Biopsy of tear sac at Virginia Mason Medical Center
1100 9th Ave., Seattle, WA · Vmfh · · NPI 1801851258
$2,723.40
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.
$5,340.00
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.
$2.44 with aetna vs $3,943.06 with cigna — 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 |
|---|---|---|---|
| aetna | medicare advantage hmo | $2.44 | ↓ -100% |
| first choice | commercial | $7.50 | ↓ -100% |
| aetna | medicare advantage | $77.32 | ↓ -97% |
| confluence health | medicare advantage | $132.73 | ↓ -95% |
| united healthcare | commercial | $266.45 | ↓ -90% |
| humana | medicare advantage | $270.89 | ↓ -90% |
| humana | choicecare medicare advantage | $270.89 | ↓ -90% |
| united healthcare | medicare advantage | $270.89 | ↓ -90% |
| kaiser foundation | hp medicare | $270.89 | ↓ -90% |
| optum care network | medicare advantage | $270.89 | ↓ -90% |
| multiplan | medicare advantage | $277.71 | ↓ -90% |
| signal health | medicare advantage | $277.71 | ↓ -90% |
| premera | medicare advantage hmo/ppo | $277.71 | ↓ -90% |
| regence | medicare advantage | $287.48 | ↓ -89% |
| regence | uniform medical plan | $472.80 | ↓ -83% |
| premera | commercial | $559.52 | ↓ -79% |
| regence | commercial | $627.48 | ↓ -77% |
| coventry - first health | commercial | $676.60 | ↓ -75% |
| aetna | medicare advantage ppo | $878.24 | ↓ -68% |
| cigna | commercial | $879.79 | ↓ -68% |
| kaiser health plan | commercial | $1,186.02 | ↓ -56% |
| aetna | commercial | $3,364.20 | ↑ +24% |
| cigna | local plus | $3,943.06 | ↑ +45% |
Visitor-reported prices
Comments
Biopsy of tear sac at other Washington hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Swedish Medical Center - First Hill Campus | Seattle | not published | $2,753.10 – $9,424.42 |
| Swedish Medical Center Cherry Hill | Seattle | not published | $2,753.10 – $9,076.09 |
| Central Medical Center | Seattle | not published | not published |
| Providence St Luke's Rehabilitation Medical Center | Spokane | not published | $2,649.34 – $2,914.27 |
| Providence Sacred Heart Medical Center and Children's Hospital | Spokane | not published | $2,649.34 – $6,742.56 |
| Swedish Issaquah | Issaquah | not published | $2,760.83 – $9,424.42 |
| Providence Centralia Hospital | Centralia | not published | $2,753.10 – $11,320.92 |
| Swedish Edmonds Hospital | Edmonds | not published | $1,638.00 – $9,366.37 |