▸ Payer

sentara health plan

Negotiated rates published by hospitals for sentara health plan across 2 states. Data sourced from federally-mandated machine-readable files.

Hospitals

Procedures

147

States

Rate rows

3,988

Median neg. rate

$300.11

Top procedures for sentara health plan

By number of hospitals reporting rates for this payer.

Procedure	Type	Code	Hospitals	Avg rate
MRI brain without contrast	CPT	70551	12	$879.32
MRI brain with and without contrast	CPT	70553	12	$1,570.34
Colonoscopy diagnostic	CPT	45378	12	$1,075.02
Colonoscopy with biopsy	CPT	45380	12	$1,386.49
Colonoscopy with polyp removal	CPT	45385	12	$1,392.68
MRI brain with contrast	CPT	70552	12	$1,045.98
CT head without contrast	CPT	70450	12	$538.83
CT head with contrast	CPT	70460	12	$711.15
CT head with and without contrast	CPT	70470	12	$931.54
CT neck with contrast	CPT	70491	12	$714.97
Upper GI endoscopy diagnostic	CPT	43235	12	$1,070.71
Upper GI endoscopy with biopsy	CPT	43239	12	$1,097.57
Sigmoidoscopy diagnostic	CPT	45330	12	$1,028.4
Sigmoidoscopy with biopsy	CPT	45331	12	$1,058.7
Heart failure & shock w MCC	MS-DRG	291	12	$16,654
Heart failure & shock w CC	MS-DRG	292	12	$13,953
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	12	$10,923
Kidney/UTI w/o MCC	MS-DRG	690	12	$11,906
Kidney/UTI w MCC	MS-DRG	689	12	$15,222
Cardiac arrhythmia w MCC	MS-DRG	308	12	$16,121
Cardiac arrhythmia w CC	MS-DRG	309	12	$11,250
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	12	$9,663.06
AMI discharged alive w MCC	MS-DRG	280	12	$20,156
AMI discharged alive w CC	MS-DRG	281	12	$14,070
Simple pneumonia & pleurisy w CC	MS-DRG	194	12	$11,859
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	12	$8,782.14
Respiratory infections & inflammations w MCC	MS-DRG	177	12	$20,645
COPD w MCC	MS-DRG	190	12	$14,952
COPD w CC	MS-DRG	191	12	$12,275
COPD w/o CC/MCC	MS-DRG	192	12	$9,575.62

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Lowest average negotiated rate across all procedures at this payer.

Hospital	City	ST	Avg neg. rate
Carilion Giles Community Hospital	—	—	$1,932.33
Carilion Giles Community Hospital	Pearisburg	VA	$1,932.33
Carilion Tazewell Community Hospital	Tazewell	VA	$2,142.45
Carilion Tazewell Community Hospital	—	—	$2,142.45
Carilion Rockbridge Community Hospital	—	—	$2,734.1
Carilion Stonewall Jackson Hospital	Lexington	VA	$3,577.75
Carilion Franklin Memorial Hospital	Rocky Mount	VA	$3,577.75
Franklin Memorial Hospital	Farmington	ME	$3,577.75
Carilion New River Valley Med Center	Christiansburg	VA	$5,092.72
Carilion Medical Center	Roanoke	VA	$6,177.57
Carilion Roanoke Memorial Hospital	—	—	$6,177.57
Carilion Roanoke Community Hospital	—	—	$6,177.57

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States with hospitals publishing rates for sentara health plan.

State	Hospitals	Avg rate
VA	6	$3,897.79
ME	1	$3,577.75

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