Which Insurance Plans Pay the Most at Virginia Hospitals?
Negotiated rates vary from $24 to $9,003 by plan
This analysis covers hospitals in Virginia. We're expanding to new states — check our latest findings or our Virginia and North Carolina pricing reports.
Not all insurance plans negotiate the same rates. Across 54 priced Virginia hospitals, the average negotiated rate varies dramatically by insurance company — from under $25 per procedure to over $9,000. This data comes directly from hospital machine-readable files, which are required to publish the negotiated rate for every payer.
Insurance plans with the lowest negotiated rates
| Insurance Plan | Avg Rate | Range | Rates Published |
|---|---|---|---|
| TriAtlantic | $18 | $3 - $75 | 60 |
| Health Net | $20 | $3 - $84 | 60 |
| Optum Transplant | $23 | $3 - $93 | 27 |
| Sentara Health | $23 | $3 - $107 | 81 |
| Virginia Premier Health | $24 | $3 - $110 | 90 |
| OptumHealth Transplant | $24 | $3 - $95 | 27 |
| Evernorth Behavioral Health | $24 | $3 - $96 | 45 |
| DaVita Village Health | $24 | $3 - $112 | 63 |
| Clear Spring Health Plan | $24 | $3 - $113 | 90 |
| Pyramid Life | $25 | $3 - $115 | 63 |
Insurance plans with the highest negotiated rates
| Insurance Plan | Avg Rate | Range | Rates Published |
|---|---|---|---|
| Optima Health | $9,003 | $17 - $29,307 | 375 |
| One Health Plan | $4,780 | $73 - $15,978 | 64 |
| 4Most Health Nework | $4,094 | $8 - $14,677 | 189 |
| Three Rivers Provider Network | $3,736 | $59 - $10,639 | 122 |
| Oscar | $3,701 | $8 - $12,499 | 115 |
| OccuNet Workers Comp | $3,681 | $7 - $14,202 | 252 |
| Multiplan | $3,536 | $8 - $15,978 | 256 |
| Bright Health | $3,393 | $7 - $23,280 | 138 |
| GEHA [40009] | $3,344 | $3 - $28,731 | 130 |
| CorVel | $3,253 | $6 - $12,782 | 286 |
These averages are across all procedures and all hospitals. Individual plan rates vary by procedure and facility. You can see your specific plan's rate at any hospital on our procedure comparison pages by selecting your insurance in the report.
Methodology: per-payer averages computed across every payer-negotiated rate published by Virginia hospitals' MRFs. "Range" is min-to-max within the payer's published rates. "Rates Published" is the count of distinct hospital × CPT pairs the payer publishes. Higher counts mean broader coverage, not lower prices. Source: hospital MRFs under 45 CFR 180.50. Recomputed against current data 2026-05-01.
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.
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