What Hospitals Charge: Virginia

What this data is

Since 2021, the Hospital Price Transparency rule (45 CFR 180) has required every hospital to publish a machine-readable file of its standard charges: the gross charge (its list price), the discounted cash price for someone paying without insurance, and the rate it has negotiated with each insurer and plan — for every item and service it provides. Since January 2026 the files follow one CMS template.

Each hospital publishes its own file, in its own layout: some are tidy, some are several gigabytes, some sit behind bot protection. These maps are built directly from those files; every number was published by the hospital.

How this was built

The hospitals are every general acute, critical access and children's hospital in Virginia on Medicare's hospital list (psychiatric, VA and military hospitals excluded). Each one's file was found automatically: through the index CMS requires at every hospital website's root, or a link on the hospital's price page. 67 files (5.5 GB) were downloaded, most recently on 2026-10-23. Their prices for 171 common procedures were extracted, the names of 27 insurers and networks, which hospitals spell in hundreds of ways were matched up (plus 121 smaller plans, administrators and employer arrangements, kept under their own names), and each rate was sorted into commercial, Medicare Advantage, Medicaid or Marketplace plans: 330,769 usable dollar prices in all.

What the prices mean

The map shows, by default, the typical commercial price: the median of the rates each commercial insurer has negotiated with that hospital. Medicare Advantage and Medicaid plans pay far less and are shown separately — a single median across all of them would describe nobody. You can also pick the cash price, the list price, or one insurer.

None of these is your bill. What you pay depends on your deductible, copay and coinsurance; a procedure usually carries more than one charge; and the doctor's fee is often billed separately from the hospital's facility fee (the maps show them separately where hospitals do).

Emergency care outside your plan's network

An insurer's price here applies only when the hospital is in your plan's network. If you go to the emergency room of a hospital that is not — which is common with marketplace (ACA) and other narrow-network plans, and when you are away from home — the federal No Surprises Act applies instead (in force since January 2022). The hospital may not bill you more than you would owe in network, and your insurer works out that amount from a benchmark of its own, not from the price on these maps. The same goes for the tests, scans and treatment given during the visit, and for the hospital stay that follows until you are stable enough to be moved.

The benchmark is usually the qualifying payment amount (QPA). It is the middle (median) rate the insurer had under contract for that service on 31 January 2019, among its plans in the same insurance market (individual, small group or large group; a self-funded employer's plans are counted on their own) and the same region, raised each year for inflation. On your explanation of benefits it appears as the “allowed amount”, usually beside a remark that the claim was paid at the in-network level. In some states a state law sets the amount instead, and in Maryland the state's hospital rates do.

This site cannot show the QPA or work it out. It comes from 2019 contracts, not this year's; it is a median across many hospitals, not this hospital's rate; it differs by kind of plan and by region; and no one is required to publish it — it is in neither the hospital files nor the insurer files this site is built from. The insurer tells the hospital the QPA when it pays, and that is all. So the allowed amount on your statement can be far below, or above, the price shown here for the same hospital, insurer and procedure. If the hospital thinks the payment too low it can take the insurer to federal arbitration; that does not change what you owe.

The rules, from the sources:

• Your rights against surprise medical bills (CMS, for patients)
• The No Surprises Act and an overview of its rules (CMS)
• 42 U.S.C. 300gg-111: the law itself, on emergency services and what the patient pays
• 45 CFR 149.110: which emergency services are covered
• 45 CFR 149.140: how the qualifying payment amount is calculated
• Independent dispute resolution: the arbitration between hospital and insurer (CMS)

What is not here

14 of the 82 hospitals have no usable prices here. They are still on the maps, as grey rings; clicking one says why. The reasons:

• The hospital's website blocks automated access (HTTP 403), so its price file could not be fetched. 7 hospitals: Centra Bedford Memorial Hospital, Centra Health - Lynchburg Gen Hospital, Page Memorial Hospital, Shenandoah Memorial Hospital, Southside Community Hospital, Warren Memorial Hospital, Winchester Medical Center
• The hospital's price index (cms-hpt.txt) does not list this hospital. 2 hospitals: Carilion Stonewall Jackson Hospital, University of Virginia Medical Center
• No website for this hospital was found in the public directories searched. 2 hospitals: Medical College of Virginia Hospitals, Virginia Hospital Center
• Only a price file for a different hospital (in another state) was found. 1 hospital: Community Memorial Hospital
• The hospital's price file does not list any of these procedures by their standard codes (CPT, HCPCS or DRG). 1 hospital: Cumberland Hospital
• The hospital's price-file link leads to a web page, not a file. 1 hospital: John Randolph Medical Center

Some hospitals state part of their insurer pricing only as a percentage of charges or a formula, with no dollar figure; those rates are counted but cannot be shown. Transplant, behavioral-health, international and employee plans are kept out of the typical prices. Rates of $0 or $1 (placeholders) and prices more than 20 times away from the procedure's usual price are left out.

Check it yourself

Every hospital's price files are public. The files used here, dated 2024-12-30 to 2026-09-02:

• CMS: Hospital Price Transparency — the rule and what hospitals must publish
• CMS's file template and data dictionary