Where Virginia Hospitals Fall on Price and Charity Care

Our analyses cover hospitals in Virginia and North Carolina — each article states its exact scope. See our latest findings or our Virginia and North Carolina pricing reports.

Put every Virginia hospital the record can place on two axes — what commercial insurers pay there compared with the state median, and how much charity care it gives at cost compared with what it spends — and the state sorts into four groups. Of the 21 nonprofit hospitals on the chart, 8 sit above the median price and below the median charity-care share. 6 sit in the opposite corner: lower prices, more charity care. The 6 for-profit hospitals, which carry no charity-care obligation in exchange for a tax exemption, are shown hollow; 3 of them price above the median.

How to read the two axes

Price. For each procedure code that at least 8 Virginia hospitals price for commercial plans, we take each hospital's median commercial negotiated rate and divide it by the Virginia median of those rates. A hospital's position is the median of its ratios across at least 25 procedures (89 procedure codes qualified; 23,178 commercial rate rows used). Laboratory, rehabilitation, office-visit and dermatology codes are left out because some hospitals publish professional fees rather than facility rates for them, and a ratio built on those would measure billing class, not price. 0 rows carrying a Medicare Advantage plan name that the record had filed under commercial were also set aside. Hospitals with fewer than 3 commercial insurers on file are not placed. A hospital at 1.40 is priced about 40% above the typical Virginia hospital on the same services; the spread from the lowest-priced hospital to the highest is 3.5×. These are posted negotiated rates, not what any patient paid, and Medicare Advantage, Medicaid and other government plans are excluded so the comparison is commercial against commercial.

Charity care. The vertical axis is the cost of charity care the hospital reported on its most recent Medicare cost report, divided by its total operating expenses. We use cost over cost on purpose. The figure on each hospital's profile page, charity care as a share of patient revenue, divides by gross charges, and gross charges are set by each hospital's own markup: a hospital that bills at eight times cost looks stingy on that measure no matter what it gives. 7 of the 28 hospitals change sides of the charity median depending on which denominator is used, so both figures are in the table below. Cost reports lag by roughly a year and a half; prices are the hospitals' current postings. That mismatch is disclosed here rather than in a footnote because it is the main reason to read the chart as a pattern, not a scoreboard.

Where each hospital falls

Above the median price and below the median charity share, nonprofit: Carilion Tazewell Community Hospital, Carilion Rockbridge Community Hospital, Carilion Giles Community Hospital, Carilion New River Valley Medical Center, Sentara Williamsburg Regional Medical Center, Sentara Princess Anne Hospital, Sentara Halifax Regional Hospital and Sentara Martha Jefferson Hospital. Below the median price and above the median charity share, nonprofit: UVA Health Culpeper Medical Center, UVA Health Prince William Medical Center, Riverside Doctors' Hospital Of Williamsburg, Riverside Shore Memorial Hospital, Southside Community Hospital, Inc and Sentara Virginia Beach General Hospital. The quadrants split at the medians of the 28 hospitals shown (0.98× and 2.51% respectively), so half the hospitals sit on each side of each line by construction.

Not placed, and why: Carilion Franklin Memorial Hospital (no cost-report charity or expense figure on file); Dominion Hospital (no cost-report charity or expense figure on file); Sentara Norfolk General Hospital (no cost-report charity or expense figure on file); Sentara Rmh Medical Center (only 1 commercial payer on file (need 3)); Fauquier Hospital (only 1 commercial payer on file (need 3)); Medical College Of Virginia Hospitals (only 2 commercial payers on file (need 3)); Sovah Health Danville (only 1 commercial payer on file (need 3)); Wythe County Community Hospital (only 2 commercial payers on file (need 3)); Buchanan General Hospital (only 2 commercial payers on file (need 3)).

Ownership follows the CMS Hospital General Information listing, except where the record's own system affiliation contradicts it: Reston Hospital Center, Henrico Doctors' Hospital carry a nonprofit label in the CMS file while belonging to HCA Virginia, a for-profit operator, and are shown as for-profit here.

What this record cannot show

• What any patient paid. Both axes are drawn from published files: posted negotiated rates and a cost report. Out-of-pocket cost depends on the plan, the deductible and how the visit was coded.
• Who the hospital serves. A hospital in a county with few uninsured residents can report little charity care for reasons that have nothing to do with its policy. The chart does not adjust for patient mix, and it does not read the hospital's financial-assistance policy or income thresholds.
• Community benefit beyond charity care. Nonprofit hospitals also report Medicaid shortfalls, bad debt, research and training. Only the charity-care line is used here.
• Why a hospital is where it is. The two axes are shown together because a patient facing a bill needs both. Nothing here says one causes the other.
• The same year on both axes. Cost reports are the most recent on file with CMS; price files are current postings. A hospital that changed either since will move.

Methodology: commercial negotiated rates from each hospital's federally required machine-readable file (45 CFR 180.50) as parsed into the HospitalCost record; five-digit CPT codes only; plan types classified by name, with Medicare Advantage, Medicaid, TRICARE and workers' compensation plans excluded by name, plus a report-level guard for Medicare Advantage plan names the record files as commercial; laboratory, rehabilitation, office-visit and dermatology codes excluded; hospitals with fewer than 3 commercial payers excluded; a hospital-procedure median across its commercial plans, then a ratio to the Virginia median of those medians for codes priced at 8+ hospitals, then the hospital's median ratio over 25+ codes. Charity care and operating expenses from CMS Hospital Cost Reports (Worksheet S-10 cost of charity care; total expenses), most recent on file. Quadrants split at the medians of the 28 hospitals placed. Recomputed September 6, 2026 by a parameterized script; the dated derivation is preserved alongside the article. Virginia hospitals only.

Cite as: HospitalCost.com, “Where Virginia Hospitals Fall on Price and Charity Care,” September 2026. Available at https://www.hospitalcost.com/insights/hospital-prices-vs-charity-care-virginia

Sources: hospital machine-readable files (45 CFR Part 180), CMS Hospital Compare, HCAHPS, CMS Cost Reports, and IRS Form 990 filings via ProPublica. Every number traces to a federal primary source — full methodology and direct links.