Biopsy roof of mouth at Inova Loudoun Hospital
44045 Riverside Parkway, Leesburg, VA · Inova · · NPI 1376564302
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.
$1,481.28 with united vs $3,988.57 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 |
|---|---|---|---|
| united | medicare advantage | $1,481.28 | — |
| anthem | medicare advantage | $1,481.28 | — |
| aetna | medicare advantage | $1,481.28 | — |
| innovation | fully insured | $1,509.00 | — |
| sentara health | medicare advantage | $1,510.91 | — |
| cigna | medicare advantage | $1,540.53 | — |
| kaiser | medicare advantage | $1,540.53 | — |
| humana | medicare advantage | $1,629.41 | — |
| innovation | self insured | $1,822.00 | — |
| sentara health | exchange | $1,847.42 | — |
| anthem | medicaid advantage | $2,047.61 | — |
| cigna | exchange | $2,067.00 | — |
| united | medicaid advantage | $2,088.56 | — |
| sentara health | medicaid advantage | $2,109.04 | — |
| humana | medicaid advantage | $2,129.51 | — |
| aetna | medicaid advantage | $2,149.99 | — |
| aetna | fannie-mae | $2,190.02 | — |
| kaiser | medicaid advantage | $2,252.37 | — |
| sentara health | ppo | $2,430.58 | — |
| sentara health | hmo | $2,430.58 | — |
| carefirst | hmo | $2,485.00 | — |
| carefirst | ppo | $2,510.00 | — |
| united | exchange | $2,538.64 | — |
| aetna | ppo | $2,561.00 | — |
| aetna | hmo | $2,561.00 | — |
| cigna | hmo | $2,678.00 | — |
| cigna | ppo | $2,678.00 | — |
| united | nonoptions | $2,857.22 | — |
| united | options | $2,857.22 | — |
| anthem | exchange hmo | $3,460.13 | — |
| anthem | hmo | $3,988.57 | — |
| anthem | ppo | $3,988.57 | — |
Visitor-reported prices
Comments
Biopsy roof of mouth at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Sentara Martha Jefferson Hospital | Charlottesville | $1,099.50 | $1,010.00 – $3,276.00 |
| Sentara Northern Virginia Medical Center | Woodbridge | $1,176.50 | $1,544.13 – $2,603.00 |
| Sentara Halifax Regional Hospital | South Boston | $1,536.50 | not published |
| Sentara Leigh Hospital | Norfolk | $1,176.50 | $1,544.13 – $3,408.00 |
| Sentara RMH Medical Center | Harrisonburg | $1,099.50 | $1,544.13 – $1,589.55 |
| Sentara CarePlex Hospital | Hampton | $1,176.50 | $1,544.13 – $1,589.55 |
| Sentara Norfolk General Hospital | Norfolk | $1,176.50 | $1,544.13 – $3,408.00 |
| Sentara Princess Anne Hospital | Virginia Beach | $1,176.50 | $1,544.13 – $3,408.00 |