Virginia Hospital Pricing Report

Updated April 2026 — 8 findings from 40 hospitals, 17 federal data sources, 24,653 insurance rates

40Hospitals
17Data sources
141Insurance plans
13xImaging variation
Finding 1
The same procedure costs up to 13x more at one Virginia hospital than another.

A CT scan of the chest costs $489 at one Virginia hospital and $6,248 at another. These are prices each hospital published in their federally mandated machine-readable files under the CMS Hospital Price Transparency Rule.

ProcedureLowestHighestDifferenceMultiple
CT Chest without Contrast$489$6,248$5,75912.8x
MRI Brain without Contrast$781$7,811$7,03010.0x
MRI Brain with Contrast$886$7,811$6,9258.8x
CT Abdomen/Pelvis with Contrast$1,064$5,869$4,8055.5x
MRI Brain with & without Contrast$1,479$7,981$6,5025.4x
Inguinal Hernia Repair$9,656$37,067$27,4113.8x
Total Hip Replacement$11,995$39,467$27,4723.3x
Finding 2
Your insurance may cost you MORE than paying cash.

20.3% of insurance negotiated rates — 5,016 of 24,653 rate records — exceed the hospital's own published cash price.

ProcedureHospitalCash PriceInsurance RateYou Overpay
Ovarian Cyst RemovalUVA Haymarket$17,282$34,123 (UHC)+$16,840
CholecystectomyUVA Haymarket$18,035$34,123 (UHC)+$16,087
Knee ArthroscopyUVA Haymarket$9,287$24,734 (UHC)+$15,446
Knee ReplacementUVA Culpeper$29,064$42,344 (Anthem)+$13,279
Hip ReplacementUVA Culpeper$29,502$42,344 (Anthem)+$12,841
Finding 3
Cheaper hospitals are often rated HIGHER by patients.

Below-average price hospitals: 3.82 stars, 72% satisfaction. Above-average price hospitals: 3.29 stars, 68%.

HospitalCMS RatingSatisfactionAvg Price
Augusta Health4 stars68%$617
Inova Alexandria4 stars70%$751
Inova Loudoun5 stars76%$751
Inova Fair Oaks5 stars79%$751
Inova Fairfax5 stars76%$751
Sovah Health Danville2 stars$4,786
Finding 4
For-profit hospitals charge more than double nonprofit hospitals.
OwnershipAvg PriceHospitalsPremium
Government$1,0271
Nonprofit (Other)$1,4648+43%
Nonprofit (Private)$1,78322+74%
For-Profit$3,4658+237%
Finding 5
Most Virginians qualify for financial assistance they don't know about.
SystemFree Care ThresholdFamily of 4 LimitHospitals
Inova400% FPL$124,8005
Sentara300% FPL$93,60011
UVA Health200% FPL$62,4003
VCU Health200% FPL$62,4001
Carilion200% FPL$62,4006

A family of four earning $93,600 or less qualifies for free care at any Sentara hospital. Under $124,800 qualifies at all Inova hospitals. Most eligible patients never apply.

Finding 6
One system dominates most of Virginia — and it's not the most expensive.

Sentara operates most Hampton Roads hospitals, yet charges 40% below the state average. In Northern Virginia, five systems compete — MRI Brain without contrast ranges from $781 (Inova) to $7,811 (HCA facility) within 25 miles.

Finding 7
ER visits cost up to 10x more at one hospital than another.
ER LevelLowestHighestMultiple
Level 3 (Moderate)$378$3,7209.8x
Level 4 (High)$631$4,3766.9x
Level 5 (Critical)$982$5,0695.2x
Finding 8
Hospital executive compensation vs. charity care.
SystemOfficer CompCharity CareRatio
Inova$22.0M$159.1M$7.23 per $1
Sentara$12.1M$105.7M$8.74 per $1
Carilion$0.3M$12.3M$41 per $1
VCU Health$0.7M$1.2M$1.71 per $1

Officer compensation from IRS 990 filings. Charity care from CMS Cost Reports.

Important Context

  • Facility fees only. Prices shown are facility fees published by each hospital. Professional fees (radiologist, surgeon, anesthesiologist) are typically billed separately and are not included in the prices shown.
  • Insurance rates are not your out-of-pocket cost. Insurance rates shown are the negotiated amount between the hospital and insurer. Your actual cost depends on your deductible status, copay percentage, and coinsurance terms.
  • Inpatient vs outpatient. Imaging, lab, and screening prices are outpatient. Surgical procedure prices (hip replacement, hernia repair, cholecystectomy) may reflect inpatient facility fees including the hospital stay.
  • Financial data timing. Charity care amounts and executive compensation reflect the most recent IRS 990 and CMS Cost Report filings, which may be from 1-2 fiscal years prior. Hospital prices are from files downloaded April 2026.
  • Financial assistance requires application. Eligibility thresholds shown are from each system's published Financial Assistance Policy. Patients must apply and provide income documentation. Asset limits may apply (e.g., Sentara requires under $50,000 in assets). Thresholds may change — always confirm directly with the hospital.
  • Quality vs price correlation. The finding that cheaper hospitals have higher ratings on average is a correlation across all Virginia hospitals. It does not mean every cheap hospital is high quality. Individual hospital quality should be evaluated independently.

Data Sources & Methodology

Every number traces to a verified federal source. All comparisons use the same CPT/HCPCS procedure code across hospitals. 17 data sources merged on CMS Certification Number (CCN) — the unique 6-digit identifier assigned to every Medicare-participating hospital.

Price data: Hospital Machine-Readable Files (45 CFR Part 180) — downloaded directly from each hospital's website, April 2026.

Quality data: CMS Hospital Compare (star ratings), HCAHPS Patient Satisfaction Survey, CMS Timely & Effective Care, CMS Complications & Deaths, CMS Unplanned Hospital Visits.

Safety data: CMS Healthcare-Associated Infections (MRSA, C.diff, CLABSI), CMS Hospital-Acquired Condition Reduction Program (penalties), CMS Value-Based Purchasing (quality scores), Medicare Spending Per Beneficiary.

Financial data: CMS Cost Reports (charity care, revenue, net income), IRS 990 filings via ProPublica Nonprofit Explorer (officer compensation), Hospital Financial Assistance Policies (ACA Section 501(r)).

Additional: Medicare Inpatient Utilization, CMS ASC Quality Reporting, CMS ASC Payment Rates (Addendum AA/BB).

We do not estimate prices. Every price is a price a hospital published. Every quality score is a score CMS calculated.

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Contact: richard@hospitalcost.com

This report is for consumer education purposes only. It is not medical advice. Actual costs depend on your insurance plan, deductible status, clinical circumstances, and negotiated rates. HospitalCost is not affiliated with any hospital, health system, insurance company, or government agency. Published April 2026.