healthcosts.net
Tonsillectomy (age 12+) at Inova Fairfax Hospital
3300 Gallows Road, Falls Church, VA · Inova · · NPI 1831220714
not published by hospital
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.
not published by hospital
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.
$3,107.67 with anthem vs $8,866.25 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 |
|---|---|---|---|
| anthem | medicaid advantage | $3,107.67 | — |
| united | medicaid advantage | $3,169.82 | — |
| sentara health | medicaid advantage | $3,200.90 | — |
| humana | medicaid advantage | $3,231.98 | — |
| aetna | medicare advantage | $3,243.07 | — |
| anthem | medicare advantage | $3,243.07 | — |
| united | medicare advantage | $3,243.07 | — |
| aetna | medicaid advantage | $3,263.05 | — |
| sentara health | medicare advantage | $3,307.93 | — |
| cigna | medicare advantage | $3,372.79 | — |
| kaiser | medicare advantage | $3,372.79 | — |
| kaiser | medicaid advantage | $3,418.44 | — |
| humana | medicare advantage | $3,567.38 | — |
| innovation | fully insured | $3,689.00 | — |
| sentara health | exchange | $3,855.49 | — |
| carefirst | hmo | $4,413.00 | — |
| innovation | self insured | $4,448.00 | — |
| carefirst | ppo | $4,455.00 | — |
| cigna | exchange | $4,528.00 | — |
| sentara health | hmo | $5,072.52 | — |
| sentara health | ppo | $5,072.52 | — |
| aetna | fannie-mae | $5,360.06 | — |
| united | exchange | $5,470.40 | — |
| cigna | hmo | $5,866.00 | — |
| cigna | ppo | $5,866.00 | — |
| united | nonoptions | $6,158.37 | — |
| united | options | $6,158.37 | — |
| aetna | hmo | $6,269.00 | — |
| aetna | ppo | $6,269.00 | — |
| anthem | exchange hmo | $7,691.87 | — |
| anthem | hmo | $8,866.25 | — |
| anthem | ppo | $8,866.25 | — |
Visitor-reported prices
Comments
Tonsillectomy (age 12+) at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | not published | $3,107.67 – $4,413.00 |
| Inova Fair Oaks Hospital | VA 22033-1709 | not published | $3,107.67 – $4,413.00 |
| Inova Loudoun Hospital | Leesburg | not published | $3,107.67 – $4,413.00 |
| Inova Mount Vernon Hospital | Alexandria | not published | $3,107.67 – $4,413.00 |