Ercp remove duct calculi 43264 at Inova Fairfax Hospital
3300 Gallows Road, Falls Church, VA · Inova · · NPI 1831220714
$1,862.50
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.
$3,725.00
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.
$2,149.00 with innovation vs $10,401.24 with anthem — 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 |
|---|---|---|---|
| innovation | fully insured | $2,149.00 | ↑ +15% |
| innovation | self insured | $2,589.00 | ↑ +39% |
| cigna | exchange | $2,763.00 | ↑ +48% |
| kaiser | hmo | $2,905.50 | ↑ +56% |
| kaiser | ppo | $2,905.50 | ↑ +56% |
| aetna | fannie-mae | $3,116.15 | ↑ +67% |
| cigna | hmo | $3,580.00 | ↑ +92% |
| cigna | ppo | $3,580.00 | ↑ +92% |
| aetna | ppo | $3,645.00 | ↑ +96% |
| aetna | hmo | $3,645.00 | ↑ +96% |
| anthem | medicare advantage | $3,804.53 | ↑ +104% |
| united | medicare advantage | $3,804.53 | ↑ +104% |
| aetna | medicare advantage | $3,804.53 | ↑ +104% |
| sentara health | exchange | $3,855.49 | ↑ +107% |
| anthem | medicaid advantage | $3,876.98 | ↑ +108% |
| sentara health | medicare advantage | $3,880.62 | ↑ +108% |
| united | medicaid advantage | $3,954.52 | ↑ +112% |
| kaiser | medicare advantage | $3,956.71 | ↑ +112% |
| cigna | medicare advantage | $3,956.71 | ↑ +112% |
| sentara health | medicaid advantage | $3,993.29 | ↑ +114% |
| humana | medicaid advantage | $4,032.06 | ↑ +116% |
| aetna | medicaid advantage | $4,070.83 | ↑ +119% |
| humana | medicare advantage | $4,184.98 | ↑ +125% |
| kaiser | medicaid advantage | $4,264.68 | ↑ +129% |
| sentara health | ppo | $5,072.52 | ↑ +172% |
| sentara health | hmo | $5,072.52 | ↑ +172% |
| united | exchange | $5,470.40 | ↑ +194% |
| carefirst | hmo | $5,515.00 | ↑ +196% |
| carefirst | ppo | $5,568.00 | ↑ +199% |
| united | nonoptions | $6,158.37 | ↑ +231% |
| united | options | $6,158.37 | ↑ +231% |
| anthem | exchange hmo | $9,023.54 | ↑ +384% |
| anthem | ppo | $10,401.24 | ↑ +458% |
| anthem | hmo | $10,401.24 | ↑ +458% |
Visitor-reported prices
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Ercp remove duct calculi 43264 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $1,862.50 | $2,149.00 – $5,515.00 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $1,862.50 | $2,149.00 – $5,515.00 |
| Inova Loudoun Hospital | Leesburg | $1,862.50 | $2,149.00 – $5,515.00 |
| Inova Mount Vernon Hospital | Alexandria | $1,862.50 | $2,149.00 – $5,515.00 |
| St Mary's Hospital | Richmond | $11,188.49 | $6,090.75 – $6,212.56 |
| St Francis Medical Center | Midlothian | $16,025.62 | $3,761.73 – $3,761.73 |
| Memorial Regional Hospital | Mechanicsville | $18,798.62 | $6,090.75 – $6,212.56 |
| Southside Regional Medical Center | Petersburg | $22,629.19 | $5,923.28 – $6,041.75 |