
| SENTARA HEALTH | SENTARA MEDICARE | $240.67 | ↑ +5% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $240.67 | ↑ +5% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $240.67 | ↑ +5% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $240.67 | ↑ +5% |
| AETNA | AETNA HEALTHCARE MEDICARE | $240.67 | ↑ +5% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $240.67 | ↑ +5% |
| HUMANA | HUMANA MEDICARE | $240.67 | ↑ +5% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $247.89 | ↑ +8% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $247.89 | ↑ +8% |
| BLUE CROSS | BLUE CROSS MEDICARE | $250.30 | ↑ +9% |
| NHC ADVANTAGE | NHC ADVANTAGE | $252.70 | ↑ +10% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $252.70 | ↑ +10% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $252.70 | ↑ +10% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $252.70 | ↑ +10% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $252.70 | ↑ +10% |
| WELLCARE | WELLCARE MEDICARE | $255.11 | ↑ +11% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $264.12 | ↑ +15% |
| SENTARA HEALTH | SENTARA HEALTH | $386.89 | ↑ +69% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $471.00 | ↑ +105% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $491.00 | ↑ +114% |
| AMBETTER | AMBETTER | $524.66 | ↑ +129% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $577.61 | ↑ +152% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $637.50 | ↑ +178% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $637.50 | ↑ +178% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $638.12 | ↑ +178% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $643.69 | ↑ +181% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $649.88 | ↑ +184% |
| AETNA | AETNA | $652.46 | ↑ +185% |
| MEDCOST | MEDCOST VHN | $727.18 | ↑ +217% |
| BLUE CROSS | ANTHEM EXCHANGE | $793.41 | ↑ +246% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $847.00 | ↑ +270% |
| BLUE CROSS | ANTHEM HMO | $920.22 | ↑ +301% |
| BLUE CROSS | BLUE CROSS S NETWORK | $979.49 | ↑ +327% |
| BLUE CROSS | BLUE CROSS P NETWORK | $979.49 | ↑ +327% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $1,081.96 | ↑ +372% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,375.20 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE CARE | $1,528.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $1,528.00 | ↑ +567% |
Visitor-reported prices
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Clsd tx trimall ankle fx without manip 27816 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $229.20 | $240.67 – $618.93 |
| Russell County Hospital | LEBANON | $229.20 | $240.67 – $618.94 |
| Sentara Martha Jefferson Hospital | Charlottesville | $245.50 | $245.48 – $1,010.00 |
| Sentara Northern Virginia Medical Center | Woodbridge | $263.00 | $245.48 – $2,603.00 |
| Smyth County Community Hospital | MARION | $229.20 | $240.67 – $618.93 |
| Sentara Halifax Regional Hospital | South Boston | $342.50 | $247.43 – $254.70 |
| Sentara Leigh Hospital | Norfolk | $263.00 | $245.48 – $3,408.00 |
| Sentara RMH Medical Center | Harrisonburg | $245.50 | $245.48 – $252.70 |