Established Patient Office Visit (level 2) at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$22.35
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.
$149.00
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.
$30.65 with BLUE CROSS vs $149.00 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 | $30.65 | ↑ +37% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $36.06 | ↑ +61% |
| SENTARA HEALTH | SENTARA HEALTH | $37.73 | ↑ +69% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $45.74 | ↑ +105% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $48.13 | ↑ +115% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $48.13 | ↑ +115% |
| BLUE CROSS | ANTHEM HMO | $58.29 | ↑ +161% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $58.29 | ↑ +161% |
| BLUE CROSS | ANTHEM EXCHANGE | $58.29 | ↑ +161% |
| BLUE CROSS | BLUE CROSS P NETWORK | $58.29 | ↑ +161% |
| BLUE CROSS | BLUE CROSS S NETWORK | $58.29 | ↑ +161% |
| CIGNA HEALTHCARE | CIGNA HMO | $62.13 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $62.13 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $62.13 | ↑ +178% |
| AETNA | AETNA | $63.62 | ↑ +185% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $69.14 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $70.91 | ↑ +217% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $134.10 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE SELECT | $149.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $149.00 | ↑ +567% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 2) at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $22.35 | $30.65 – $55.43 |
| Russell County Hospital | LEBANON | $22.35 | $30.65 – $55.43 |
| Smyth County Community Hospital | MARION | $22.35 | $30.65 – $55.43 |
| Dickenson Community Hospital | CLINTWOOD | $21.85 | $30.65 – $37.15 |
| Lee County Community Hospital | PENNINGTON GAP | $21.85 | $30.65 – $37.15 |
| Rappahannock General Hospital | Kilmarnock | $174.60 | not published |
| Maryview Hospital | Portsmouth | $156.60 | not published |
| St Mary's Hospital | Richmond | $229.80 | not published |