X-ray exam of tear duct at Sentara Northern Virginia Medical Center
2300 Opitz Boulevard, Woodbridge, VA · Sentara · · NPI 1548366404
$367.50
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.
$735.00
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.
$186.73 with Carefirst vs $550.10 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 |
|---|---|---|---|
| Carefirst | Hmo | $186.73 | ↓ -49% |
| Carefirst | Ppo | $205.46 | ↓ -44% |
| Aetna | Medicare Managed Care Plan | $237.46 | ↓ -35% |
| Humana | Medicare Managed Care Plan | $239.78 | ↓ -35% |
| Bcbs | Anthem Medicare Managed Care Plan | $243.86 | ↓ -34% |
| Unitedhealthcare | Dsnp Medicare Managed Care Plan | $244.44 | ↓ -33% |
| Bcbs | Anthem Exchange | $478.90 | ↑ +30% |
| Bcbs | Anthem Hmo | $514.95 | ↑ +40% |
| Bcbs | Anthem Ppo | $550.10 | ↑ +50% |
Visitor-reported prices
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X-ray exam of tear duct at other Virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Inova Alexandria Hospital | Alexandria | $219.00 | $167.33 – $288.64 |
| Inova Fairfax Hospital | Falls Church | $219.00 | $167.33 – $288.64 |
| Inova Fair Oaks Hospital | VA 22033-1709 | $219.00 | $167.33 – $288.64 |
| Inova Loudoun Hospital | Leesburg | $219.00 | $167.33 – $288.64 |
| Inova Mount Vernon Hospital | Alexandria | $219.00 | $167.33 – $288.64 |
| Sentara Martha Jefferson Hospital | Charlottesville | $299.50 | $237.46 – $244.44 |
| Lonesome Pine Hospital | BIG STONE GAP | $153.90 | $58.70 – $558.72 |
| Sentara Halifax Regional Hospital | South Boston | $375.50 | $239.34 – $246.38 |