Carotene at Lee County Community Hospital
127 HEALTHCARE DRIVE, PENNINGTON GAP, VA · Balladhealth · · NPI 1205488996
$15.87
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.
?
What you pay up front if you don't use insurance.
$69.00
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.
?
The hospital's undiscounted list price — almost no one pays this.
$8.17 with OPTIMA HEALTH vs $69.00 with BLUE CROSS — same scan, same building. Share
Negotiated rates by payer
?
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 →
?
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 |
|---|---|---|---|
| OPTIMA HEALTH | OPTIMA HEALTH MEDICAID | $8.17 | ↓ -49% |
| BLUE CROSS | ANTHEM HLTHKEEP MEDICIAD | $8.17 | ↓ -49% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICAID VIRGINIA | $8.42 | ↓ -47% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA | $8.50 | ↓ -46% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICAID | $8.50 | ↓ -46% |
| BLUE CROSS | ANTHEM PPO, TRADITIONAL INDEMNITY | $9.22 | ↓ -42% |
| BLUE CROSS | BLUE CROSS P NETWORK | $9.22 | ↓ -42% |
| BLUE CROSS | ANTHEM EXCHANGE | $9.22 | ↓ -42% |
| UNITED HEALTHCARE | UHC HERITAGE RIVER VALLEY | $9.22 | ↓ -42% |
| UNITED HEALTHCARE | UHC HERITAGE SELECT | $9.22 | ↓ -42% |
| UNITED HEALTHCARE | UNITED HEALTHCARE | $9.22 | ↓ -42% |
| BLUE CROSS | ANTHEM HMO | $9.22 | ↓ -42% |
| BLUE CROSS | BLUE CROSS S NETWORK | $9.22 | ↓ -42% |
| UNITED HEALTHCARE | TENNCARE UNITED HEALTHCARE | $11.75 | ↓ -26% |
| AMBETTER | AMBETTER | $15.18 | ↓ -4% |
| UNITED HEALTHCARE | UNITED HEALTHCARE MEDICARE | $15.18 | ↓ -4% |
| AETNA | AETNA BETTER HEALTH OF VIRGINIA MEDICARE | $15.18 | ↓ -4% |
| AETNA | AETNA HEALTHCARE MEDICARE | $15.18 | ↓ -4% |
| AMERIGROUP | AMERIGROUP MEDICARE WELLPOINT | $15.18 | ↓ -4% |
| ALLCARE MEDICARE | ALLCARE MEDICARE | $15.18 | ↓ -4% |
| MANAGED MEDICAIRE | MANAGED MEDICAIRE | $15.18 | ↓ -4% |
| MOUNTAIN EMPIRE PACE | MOUNTAIN EMPIRE PACE | $15.18 | ↓ -4% |
| SENTARA HEALTH | SENTARA MEDICARE | $15.18 | ↓ -4% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA | $15.18 | ↓ -4% |
| UNITED MINE WORKERS OF AMERICA | UNITED MINE WORKERS OF AMERICA MEDICARE | $15.18 | ↓ -4% |
| HUMANA | HUMANA MEDICARE | $15.42 | ↓ -3% |
| BLUE CROSS | ANTHEM MEDICARE VIRGINIA | $15.64 | ↓ -1% |
| MOLINA HEALTHCARE | MOLINA HEALTHCARE MEDICARE | $15.79 | ↓ -1% |
| CIGNA HEALTHCARE | CIGNA MEDICARE | $15.94 | ↑ +0% |
| NHC ADVANTAGE | NHC ADVANTAGE | $15.94 | ↑ +0% |
| DEVOTED HEALTH PLAN | DEVOTED HEALTH PLAN MEDICARE | $15.94 | ↑ +0% |
| BLUE CROSS | BLUE CROSS MEDICARE | $16.09 | ↑ +1% |
| SENTARA HEALTH | SENTARA HEALTH | $17.81 | ↑ +12% |
| CIGNA HEALTHCARE | CIGNA INDIVIDUAL FAMILY PLAN | $20.21 | ↑ +27% |
| BLUE CROSS | BLUE CROSS BALLAD HEALTH EMPLOYEE | $30.19 | ↑ +90% |
| SEVEN CORNERS, INC. | SEVEN CORNERS, INC. | $36.43 | ↑ +130% |
| BLUE CROSS | TENNCARE BLUE SELECT | $69.00 | ↑ +335% |
| AETNA | AETNA | $69.00 | ↑ +335% |
| CIGNA HEALTHCARE | CIGNA PPO | $69.00 | ↑ +335% |
| CIGNA HEALTHCARE | CIGNA OPEN ACCESS PLUS | $69.00 | ↑ +335% |
| FIRST HEALTH COVENTRY | FIRST HEALTH COVENTRY | $69.00 | ↑ +335% |
| MEDCOST | MEDCOST VHN | $69.00 | ↑ +335% |
| AMERIGROUP | AMERIGROUP | $69.00 | ↑ +335% |
| BLUE CROSS | TENNCARE BLUE CARE | $69.00 | ↑ +335% |
Visitor-reported prices
Comments
Carotene at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| LEWISGALE HOSPITAL-ALLEGHANY | LOW MOOR | $356.00 | $8.02 – $13.37 |
| Inova Alexandria Hospital | Alexandria | $109.50 | $6.47 – $137.77 |
| Inova Fairfax Hospital | Falls Church | $109.50 | $6.47 – $137.77 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $109.50 | $6.47 – $137.77 |
| Inova Loudoun Hospital | Leesburg | $109.50 | $6.47 – $137.77 |
| Inova Mount Vernon Hospital | Alexandria | $109.50 | $6.47 – $137.77 |
| Johnston Memorial Hospital | ABINGDON | $16.20 | $4.61 – $20.10 |
| Russell County Hospital | LEBANON | $16.20 | $5.72 – $20.10 |