Oth resp proc, group at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$79.05
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.
$527.00
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.
$11.49 with BLUE CROSS vs $527.00 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 | $11.49 | ↓ -85% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $14.86 | ↓ -81% |
| SENTARA HEALTH | SENTARA MEDICARE | $36.44 | ↓ -54% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $36.44 | ↓ -54% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $36.44 | ↓ -54% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $36.44 | ↓ -54% |
| HUMANA | HUMANA MEDICARE | $36.44 | ↓ -54% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $36.44 | ↓ -54% |
| AETNA | AETNA HEALTHCARE MEDICARE | $36.44 | ↓ -54% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $36.44 | ↓ -54% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $37.54 | ↓ -53% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $37.54 | ↓ -53% |
| BLUE CROSS | BLUE CROSS MEDICARE | $37.90 | ↓ -52% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $38.26 | ↓ -52% |
| NHC ADVANTAGE | NHC ADVANTAGE | $38.26 | ↓ -52% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $38.26 | ↓ -52% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $38.26 | ↓ -52% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $38.26 | ↓ -52% |
| WELLCARE | WELLCARE MEDICARE | $38.63 | ↓ -51% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $44.98 | ↓ -43% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $44.98 | ↓ -43% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $45.02 | ↓ -43% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $45.42 | ↓ -43% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $45.85 | ↓ -42% |
| AMBETTER | AMBETTER | $79.45 | ↑ +1% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $87.46 | ↑ +11% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $106.00 | ↑ +34% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $112.00 | ↑ +42% |
| BLUE CROSS | ANTHEM EXCHANGE | $120.13 | ↑ +52% |
| SENTARA HEALTH | SENTARA HEALTH | $133.44 | ↑ +69% |
| BLUE CROSS | ANTHEM HMO | $139.33 | ↑ +76% |
| BLUE CROSS | BLUE CROSS S NETWORK | $148.30 | ↑ +88% |
| BLUE CROSS | BLUE CROSS P NETWORK | $148.30 | ↑ +88% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $163.82 | ↑ +107% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $175.00 | ↑ +121% |
| CIGNA HEALTHCARE | CIGNA HMO | $219.76 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $219.76 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $219.76 | ↑ +178% |
| AETNA | AETNA | $225.03 | ↑ +185% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $244.53 | ↑ +209% |
| MEDCOST | MEDCOST VHN | $250.80 | ↑ +217% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $474.30 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE SELECT | $527.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $527.00 | ↑ +567% |
Visitor-reported prices
Comments
Oth resp proc, group at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $137.00 | $39.25 – $161.00 |
| Inova Fairfax Hospital | Falls Church | $137.00 | $39.25 – $161.00 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $137.00 | $39.25 – $161.00 |
| Inova Loudoun Hospital | Leesburg | $137.00 | $39.25 – $161.00 |
| Inova Mount Vernon Hospital | Alexandria | $137.00 | $39.25 – $161.00 |
| Johnston Memorial Hospital | ABINGDON | $79.05 | $11.49 – $79.45 |
| Russell County Hospital | LEBANON | $79.05 | $11.49 – $79.45 |
| Sentara Martha Jefferson Hospital | Charlottesville | $139.00 | $37.17 – $38.26 |