Summary

7 facilities within 25 miles of Roanoke publish prices for Office Visit Established Patient Level 3. Cash prices range from $94 to $528 — a 5.6x difference for an identical procedure. The Virginia average is $215.

Choosing the lowest-priced facility over the highest saves $434.

$94 lowest
$528 highest
Best Value

Carilion Giles Community Hospital

Pearisburg, VA · Carilion Clinic · 0.1 mi

$135 Cash price
4/5 CMS rating
83.0% Patient satisfaction

Lowest price among hospitals rated 4 stars or above. Patient satisfaction: 83%. Cash price of $135 is below the statewide average of $215.

All facilities ranked by price

1
Sentara Halifax Regional Hospital 3★ · 0.1 mi · Nonprofit
$94
2
Carilion Stonewall Jackson Hospital 3★ · 0.1 mi · Nonprofit
$109
3
Carilion Giles Community Hospital 4★ · 0.1 mi · Nonprofit
$135
4
Carilion New River Valley Medical Center 4★ · 0.1 mi · Nonprofit
$135
5
Carilion Medical Center 4★ · 0.0 mi · Nonprofit
$135
6
Sovah Health Danville 2★ · 0.1 mi · For-profit
$192
7
Lewisgale Medical Center 2★ · 0.1 mi · For-profit
$528
Complete facility data
# Facility Cash Price Gross Charge Markup CMS Stars Patient Rating Ownership
1 Sentara Halifax Regional Hospital Sentara Health South Boston, VA · 0.1 mi $94 $187 2.0x 3/5 71.0% Nonprofit
2 Carilion Stonewall Jackson Hospital Carilion Clinic Lexington, VA · 0.1 mi $109 $182 1.67x 3/5 75.0% Nonprofit
3 Carilion Giles Community Hospital Carilion Clinic Pearisburg, VA · 0.1 mi $135 $225 1.67x 4/5 83.0% Nonprofit
4 Carilion New River Valley Medical Center Carilion Clinic Christiansburg, VA · 0.1 mi $135 $225 1.67x 4/5 69.0% Nonprofit
5 Carilion Medical Center Carilion Clinic Roanoke, VA · 0.0 mi $135 $225 1.67x 4/5 66.0% Nonprofit
6 Sovah Health Danville Danville, VA · 0.1 mi $192 $481 2.5x 2/5 59.0% For-profit
7 Lewisgale Medical Center HCA Virginia Salem, VA · 0.1 mi $528 $528 1.0x 2/5 57.0% For-profit

Insurance negotiated rates by facility

The rates below are what each insurer has contractually agreed to pay this hospital for Office Visit Established Patient Level 3. Your actual out-of-pocket cost depends on your deductible status and copay structure.

Carilion Stonewall Jackson Hospital

Cash: $109
Insurance Plan Negotiated Rate vs Cash
Aetna Medicare Advantage $42 -$67
UnitedHealthcare Medicare Advantage $53 -$56
Medicaid Traditional Medicaid $62 -$48
Virginia Premier - CCC Plus CCC Plus $62 -$48
Virginia Premier Managed Medicaid $63 -$46
HealthKeepers Plus Managed Medicaid $65 -$44
Aetna Managed Medicaid $68 -$41
Community Plan Managed Medicaid $68 -$41
Intotal Health Managed Medicaid $68 -$41
Magellan Complete Care Managed Medicaid $68 -$41
Magellan Complete Care MLTSS/CCC+ $68 -$41
Medicaid Managed Medicaid $68 -$41
Aetna Commercial $92 -$17
Aetna CC Employee $93 -$16
Optima Health Commercial $108 -$1

11 additional plans not shown.

Carilion Giles Community Hospital

Cash: $135
Insurance Plan Negotiated Rate vs Cash
Anthem Managed Medicaid $70 -$65
Sentara Health Plan Managed Medicaid $71 -$64
Humana Managed Medicaid $73 -$62
ABH of VA (formerly Coventry) Managed Medicaid $73 -$62
UnitedHealthcare Managed Medicaid $73 -$62
Aetna Exchange $108 -$27
UnitedHealthcare Commercial $113 -$22
Aetna Choice POS II $117 -$18
Gateway - Tier 3 Commercial $124 -$11
VHN - ULTRA Commercial $140 +$4
Sentara Health Plan Commercial $140 +$4
Aetna Commercial $150 +$15
Connecticare Commercial $158 +$22
Cigna Commercial $162 +$27

6 additional plans not shown.

Carilion New River Valley Medical Center

Cash: $135
Insurance Plan Negotiated Rate vs Cash
Anthem Managed Medicaid $70 -$65
Sentara Health Plan Managed Medicaid $71 -$64
Humana Managed Medicaid $73 -$62
ABH of VA (formerly Coventry) Managed Medicaid $73 -$62
UnitedHealthcare Managed Medicaid $73 -$62
Aetna Exchange $108 -$27
Aetna Choice POS II $117 -$18
Gateway - Tier 3 Commercial $124 -$11
UnitedHealthcare Commercial $130 -$5
VHN - ULTRA Commercial $140 +$4
Sentara Health Plan Commercial $140 +$4
Aetna Commercial $150 +$15
Cigna Commercial $152 +$17
Connecticare Commercial $158 +$22

6 additional plans not shown.

Carilion Medical Center

Cash: $135
Insurance Plan Negotiated Rate vs Cash
Anthem Managed Medicaid $70 -$65
Sentara Health Plan Managed Medicaid $71 -$64
Humana Managed Medicaid $73 -$62
ABH of VA (formerly Coventry) Managed Medicaid $73 -$62
UnitedHealthcare Managed Medicaid $73 -$62
Aetna Exchange $108 -$27
Aetna Choice POS II $117 -$18
Gateway - Tier 3 Commercial $124 -$11
UnitedHealthcare Commercial $130 -$5
VHN - ULTRA Commercial $140 +$4
Sentara Health Plan Commercial $140 +$4
Aetna Commercial $150 +$15
Cigna Commercial $152 +$17
Connecticare Commercial $158 +$22

6 additional plans not shown.

Lewisgale Medical Center

Cash: $528
Insurance Plan Negotiated Rate vs Cash
Lifeworks MCR $100 -$428
Universal Healthcare Group MCR $116 -$412
Virginia Health Network ULTRA $185 -$343
Aetna SharedSavings $190 -$338
UnitedHealthcare OptionsPPO $201 -$327
UnitedHealthcare GlobalBenefitPlan $238 -$290
Aetna Broad $285 -$243
Greenvbrier Sporting Club COMM $317 -$211
Virginia Health Network COMM $375 -$153
Virginia Health Network WC $375 -$153
CorVel WorkersComp $380 -$148
CSX Hotels Product $422 -$106
OccuNet Workers Comp WorkersComp $422 -$106
Health Payors Organization COMM $449 -$79
4Most COMM $475 -$53

8 additional plans not shown.

Before you call

The data in this report is from each hospital's publicly filed prices. Here's how to use it.

Confirm the price

Call the hospital's billing department and ask for a price estimate or Good Faith Estimate for Office Visit Established Patient Level 3 (CPT 99213). Under federal law, they must provide this. Compare it to the published price in this report.

Ask about cash pay

If you haven't met your deductible, ask for the cash/self-pay rate. At many hospitals, the cash price is lower than the insurance-negotiated rate. You can see this in the insurance table above — some negotiated rates exceed the cash price.

Compare before you schedule

You are not required to use the facility your doctor referred you to. You can request a referral to any in-network facility. The same procedure, same quality — sometimes at a fraction of the price.

Ask about financial help

Most nonprofit hospitals in Virginia offer financial assistance to patients based on household income. This is separate from insurance — even insured patients can qualify. Ask billing for their Financial Assistance Policy.

Financial assistance by facility

Nonprofit hospitals are legally required to have financial assistance programs. Below is what we know about each facility's charitable care.

Facility Status Charity Care Provided How to Apply
Sentara Halifax Regional Hospital Nonprofit Call billing, request Financial Assistance application
Carilion Stonewall Jackson Hospital Nonprofit Call billing, request Financial Assistance application
Carilion Giles Community Hospital Nonprofit Call billing, request Financial Assistance application
Carilion New River Valley Medical Center Nonprofit Call billing, request Financial Assistance application
Carilion Medical Center Nonprofit Call billing, request Financial Assistance application
Sovah Health Danville For-profit N/A (for-profit)
Lewisgale Medical Center For-profit N/A (for-profit)

What to do next

  1. Identify your top 2-3 facilities based on price, quality rating, and distance. The data in this report shows that lower price does not mean lower quality — check the star ratings.
  2. Call billing before you schedule. Confirm the published price. Ask for a Good Faith Estimate. Ask whether there's a prompt-pay or cash-pay discount beyond the listed rate.
  3. Check your deductible status. If you haven't met your deductible, compare the cash rate to what you'd owe through insurance. In some cases, paying cash is cheaper than using your plan.
  4. Apply for financial assistance if your household income is under $60,000-$125,000 (thresholds vary). Most eligible patients never apply because they don't know the program exists.
  5. Get everything in writing. Before your procedure, get a written price estimate. After, review the bill line by line. Roughly 80% of hospital bills contain errors (Becker's Hospital Review).

Data sources

Hospital prices
Published machine-readable files, required under CMS Hospital Price Transparency Rule (45 CFR Part 180)
Quality ratings
CMS Hospital Compare, updated quarterly
Patient satisfaction
HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems)
Financial data
CMS Cost Reports (charity care, revenue) and IRS 990 filings (officer compensation)

This report is for informational purposes only. It is not medical advice. Every price shown is a price a hospital published — not an estimate. Actual out-of-pocket costs depend on your insurance plan, deductible status, and clinical circumstances. Consult your healthcare provider and insurer before making decisions.