Sentara Northern Virginia Medical Center
2300 Opitz Boulevard, Woodbridge, VA 22191 · 119 Priced Procedures · 65% Patient Recommendation
Typical commercial prices here are +31% above the fair benchmark (1.31×) even after accounting for local nurse/doctor wages and patient complexity.
3-Star CMS clinical quality rating paired with 1.31× fair market pricing.
Loss-Leader / Captive Ancillary Cross-Subsidizer
Sentara Northern Virginia Medical Center prices routine shoppable procedures near 1.4× Medicare (p50 1.36×) while skewing captive emergency, lab, and upper-quartile codes to 1.9× Medicare (p75 1.84×, +35% upper-tail jump). Patients scheduling elective outpatient care can capture competitive rates, but emergency and ancillary bills require strict line-item auditing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.02× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 24% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (66/100 safety score) with 65% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (16.3% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.31× 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.
- Captive ER (1.0×) & laboratory (2.0×) services average 1.36× higher multiples than routine shoppable care (1.4×)
- Upper-quartile procedures (Q75 1.84×) jump +35% above the median procedure ratio (Q50 1.36×)
- Unnegotiated chargemaster list prices average 11.8× Medicare (14¢ 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 Sentara Northern Virginia Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 119 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $41,003 | 1.3× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $25,359 | 1.3× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $24,766 | 1.3× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $23,200 | 1.3× |
| Total hip replacement CPT Code: 27130 | $12,840 | 1.0× |
| Total knee replacement CPT Code: 27447 | $12,840 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $10,130 | 1.2× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $6,252 | 1.0× |
| Inguinal hernia repair CPT Code: 49505 | $5,201 | 1.4× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $4,786 | 1.4× |
| Bunion correction surgery CPT Code: 28296 | $4,691 | 1.4× |
| Vaginal delivery (full package) CPT Code: 59400 | $4,162 | 1.6× |
| C-section delivery (full package) CPT Code: 59510 | $4,162 | 1.4× |
| Breast lump removal CPT Code: 19120 | $4,006 | 1.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $3,803 | 1.5× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $2,188 | 2.1× |
| Colonoscopy with biopsy CPT Code: 45380 | $2,191 | 1.7× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $1,924 | 2.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $1,889 | 1.9× |
| Injection procedure for pain management HCPCS Code: G0260 | $1,470 | 1.7× |
| Trauma team activation HCPCS Code: G0390 | $1,366 | 0.9× |
| Blood transfusion CPT Code: 36430 | $845 | 1.7× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $753 | 1.5× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $700 | 1.6× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $560 | 1.0× |
Audit a Bill or Quote at Sentara Northern Virginia Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $16,001
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (16.3% of gross = $16,001).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Sentara Northern Virginia Medical Center'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 ($98,407) is $67,632 above the denoised Fair BaseRate ($30,775) and 4.2× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (16.3% 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)Source: CMS Hospital Care Compare (877 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 Sentara Northern Virginia Medical Center.
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.