Consult comp w/report rfrd material at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$135.15
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.
$901.00
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.
$28.83 with UNITED HEALTHCARE vs $901.00 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 | $28.83 | ↓ -79% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $49.47 | ↓ -63% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $49.47 | ↓ -63% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $51.45 | ↓ -62% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $125.48 | ↓ -7% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $125.48 | ↓ -7% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $125.60 | ↓ -7% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $126.70 | ↓ -6% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $127.91 | ↓ -5% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $133.04 | ↓ -2% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $166.23 | ↑ +23% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $166.23 | ↑ +23% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $166.23 | ↑ +23% |
| SENTARA HEALTH | SENTARA MEDICARE | $166.23 | ↑ +23% |
| AETNA | AETNA HEALTHCARE MEDICARE | $166.23 | ↑ +23% |
| HUMANA | HUMANA MEDICARE | $166.23 | ↑ +23% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $166.23 | ↑ +23% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $166.23 | ↑ +23% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $171.21 | ↑ +27% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $171.21 | ↑ +27% |
| BLUE CROSS | BLUE CROSS MEDICARE | $172.88 | ↑ +28% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $174.54 | ↑ +29% |
| NHC ADVANTAGE | NHC ADVANTAGE | $174.54 | ↑ +29% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $174.54 | ↑ +29% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $174.54 | ↑ +29% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $174.54 | ↑ +29% |
| WELLCARE | WELLCARE MEDICARE | $176.20 | ↑ +30% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $201.90 | ↑ +49% |
| SENTARA HEALTH | SENTARA HEALTH | $228.13 | ↑ +69% |
| CIGNA HEALTHCARE | CIGNA HMO | $353.88 | ↑ +162% |
| CIGNA HEALTHCARE | CIGNA PPO | $353.88 | ↑ +162% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $353.88 | ↑ +162% |
| AMBETTER | AMBETTER | $362.38 | ↑ +168% |
| AETNA | AETNA | $384.73 | ↑ +185% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $398.95 | ↑ +195% |
| MEDCOST | MEDCOST VHN | $428.79 | ↑ +217% |
| BLUE CROSS | ANTHEM EXCHANGE | $548.00 | ↑ +305% |
| BLUE CROSS | ANTHEM HMO | $635.59 | ↑ +370% |
| BLUE CROSS | BLUE CROSS S NETWORK | $676.53 | ↑ +401% |
| BLUE CROSS | BLUE CROSS P NETWORK | $676.53 | ↑ +401% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $747.30 | ↑ +453% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $810.90 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE CARE | $901.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $901.00 | ↑ +567% |
Visitor-reported prices
Comments
Consult comp w/report rfrd material at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $427.50 | $137.85 – $537.88 |
| Inova Fairfax Hospital | Falls Church | $427.50 | $137.85 – $537.88 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $427.50 | $137.85 – $537.88 |
| Inova Loudoun Hospital | Leesburg | $427.50 | $137.85 – $537.88 |
| Inova Mount Vernon Hospital | Alexandria | $427.50 | $137.85 – $537.88 |
| Johnston Memorial Hospital | ABINGDON | $135.15 | $49.47 – $362.38 |
| Russell County Hospital | LEBANON | $135.15 | $49.47 – $362.38 |
| Smyth County Community Hospital | MARION | $135.15 | $49.47 – $362.38 |