Consultation pathology during surgery at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$52.05
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.
$347.00
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.
$8.54 with UNITED HEALTHCARE vs $347.00 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 | $8.54 | ↓ -84% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $33.43 | ↓ -36% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $33.43 | ↓ -36% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $34.77 | ↓ -33% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $53.05 | ↑ +2% |
| AETNA | AETNA HEALTHCARE MEDICARE | $57.56 | ↑ +11% |
| HUMANA | HUMANA MEDICARE | $57.56 | ↑ +11% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $57.56 | ↑ +11% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $57.56 | ↑ +11% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $57.56 | ↑ +11% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $57.56 | ↑ +11% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $57.56 | ↑ +11% |
| SENTARA HEALTH | SENTARA MEDICARE | $57.56 | ↑ +11% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $59.28 | ↑ +14% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $59.28 | ↑ +14% |
| BLUE CROSS | BLUE CROSS MEDICARE | $59.86 | ↑ +15% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $60.44 | ↑ +16% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $60.44 | ↑ +16% |
| NHC ADVANTAGE | NHC ADVANTAGE | $60.44 | ↑ +16% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $60.44 | ↑ +16% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $60.44 | ↑ +16% |
| WELLCARE | WELLCARE MEDICARE | $61.01 | ↑ +17% |
| SENTARA HEALTH | SENTARA HEALTH | $87.86 | ↑ +69% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $97.67 | ↑ +88% |
| CIGNA HEALTHCARE | CIGNA HMO | $97.67 | ↑ +88% |
| CIGNA HEALTHCARE | CIGNA PPO | $97.67 | ↑ +88% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $108.84 | ↑ +109% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $125.48 | ↑ +141% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $125.48 | ↑ +141% |
| AMBETTER | AMBETTER | $125.48 | ↑ +141% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $125.60 | ↑ +141% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $126.70 | ↑ +143% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $127.91 | ↑ +146% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $138.14 | ↑ +165% |
| AETNA | AETNA | $148.17 | ↑ +185% |
| MEDCOST | MEDCOST VHN | $165.14 | ↑ +217% |
| BLUE CROSS | ANTHEM EXCHANGE | $189.75 | ↑ +265% |
| BLUE CROSS | ANTHEM HMO | $220.07 | ↑ +323% |
| BLUE CROSS | BLUE CROSS S NETWORK | $234.25 | ↑ +350% |
| BLUE CROSS | BLUE CROSS P NETWORK | $234.25 | ↑ +350% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $258.76 | ↑ +397% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $312.30 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE CARE | $347.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $347.00 | ↑ +567% |
Visitor-reported prices
Comments
Consultation pathology during surgery at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $52.05 | $15.37 – $125.48 |
| Russell County Hospital | LEBANON | $52.05 | $15.37 – $125.48 |
| Sentara Martha Jefferson Hospital | Charlottesville | $160.00 | $14.14 – $60.44 |
| Sentara Northern Virginia Medical Center | Woodbridge | $84.50 | $9.90 – $79.44 |
| CJW Medical Center-Chippenham Hospital Campus | CHESTERFIELD | $142.00 | $33.84 – $151.30 |
| Smyth County Community Hospital | MARION | $52.05 | $15.37 – $125.48 |
| Sentara Halifax Regional Hospital | South Boston | $72.50 | $18.86 – $60.77 |
| LEWISGALE HOSPITAL-PULASKI | PULASKI | $545.00 | $33.84 – $145.17 |