Biopsy of rectum wall anal approach 45100 at Sentara CarePlex Hospital
3000 Coliseum Drive, Hampton, VA · Sentara · · NPI 1336109107
$1,914.00
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.
$3,828.00
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.
$2,762.33 with Sentara Health Plan vs $9,469.76 with Bcbs — 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 |
|---|---|---|---|
| Sentara Health Plan | Medicare Managed Care Plan | $2,762.33 | ↑ +44% |
| Humana | Medicare Managed Care Plan | $2,789.41 | ↑ +46% |
| Bcbs | Anthem Medicare Managed Care Plan | $2,836.81 | ↑ +48% |
| Unitedhealthcare | Dsnp Medicare Managed Care Plan | $2,843.58 | ↑ +49% |
| Unitedhealthcare | All Commercial Plans | $5,169.00 | ↑ +170% |
| Unitedhealthcare | Options Ppo | $5,790.00 | ↑ +203% |
| Bcbs | Anthem Exchange | $8,500.05 | ↑ +344% |
| Bcbs | Anthem Hmo | $9,090.69 | ↑ +375% |
| Bcbs | Anthem Ppo | $9,469.76 | ↑ +395% |
Visitor-reported prices
Comments
Biopsy of rectum wall anal approach 45100 at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $5,015.00 | $1,509.00 – $4,413.00 |
| Inova Fairfax Hospital | Falls Church | $5,015.00 | $1,509.00 – $4,413.00 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $5,015.00 | $1,509.00 – $4,413.00 |
| Inova Loudoun Hospital | Leesburg | $5,015.00 | $1,509.00 – $4,413.00 |
| Inova Mount Vernon Hospital | Alexandria | $5,015.00 | $1,509.00 – $4,413.00 |
| Johnston Memorial Hospital | ABINGDON | $1,159.80 | $257.73 – $5,903.81 |
| Russell County Hospital | LEBANON | $1,159.80 | $257.73 – $5,903.81 |
| Sentara Martha Jefferson Hospital | Charlottesville | $1,789.00 | $1,010.00 – $3,276.00 |