Pt evaluation moderate complexity patient/family at LEWISGALE HOSPITAL-PULASKI
2400 Lee Hwy, PULASKI, VA · HCA Virginia · · NPI 1205882396
$753.00
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.
$753.00
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.
$72.78 with Humana Military vs $677.70 with PHCS — 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 |
|---|---|---|---|
| Humana Military | TRCR | $72.78 | ↓ -90% |
| TriAtlantic | TRICR | $82.48 | ↓ -89% |
| Sentara Health | MCR | $86.88 | ↓ -88% |
| Magellan | MCR | $86.88 | ↓ -88% |
| Good Samaritan Hospice | COMM | $86.88 | ↓ -88% |
| Devoted | MCR | $86.88 | ↓ -88% |
| United | VACCN | $86.88 | ↓ -88% |
| United Mine Workers | MCR | $86.88 | ↓ -88% |
| Humana | MCR | $86.88 | ↓ -88% |
| United | MGMCR | $87.32 | ↓ -88% |
| Health Net | TRICR | $87.34 | ↓ -88% |
| Aetna | MGMCR | $87.87 | ↓ -88% |
| Virginia Premier Health | MGMCR | $88.62 | ↓ -88% |
| Anthem | MGMCR | $89.49 | ↓ -88% |
| Cigna HealthSpring | MCR | $90.36 | ↓ -88% |
| Evernorth Behavioral Health | MCR | $90.36 | ↓ -88% |
| Clear Spring Health Plan | MCR | $91.23 | ↓ -88% |
| Pyramid Life | MGMCR | $92.96 | ↓ -88% |
| Align Senior Care | MGMCR | $92.96 | ↓ -88% |
| Lifeworks | MCR | $143.07 | ↓ -81% |
| Universal Healthcare Group | MCR | $165.66 | ↓ -78% |
| United | OptionsPPO | $251.50 | ↓ -67% |
| Virginia Health Network | ULTRA | $263.55 | ↓ -65% |
| United | GlobalBenefitPlan | $338.85 | ↓ -55% |
| Aetna | Broad | $338.85 | ↓ -55% |
| Greenvbrier Sporting Club | COMM | $451.80 | ↓ -40% |
| Virginia Health Network | COMM | $534.63 | ↓ -29% |
| Virginia Health Network | WC | $534.63 | ↓ -29% |
| CorVel | WorkersComp | $542.16 | ↓ -28% |
| Richfield Nursing Center | COMM | $564.75 | ↓ -25% |
| Richfield Retirement Community | COMM | $564.75 | ↓ -25% |
| Multiplan | PHCS | $579.81 | ↓ -23% |
| OccuNet Workers Comp | WorkersComp | $602.40 | ↓ -20% |
| One Health Plan | POS | $602.40 | ↓ -20% |
| One Health Plan | PPO | $602.40 | ↓ -20% |
| Graham-White Manufacturing | COMM | $602.40 | ↓ -20% |
| Community Care Network | COMM | $602.40 | ↓ -20% |
| Patients Choice | COMM | $662.64 | ↓ -12% |
| Star Transportation | COMM | $677.70 | ↓ -10% |
| 4Most | COMM | $677.70 | ↓ -10% |
| American Postal Workers Union | COMM | $677.70 | ↓ -10% |
| PHCS | COMM | $677.70 | ↓ -10% |
| Aetna | SharedSavings | not published by hospital | — |
| Optima Health | POS | not published by hospital | — |
| Optima Health | HMO | not published by hospital | — |
| Optima Health | PPO | not published by hospital | — |
Visitor-reported prices
Comments
Pt evaluation moderate complexity patient/family at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| LEWISGALE HOSPITAL-ALLEGHANY | LOW MOOR | $1,306.00 | $82.48 – $94.13 |
| Inova Alexandria Hospital | Alexandria | $212.50 | $110.07 – $348.87 |
| Inova Fairfax Hospital | Falls Church | $212.50 | $110.07 – $348.87 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $212.50 | $110.07 – $348.87 |
| Inova Loudoun Hospital | Leesburg | $212.50 | $110.07 – $348.87 |
| Inova Mount Vernon Hospital | Alexandria | $212.50 | $110.07 – $348.87 |
| TRICITIES HOSPITAL | HOPEWELL | $997.00 | $82.48 – $117.29 |
| SPOTSYLVANIA REGIONAL MEDICAL CENTER | Fredericksburg | $710.64 | $86.88 – $97.04 |