Surgical pathology level 5 gross & microscopic examination at Russell County Hospital
58 CARROLL ST., LEBANON, VA · Balladhealth · · NPI 1891973939
$235.20
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.
$1,568.00
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.
$34.65 with BLUE CROSS vs $1,568.00 with FIRST HEALTH COVENTRY — 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 |
|---|---|---|---|
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $34.65 | ↓ -85% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $51.89 | ↓ -78% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $204.23 | ↓ -13% |
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $204.23 | ↓ -13% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $210.35 | ↓ -11% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $212.40 | ↓ -10% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $214.44 | ↓ -9% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $283.41 | ↑ +20% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $283.41 | ↑ +20% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $283.41 | ↑ +20% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $349.73 | ↑ +49% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $349.73 | ↑ +49% |
| AETNA | AETNA HEALTHCARE MEDICARE | $349.73 | ↑ +49% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $349.73 | ↑ +49% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $349.73 | ↑ +49% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $349.73 | ↑ +49% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $349.73 | ↑ +49% |
| SENTARA HEALTH | SENTARA MEDICARE | $349.73 | ↑ +49% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $349.73 | ↑ +49% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $349.73 | ↑ +49% |
| HUMANA | HUMANA MEDICARE | $355.33 | ↑ +51% |
| BLUE CROSS | BLUE CROSS MEDICARE | $363.72 | ↑ +55% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $363.72 | ↑ +55% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $367.22 | ↑ +56% |
| NHC ADVANTAGE | NHC ADVANTAGE | $367.22 | ↑ +56% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $367.22 | ↑ +56% |
| CIGNA HEALTHCARE | CIGNA PPO | $432.63 | ↑ +84% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $432.63 | ↑ +84% |
| CIGNA HEALTHCARE | CIGNA HMO | $432.63 | ↑ +84% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $451.42 | ↑ +92% |
| MEDCOST | MEDCOST VHN | $548.80 | ↑ +133% |
| SENTARA HEALTH | SENTARA HEALTH | $571.07 | ↑ +143% |
| AMBETTER | AMBETTER | $762.41 | ↑ +224% |
| BLUE CROSS | ANTHEM EXCHANGE | $1,184.57 | ↑ +404% |
| AETNA | AETNA | $1,254.40 | ↑ +433% |
| BLUE CROSS | BLUE CROSS P NETWORK | $1,289.13 | ↑ +448% |
| BLUE CROSS | BLUE CROSS S NETWORK | $1,289.13 | ↑ +448% |
| BLUE CROSS | ANTHEM HMO | $1,294.70 | ↑ +450% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $1,377.30 | ↑ +486% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $1,568.00 | ↑ +567% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $1,568.00 | ↑ +567% |
Visitor-reported prices
Comments
Surgical pathology level 5 gross & microscopic examination at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| LEWISGALE HOSPITAL-ALLEGHANY | LOW MOOR | $223.00 | $291.26 – $1,644.16 |
| Inova Alexandria Hospital | Alexandria | $346.50 | $231.10 – $435.97 |
| Inova Fairfax Hospital | Falls Church | $346.50 | $231.10 – $435.97 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $346.50 | $231.10 – $435.97 |
| Inova Loudoun Hospital | Leesburg | $346.50 | $231.10 – $435.97 |
| Inova Mount Vernon Hospital | Alexandria | $346.50 | $231.10 – $435.97 |
| Johnston Memorial Hospital | ABINGDON | $235.20 | $34.65 – $762.41 |
| Sentara Martha Jefferson Hospital | Charlottesville | $233.50 | $41.78 – $367.22 |