Reduction of procidentia 45900 at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$1,226.10
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.
$8,174.00
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 $8,174.00 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 | ↓ -91% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $106.92 | ↓ -91% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $471.00 | ↓ -62% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $491.00 | ↓ -60% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $847.00 | ↓ -31% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $907.35 | ↓ -26% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $907.35 | ↓ -26% |
| AETNA | AETNA HEALTHCARE MEDICARE | $907.35 | ↓ -26% |
| HUMANA | HUMANA MEDICARE | $907.35 | ↓ -26% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $907.35 | ↓ -26% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $907.35 | ↓ -26% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $907.35 | ↓ -26% |
| SENTARA HEALTH | SENTARA MEDICARE | $907.35 | ↓ -26% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $934.57 | ↓ -24% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $934.57 | ↓ -24% |
| BLUE CROSS | BLUE CROSS MEDICARE | $943.64 | ↓ -23% |
| NHC ADVANTAGE | NHC ADVANTAGE | $952.71 | ↓ -22% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $952.71 | ↓ -22% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $952.71 | ↓ -22% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $952.71 | ↓ -22% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $952.71 | ↓ -22% |
| WELLCARE | WELLCARE MEDICARE | $961.79 | ↓ -22% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $1,927.79 | ↑ +57% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $1,927.79 | ↑ +57% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $1,929.66 | ↑ +57% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $1,946.51 | ↑ +59% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $1,965.22 | ↑ +60% |
| AMBETTER | AMBETTER | $1,978.01 | ↑ +61% |
| SENTARA HEALTH | SENTARA HEALTH | $2,069.66 | ↑ +69% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $2,177.63 | ↑ +78% |
| BLUE CROSS | ANTHEM EXCHANGE | $2,991.19 | ↑ +144% |
| BLUE CROSS | ANTHEM HMO | $3,469.28 | ↑ +183% |
| AETNA | AETNA | $3,490.30 | ↑ +185% |
| BLUE CROSS | BLUE CROSS P NETWORK | $3,692.74 | ↑ +201% |
| BLUE CROSS | BLUE CROSS S NETWORK | $3,692.74 | ↑ +201% |
| MEDCOST | MEDCOST VHN | $3,890.01 | ↑ +217% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $4,079.06 | ↑ +233% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $7,356.60 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE CARE | $8,174.00 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE SELECT | $8,174.00 | ↑ +567% |
Visitor-reported prices
Comments
Reduction of procidentia 45900 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $1,226.10 | $106.92 – $1,978.01 |
| Russell County Hospital | LEBANON | $1,226.10 | $106.92 – $1,978.01 |
| Smyth County Community Hospital | MARION | $1,226.10 | $106.92 – $1,978.01 |
| Dickenson Community Hospital | CLINTWOOD | $1,203.13 | $106.92 – $2,781.73 |
| Lee County Community Hospital | PENNINGTON GAP | $1,203.13 | $106.92 – $2,781.73 |
| Southern Virginia Medical Center | Emporia | $346.50 | not published |
| Rappahannock General Hospital | Kilmarnock | $598.80 | not published |
| Southampton Medical Center | Franklin | $577.50 | not published |