Vaccine pneumococcal conjugate 13 valent (pcv13) im at Lonesome Pine Hospital
1990 HOLTON AVE., BIG STONE GAP, VA · Balladhealth · · NPI 1326041716
$326.57
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.
$2,177.13
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.
$64.64 with UNITED HEALTHCARE vs $2,177.13 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 | $64.64 | ↓ -80% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $130.35 | ↓ -60% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $161.07 | ↓ -51% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $161.07 | ↓ -51% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $161.23 | ↓ -51% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $162.63 | ↓ -50% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $164.20 | ↓ -50% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $314.75 | ↓ -4% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $314.75 | ↓ -4% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $325.07 | ↓ -0% |
| AMERIGROUP | AMERIGROUP | $384.70 | ↑ +18% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $413.65 | ↑ +27% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $413.65 | ↑ +27% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $413.65 | ↑ +27% |
| SENTARA HEALTH | SENTARA MEDICARE | $413.65 | ↑ +27% |
| AETNA | AETNA HEALTHCARE MEDICARE | $413.65 | ↑ +27% |
| HUMANA | HUMANA MEDICARE | $413.65 | ↑ +27% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $413.65 | ↑ +27% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $413.65 | ↑ +27% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $426.06 | ↑ +30% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $426.06 | ↑ +30% |
| BLUE CROSS | BLUE CROSS MEDICARE | $430.20 | ↑ +32% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $434.34 | ↑ +33% |
| NHC ADVANTAGE | NHC ADVANTAGE | $434.34 | ↑ +33% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $434.34 | ↑ +33% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $434.34 | ↑ +33% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $434.34 | ↑ +33% |
| WELLCARE | WELLCARE MEDICARE | $438.47 | ↑ +34% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $446.34 | ↑ +37% |
| SENTARA HEALTH | SENTARA HEALTH | $551.25 | ↑ +69% |
| BLUE CROSS | BLUE CROSS P NETWORK | $683.67 | ↑ +109% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $683.67 | ↑ +109% |
| BLUE CROSS | ANTHEM HMO | $683.67 | ↑ +109% |
| BLUE CROSS | ANTHEM EXCHANGE | $683.67 | ↑ +109% |
| BLUE CROSS | BLUE CROSS S NETWORK | $683.67 | ↑ +109% |
| AMBETTER | AMBETTER | $901.77 | ↑ +176% |
| CIGNA HEALTHCARE | CIGNA HMO | $907.86 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA PPO | $907.86 | ↑ +178% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $907.86 | ↑ +178% |
| AETNA | AETNA | $929.63 | ↑ +185% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $992.77 | ↑ +204% |
| MEDCOST | MEDCOST VHN | $1,036.10 | ↑ +217% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,959.42 | ↑ +500% |
| BLUE CROSS | TENNCARE BLUE SELECT | $2,177.13 | ↑ +567% |
| BLUE CROSS | TENNCARE BLUE CARE | $2,177.13 | ↑ +567% |
Visitor-reported prices
Comments
Vaccine pneumococcal conjugate 13 valent (pcv13) im at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Johnston Memorial Hospital | ABINGDON | $326.57 | $116.35 – $446.34 |
| Russell County Hospital | LEBANON | $326.57 | $116.35 – $949.23 |
| Smyth County Community Hospital | MARION | $326.57 | $116.35 – $446.34 |
| Dickenson Community Hospital | CLINTWOOD | $516.40 | $116.35 – $446.34 |
| Lee County Community Hospital | PENNINGTON GAP | $500.74 | $116.35 – $446.34 |
| Maryview Hospital | Portsmouth | $222.60 | not published |
| St Francis Medical Center | Midlothian | $276.00 | not published |
| LEWISGALE HOSPITAL-ALLEGHANY | LOW MOOR | not published | $219.29 – $683.30 |