Inova Fair Oaks Hospital
3600 Joseph Siewick Drive, Fairfax, VA 22033 · 120 Priced Procedures · 77% Patient Recommendation
Typical commercial prices here are +65% above the fair benchmark (1.65×) even after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 1.65× fair market pricing.
Cash-Arbitrage Bifurcated Pricer
Inova Fair Oaks Hospital maintains elevated commercial insurance contracts (1.65× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 64% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.16× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 64% of shoppable procedures (99/100 Cash Honesty)
- 5-Star CMS clinical rating with 77% patient recommendation (73/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (32.5% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.65× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
- Commercial insurance median sits at 1.80× Fair BaseRate (2.5× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Upper-quartile procedures (Q75 2.19×) jump +22% above the median procedure ratio (Q50 1.80×)
- Unnegotiated chargemaster list prices average 11.5× Medicare (15¢ true HCRIS cost per $1 gross)
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Inova Fair Oaks Hospital
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 120 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $57,457 | 1.9× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $35,698 | 1.9× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $34,728 | 1.8× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $32,917 | 1.8× |
| Total hip replacement CPT Code: 27130 | $22,351 | 1.7× |
| Total knee replacement CPT Code: 27447 | $21,306 | 1.6× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $14,215 | 1.7× |
| Bunion correction surgery CPT Code: 28296 | $7,701 | 2.2× |
| Trauma team activation HCPCS Code: G0390 | $7,552 | 5.2× |
| Inguinal hernia repair CPT Code: 49505 | $6,844 | 1.9× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,068 | 1.0× |
| Breast lump removal CPT Code: 19120 | $5,716 | 1.5× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $5,595 | 1.7× |
| Cataract surgery with lens implant CPT Code: 66984 | $5,056 | 2.0× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $3,523 | 3.5× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,431 | 1.9× |
| Upper endoscopy with biopsy CPT Code: 43239 | $2,174 | 2.2× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $2,144 | 2.2× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,610 | 1.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $1,483 | unverified |
| Blood transfusion CPT Code: 36430 | $1,054 | 2.1× |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $970 | unverified |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $906 | 2.0× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $906 | 1.8× |
| Psychological testing by technician CPT Code: 96138 | $837 | 2.1× |
Audit a Bill or Quote at Inova Fair Oaks Hospital (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $44,830
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (32.5% of gross = $44,830).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Inova Fair Oaks Hospital's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($137,897) is $107,122 above the denoised Fair BaseRate ($30,775) and 5.9× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (32.5% of gross charges)
Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Inova Fair Oaks Hospital. Prior administrative notices do not necessarily reflect current compliance status.
- 2022-04-12·administrative_or_closure
Closure Notice
Recorded - 2021-08-25·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (650 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Inova Fair Oaks Hospital.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.