Braxton County Memorial Hospital
Braxton County Memorial Hospital in Gassaway, WV publishes cash prices for 374 common procedures listed here, from its own machine-readable price file updated Jul 11, 2026. Compared with other hospitals in the state, its outpatient cash prices are below the West Virginia median for 250 of 370 procedures and above it for 95. By typical cash price it ranks #3 of 36 West Virginia hospitals, cheapest first. Select a procedure to compare it with other hospitals nearby.
100 Hoylman Dr,Gassaway,WV,26624 Collected Sep 23, 2026 Source price file Check a bill from this hospital (304) 364-5156
Critical access hospital (rural, 25 beds or fewer) Nonprofit hospital Emergency department CCN 511308 · CMS hospital register NPI 1356304547
Financial assistance
Nonprofit hospital: it must offer free or discounted care to patients who qualify. How to apply
Braxton County Memorial Hospital is a nonprofit hospital in the CMS register. Under section 501(r) of the federal tax code it must have a written Financial Assistance Policy with a free application, publish both on its website, and charge patients who qualify no more than the amounts generally billed to insured patients for emergency and other medically necessary care. Who qualifies depends on household income; the policy states the limits.
You can apply up to 240 days after the first bill. Before collection actions such as credit reporting or a lawsuit, the hospital must tell you about the policy and wait at least 120 days after that bill. Ask the billing office for the policy and the application before you pay, or search the hospital's website for “financial assistance”. Letters you can copy.
Source: IRS, section 501(r) requirements for nonprofit hospitals.
Scans and imaging
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Abdominal CT scan without and with contrast CPT 74170 CT ABD WO CNTRST FLWD CNTRST | $820.00 | $1,640.00 | — | 34% below | 50% |
| Abdominal X-ray, 2 views CPT 74019 RADEX ABDOMEN 2 VIEWS | $159.50 | $319.00 | — | 27% below | 50% |
| Ankle X-ray, complete, 3 or more views CPT 73610 X-RAY EXAM OF ANKLE | $121.00 | $242.00 | — | 33% below | 50% |
| Ankle-brachial index (ABI), blood pressure test for leg arteries CPT 93922 UPR/L XTREMITY ART 2 LEVELS | $216.00 | $432.00 | — | 26% below | 50% |
| Arm CT scan without contrast (shoulder to hand, any part) CPT 73200 CT UPPER EXTREMITY W/O DYE | $299.00 | $598.00 | — | 58% below | 50% |
| Bone scan, whole body (nuclear medicine) CPT 78306 BONE IMAGING WHOLE BODY | $383.00 | $766.00 | — | 56% below | 50% |
| Breast ultrasound, complete, one breast CPT 76641 ULTRASOUND BREAST COMPLETE | $300.00 | $600.00 | — | 3% above | 50% |
| Breast ultrasound, limited (one breast or one area) CPT 76642 ULTRASOUND BREAST LIMITED | $254.00 | $508.00 | — | 4% below | 50% |
| CT angiography (CTA) of the abdomen and pelvis CPT 74174 CTA ABD&PLVS W/CONTRAST | $1,351.50 | $2,703.00 | — | 21% below | 50% |
| CT angiography (CTA) of the head CPT 70496 CT ANGIOGRAPHY HEAD | $669.00 | $1,338.00 | — | 45% below | 50% |
| CT angiography (CTA) of the neck CPT 70498 CT ANGIOGRAPHY NECK | $669.00 | $1,338.00 | — | 42% below | 50% |
| CT angiography of the chest (CTA), for blood clots in the lungs CPT 71275 CT ANGIOGRAPHY CHEST | $941.50 | $1,883.00 | — | 25% below | 50% |
| CT scan of abdomen and pelvis, no contrast dye CPT 74176 CT ABD & PELVIS W/O CONTRAST | $1,166.00 | $2,332.00 | — | 14% below | 50% |
| CT scan of abdomen and pelvis, with contrast dye CPT 74177 CT ABD & PELVIS W/CONTRAST | $1,316.50 | $2,633.00 | — | 18% below | 50% |
| CT scan of abdomen and pelvis, without and then with contrast dye CPT 74178 CT ABD&PLV WO CNTR FLWD CNTR | $1,583.00 | $3,166.00 | — | 7% below | 50% |
| CT scan of the abdomen with contrast CPT 74160 CT ABDOMEN W/CONTRAST | $669.00 | $1,338.00 | — | 37% below | 50% |
| CT scan of the abdomen without contrast CPT 74150 CT ABDOMEN W/O CONTRAST | $621.00 | $1,242.00 | — | 16% below | 50% |
| CT scan of the face and sinuses, no contrast dye CPT 70486 CT MAXILLOFACIAL W/O DYE | $304.00 | $608.00 | — | 56% below | 50% |
| CT scan of the head or brain, no contrast dye CPT 70450 CT HEAD/BRAIN W/O DYE | $605.00 | $1,210.00 | — | 15% below | 50% |
| CT scan of the head with contrast CPT 70460 CT HEAD/BRAIN W/DYE | $657.00 | $1,314.00 | — | 36% below | 50% |
| CT scan of the head without and with contrast CPT 70470 CT HEAD/BRAIN W/O & W/DYE | $807.00 | $1,614.00 | — | 31% below | 50% |
| CT scan of the lower back (lumbar spine) without contrast CPT 72131 CT LUMBAR SPINE W/O DYE | $1,132.50 | $2,265.00 | — | 35% above | 50% |
| CT scan of the neck (cervical spine), no contrast dye CPT 72125 CT NECK SPINE W/O DYE | $730.00 | $1,460.00 | — | 11% below | 50% |
| CT scan of the pelvis, with contrast dye CPT 72193 CT PELVIS W/DYE | $647.00 | $1,294.00 | — | 32% below | 50% |
| Carotid artery ultrasound (duplex), both sides of the neck both sides CPT 93880 EXTRACRANIAL BILAT STUDY | $272.50 | $545.00 | — | — | 50% |
| Chest CT scan without and with contrast CPT 71270 CT THORAX DX C-/C+ | $845.50 | $1,691.00 | — | 33% below | 50% |
| Chest X-ray, 2 views CPT 71046 X-RAY EXAM CHEST 2 VIEWS | $141.00 | $282.00 | — | 25% below | 50% |
| Chest X-ray, single view CPT 71045 X-RAY EXAM CHEST 1 VIEW | $96.00 | $192.00 | — | 45% below | 50% |
| Collarbone (clavicle) X-ray, complete CPT 73000 X-RAY EXAM OF COLLAR BONE | $121.00 | $242.00 | — | 31% below | 50% |
| Complete ultrasound of the back of the abdomen, such as both kidneys CPT 76770 US EXAM ABDO BACK WALL COMP | $420.00 | $840.00 | — | 4% below | 50% |
| DEXA bone density scan of the hip, pelvis or spine CPT 77080 DXA BONE DENSITY AXIAL | $214.50 | $429.00 | — | 32% below | 50% |
| Diagnostic CT scan of the chest, no contrast dye CPT 71250 CT THORAX DX C- | $647.00 | $1,294.00 | — | 18% below | 50% |
| Diagnostic CT scan of the chest, with contrast dye CPT 71260 CT THORAX DX C+ | $694.00 | $1,388.00 | — | 37% below | 50% |
| Diagnostic mammogram, both breasts both sides CPT 77066 DX MAMMO INCL CAD BI | $225.00 | $450.00 | — | — | 50% |
| Diagnostic mammogram, one breast CPT 77065 DX MAMMO INCL CAD UNI | $181.50 | $363.00 | — | 17% below | 50% |
| Duplex ultrasound of the leg arteries, both legs CPT 93925 LOWER EXTREMITY STUDY | $338.50 | $677.00 | — | 46% below | 50% |
| Duplex ultrasound of the leg veins, both legs CPT 93970 EXTREMITY STUDY | $229.00 | $458.00 | — | 62% below | 50% |
| Echocardiogram through the chest wall, complete, with Doppler CPT 93306 TTE W/DOPPLER COMPLETE | $523.50 | $1,047.00 | — | 55% below | 50% |
| Elbow X-ray, 2 views CPT 73070 X-RAY EXAM OF ELBOW | $121.00 | $242.00 | — | 37% below | 50% |
| Elbow X-ray, complete, 3 or more views CPT 73080 X-RAY EXAM OF ELBOW | $139.00 | $278.00 | — | 23% below | 50% |
| Eye socket (orbit) CT scan without contrast CPT 70480 CT ORBIT/EAR/FOSSA W/O DYE | $295.00 | $590.00 | — | 57% below | 50% |
| Facial bones X-ray, complete, 3 or more views CPT 70150 X-RAY EXAM OF FACIAL BONES | $229.00 | $458.00 | — | 3% below | 50% |
| Forearm X-ray (radius and ulna), 2 views CPT 73090 X-RAY EXAM OF FOREARM | $121.00 | $242.00 | — | 32% below | 50% |
| HIDA scan: nuclear imaging of the liver, bile ducts and gallbladder CPT 78226 HEPATOBILIARY SYSTEM IMAGING | $383.00 | $766.00 | — | 55% below | 50% |
| Hand X-ray, 2 views CPT 73120 X-RAY EXAM OF HAND | $104.00 | $208.00 | — | 47% below | 50% |
| Heel bone (calcaneus) X-ray, 2 or more views CPT 73650 X-RAY EXAM OF HEEL | $109.50 | $219.00 | — | 37% below | 50% |
| Knee X-ray, 3 views CPT 73562 X-RAY EXAM OF KNEE 3 | $164.00 | $328.00 | — | 18% below | 50% |
| Knee X-ray, complete, 4 or more views CPT 73564 X-RAY EXAM KNEE 4 OR MORE | $220.00 | $440.00 | — | 18% below | 50% |
| Leg CT scan without contrast (hip to foot, any part) CPT 73700 CT LOWER EXTREMITY W/O DYE | $287.50 | $575.00 | — | 60% below | 50% |
| Limited abdominal ultrasound of one organ or area, such as the gallbladder CPT 76705 ECHO EXAM OF ABDOMEN | $219.50 | $439.00 | — | 45% below | 50% |
| Limited ultrasound of an arm or leg (non-vascular) CPT 76882 US LMTD JT/FCL EVL NVASC XTR | $205.00 | $410.00 | — | 31% below | 50% |
| Low-dose CT of the chest for lung cancer screening, no contrast dye CPT 71271 CT THORAX LUNG CANCER SCR C- | $120.00 | $240.00 | — | 23% below | 50% |
| Lower leg X-ray (tibia and fibula), 2 views CPT 73590 X-RAY EXAM OF LOWER LEG | $126.00 | $252.00 | — | 34% below | 50% |
| MR angiography (MRA) of the head without contrast CPT 70544 MR ANGIOGRAPHY HEAD W/O DYE | $670.50 | $1,341.00 | — | 52% below | 50% |
| MRI of knee or other lower-limb joint, no contrast dye CPT 73721 MRI JNT OF LWR EXTRE W/O DYE | $868.50 | $1,737.00 | — | 33% below | 50% |
| MRI of knee or other lower-limb joint, without and then with contrast dye CPT 73723 MRI JOINT LWR EXTR W/O&W/DYE | $1,191.50 | $2,383.00 | — | 36% below | 50% |
| MRI of the abdomen without contrast CPT 74181 MRI ABDOMEN W/O CONTRAST | $1,184.00 | $2,368.00 | — | 6% below | 50% |
| MRI of the abdomen, without and then with contrast dye CPT 74183 MRI ABD W/O CNTR FLWD CNTR | $1,445.50 | $2,891.00 | — | 26% below | 50% |
| MRI of the brain, no contrast dye CPT 70551 MRI BRAIN STEM W/O DYE | $868.50 | $1,737.00 | — | 37% below | 50% |
| MRI of the brain, with and without contrast dye CPT 70553 MRI BRAIN STEM W/O & W/DYE | $1,349.00 | $2,698.00 | — | 31% below | 50% |
| MRI of the lower back, no contrast dye CPT 72148 MRI LUMBAR SPINE W/O DYE | $868.50 | $1,737.00 | — | 36% below | 50% |
| MRI of the lower back, without and then with contrast dye CPT 72158 MRI LUMBAR SPINE W/O & W/DYE | $1,445.50 | $2,891.00 | — | 24% below | 50% |
| MRI of the mid back (thoracic spine), no contrast dye CPT 72146 MRI CHEST SPINE W/O DYE | $868.50 | $1,737.00 | — | 36% below | 50% |
| MRI of the neck (cervical spine) without and with contrast CPT 72156 MRI NECK SPINE W/O & W/DYE | $1,445.50 | $2,891.00 | — | 23% below | 50% |
| MRI of the neck (cervical spine), no contrast dye CPT 72141 MRI NECK SPINE W/O DYE | $868.50 | $1,737.00 | — | 40% below | 50% |
| MRI of the pelvis without and with contrast CPT 72197 MRI PELVIS W/O & W/DYE | $1,808.00 | $3,616.00 | — | 7% below | 50% |
| MRI of the pelvis, no contrast dye CPT 72195 MRI PELVIS W/O DYE | $868.50 | $1,737.00 | — | 36% below | 50% |
| MRI of the shoulder, elbow or wrist joint, no contrast dye CPT 73221 MRI JOINT UPR EXTREM W/O DYE | $868.50 | $1,737.00 | — | 35% below | 50% |
| Neck (cervical spine) X-ray, 4 or 5 views CPT 72050 X-RAY EXAM NECK SPINE 4/5VWS | $220.50 | $441.00 | — | 21% below | 50% |
| Neck soft tissue CT scan with contrast CPT 70491 CT SOFT TISSUE NECK W/DYE | $442.50 | $885.00 | — | 59% below | 50% |
| Neck soft tissue CT scan without contrast CPT 70490 CT SOFT TISSUE NECK W/O DYE | $304.00 | $608.00 | — | 56% below | 50% |
| Neck soft tissue X-ray CPT 70360 X-RAY EXAM OF NECK | $121.00 | $242.00 | — | 34% below | 50% |
| Nuclear stress test imaging (SPECT), rest and stress studies CPT 78452 HT MUSCLE IMAGE SPECT MULT | $1,240.00 | $2,480.00 | — | 56% below | 50% |
| PET/CT scan from the base of the skull to mid-thigh CPT 78815 PET IMAGE W/CT SKULL-THIGH | $1,467.50 | $2,935.00 | — | 56% below | 50% |
| Pelvic CT scan without contrast CPT 72192 CT PELVIS W/O DYE | $546.50 | $1,093.00 | — | 32% below | 50% |
| Pelvic ultrasound (not pregnancy), limited or follow-up CPT 76857 US EXAM PELVIC LIMITED | $166.00 | $332.00 | — | 46% below | 50% |
| Pelvic ultrasound through the belly, complete (not pregnancy) CPT 76856 US EXAM PELVIC COMPLETE | $108.50 | $217.00 | — | 74% below | 50% |
| Pregnancy ultrasound, limited (heartbeat, position, fluid) CPT 76815 OB US LIMITED FETUS(S) | $368.50 | $737.00 | — | 22% above | 50% |
| Rib X-ray, one side, 2 views CPT 71100 X-RAY EXAM RIBS UNI 2 VIEWS | $129.50 | $259.00 | — | 33% below | 50% |
| Rib X-ray, one side, with a chest view, 3 or more views one side CPT 71101 X-RAY EXAM UNILAT RIBS/CHEST | $152.50 | $305.00 | — | 34% below | 50% |
| Screening mammogram, both breasts both sides CPT 77067 SCR MAMMO BI INCL CAD | $189.50 | $379.00 | — | — | 50% |
| Shoulder X-ray, complete, 2 or more views CPT 73030 X-RAY EXAM OF SHOULDER | $166.00 | $332.00 | — | 7% below | 50% |
| Sinus X-ray, complete, 3 or more views CPT 70220 X-RAY EXAM OF SINUSES | $220.00 | $440.00 | — | at median | 50% |
| Skull X-ray, fewer than 4 views CPT 70250 X-RAY EXAM OF SKULL | $208.00 | $416.00 | — | 3% above | 50% |
| Thigh bone (femur) X-ray, 2 or more views CPT 73552 X-RAY EXAM OF FEMUR 2/> | $126.00 | $252.00 | — | 33% below | 50% |
| Thoracic spine (mid back) CT scan without contrast CPT 72128 CT CHEST SPINE W/O DYE | $718.50 | $1,437.00 | — | 13% below | 50% |
| Toe X-ray, 2 or more views CPT 73660 X-RAY EXAM OF TOE(S) | $233.00 | $466.00 | — | 35% above | 50% |
| Transvaginal pelvic ultrasound CPT 76830 TRANSVAGINAL US NON-OB | $311.50 | $623.00 | — | 23% below | 50% |
| Transvaginal ultrasound during pregnancy CPT 76817 TRANSVAGINAL US OBSTETRIC | $232.50 | $465.00 | — | 19% below | 50% |
| Ultrasound of the abdomen, complete CPT 76700 US EXAM ABDOM COMPLETE | $448.00 | $896.00 | — | 2% above | 50% |
| Ultrasound of the scrotum and testicles CPT 76870 US EXAM SCROTUM | $337.50 | $675.00 | — | 11% below | 50% |
| Ultrasound of the soft tissues of the head and neck, such as the thyroid CPT 76536 US EXAM OF HEAD AND NECK | $309.50 | $619.00 | — | 16% below | 50% |
| Upper arm X-ray (humerus), 2 views CPT 73060 X-RAY EXAM OF HUMERUS | $156.00 | $312.00 | — | 14% below | 50% |
| Vein ultrasound (duplex) of one arm or leg, or a limited study CPT 93971 EXTREMITY STUDY | $296.50 | $593.00 | — | 23% below | 50% |
| Wrist X-ray, 2 views CPT 73100 X-RAY EXAM OF WRIST | $121.00 | $242.00 | — | 24% below | 50% |
| Wrist X-ray, complete, 3 or more views CPT 73110 X-RAY EXAM OF WRIST | $139.00 | $278.00 | — | 21% below | 50% |
| X-ray of one hip, 2 or 3 views, with the pelvis when included CPT 73502 X-RAY EXAM HIP UNI 2-3 VIEWS | $83.50 | $167.00 | — | 56% below | 50% |
| X-ray of the abdomen, 1 view CPT 74018 RADEX ABDOMEN 1 VIEW | $83.50 | $167.00 | — | 55% below | 50% |
| X-ray of the ankle, 2 views CPT 73600 X-RAY EXAM OF ANKLE | $104.00 | $208.00 | — | 41% below | 50% |
| X-ray of the finger(s), 2 or more views CPT 73140 X-RAY EXAM OF FINGER(S) | $83.50 | $167.00 | — | 53% below | 50% |
| X-ray of the foot, 2 views CPT 73620 X-RAY EXAM OF FOOT | $104.00 | $208.00 | — | 35% below | 50% |
| X-ray of the foot, complete, 3 or more views CPT 73630 X-RAY EXAM OF FOOT | $121.00 | $242.00 | — | 32% below | 50% |
| X-ray of the hand, 3 or more views CPT 73130 X-RAY EXAM OF HAND | $121.00 | $242.00 | — | 34% below | 50% |
| X-ray of the knee, 1 or 2 views CPT 73560 X-RAY EXAM OF KNEE 1 OR 2 | $120.50 | $241.00 | — | 33% below | 50% |
| X-ray of the lower back (lumbar spine), 2 or 3 views CPT 72100 X-RAY EXAM L-S SPINE 2/3 VWS | $141.00 | $282.00 | — | 35% below | 50% |
| X-ray of the lower back, 4 or more views CPT 72110 X-RAY EXAM L-2 SPINE 4/>VWS | $284.00 | $568.00 | — | at median | 50% |
| X-ray of the mid back (thoracic spine), 2 views CPT 72070 X-RAY EXAM THORAC SPINE 2VWS | $126.00 | $252.00 | — | 45% below | 50% |
| X-ray of the nasal bones, 3 or more views CPT 70160 X-RAY EXAM OF NASAL BONES | $121.00 | $242.00 | — | 35% below | 50% |
| X-ray of the neck (cervical spine), 2 or 3 views CPT 72040 X-RAY EXAM NECK SPINE 2-3 VW | $121.00 | $242.00 | — | 38% below | 50% |
| X-ray of the pelvis, 1 or 2 views CPT 72170 X-RAY EXAM OF PELVIS | $100.50 | $201.00 | — | 49% below | 50% |
| X-ray of the tailbone (sacrum and coccyx), 2 or more views CPT 72220 X-RAY EXAM SACRUM TAILBONE | $126.00 | $252.00 | — | 30% below | 50% |
Lab tests
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| ACTH blood test CPT 82024 ASSAY OF ACTH | $65.50 | $131.00 | — | 65% below | 50% |
| ALT (alanine aminotransferase) liver enzyme test CPT 84460 ALANINE AMINO (ALT) (SGPT) | $25.50 | $51.00 | — | 12% below | 50% |
| AST (aspartate aminotransferase) enzyme test CPT 84450 TRANSFERASE (AST) (SGOT) | $25.00 | $50.00 | — | 18% below | 50% |
| Acute hepatitis panel (hepatitis A, B and C) CPT 80074 ACUTE HEPATITIS PANEL | $221.00 | $442.00 | — | at median | 50% |
| Albumin blood test CPT 82040 ASSAY OF SERUM ALBUMIN | $7.50 | $15.00 | — | 58% below | 50% |
| Aldosterone blood test CPT 82088 ASSAY OF ALDOSTERONE | $26.00 | $52.00 | — | 29% below | 50% |
| Alkaline phosphatase (ALP) blood test CPT 84075 ASSAY ALKALINE PHOSPHATASE | $4.00 | $8.00 | — | 81% below | 50% |
| Allergy blood test, specific IgE, per allergen CPT 86003 ALLG SPEC IGE CRUDE XTRC EA | $138.00 | $276.00 | — | 705% above | 50% |
| Alpha-fetoprotein (AFP) blood test CPT 82105 ALPHA-FETOPROTEIN SERUM | $25.00 | $50.00 | — | 67% below | 50% |
| Ammonia blood test CPT 82140 ASSAY OF AMMONIA | $60.50 | $121.00 | — | 31% above | 50% |
| Amylase blood test CPT 82150 ASSAY OF AMYLASE | $37.50 | $75.00 | — | 3% below | 50% |
| Anti-CCP antibody test (rheumatoid arthritis) CPT 86200 CCP ANTIBODY | $17.00 | $34.00 | — | 60% below | 50% |
| Antinuclear antibody (ANA) blood test, screen CPT 86038 ANTINUCLEAR ANTIBODIES | $39.00 | $78.00 | — | 36% below | 50% |
| BNP or NT-proBNP blood test (heart failure marker) CPT 83880 ASSAY OF NATRIURETIC PEPTIDE | $45.00 | $90.00 | — | 62% below | 50% |
| Bacterial culture of a sample other than urine, blood or stool (wound, throat, fluid) CPT 87070 CULTURE OTHR SPECIMN AEROBIC | $34.00 | $68.00 | — | 34% below | 50% |
| Basic metabolic panel (blood test) CPT 80048 METABOLIC PANEL TOTAL CA | $39.00 | $78.00 | — | 28% below | 50% |
| Bilirubin blood test, total CPT 82247 BILIRUBIN TOTAL | $24.00 | $48.00 | — | 2% below | 50% |
| Biopsy tissue exam by a pathologist (level IV) CPT 88305 TISSUE EXAM BY PATHOLOGIST | $41.50 | $83.00 | — | 62% below | 50% |
| Blood culture for bacteria CPT 87040 BLOOD CULTURE FOR BACTERIA | $62.00 | $124.00 | — | 16% below | 50% |
| Blood draw from a vein (venipuncture), collection fee only CPT 36415 COLL VENOUS BLD VENIPUNCTURE | $6.50 | $13.00 | — | 38% below | 50% |
| Blood glucose (sugar) test CPT 82947 ASSAY GLUCOSE BLOOD QUANT | $29.50 | $59.00 | — | 28% above | 50% |
| Blood lead test CPT 83655 ASSAY OF LEAD | $6.50 | $13.00 | — | 82% below | 50% |
| Blood pregnancy test (hCG, qualitative: yes or no) CPT 84703 CHORIONIC GONADOTROPIN ASSAY | $15.00 | $30.00 | — | 64% below | 50% |
| Blood type test, ABO group only (Rh factor is a separate test) CPT 86900 BLOOD TYPING SEROLOGIC ABO | $68.00 | $136.00 | — | 67% above | 50% |
| Blood urea nitrogen (BUN) test CPT 84520 ASSAY OF UREA NITROGEN | $27.50 | $55.00 | — | at median | 50% |
| C-peptide blood test CPT 84681 ASSAY OF C-PEPTIDE | $37.00 | $74.00 | — | 50% below | 50% |
| C-reactive protein (CRP) blood test, standard (not high-sensitivity) CPT 86140 C-REACTIVE PROTEIN | $26.50 | $53.00 | — | 13% below | 50% |
| C. difficile toxin gene test (stool PCR) CPT 87493 C DIFF AMPLIFIED PROBE | $49.50 | $99.00 | — | 56% below | 50% |
| CA 19-9 blood test (tumor marker) CPT 86301 IMMUNOASSAY TUMOR CA 19-9 | $31.00 | $62.00 | — | 63% below | 50% |
| CA-125 blood test (ovarian cancer marker) CPT 86304 IMMUNOASSAY TUMOR CA 125 | $63.00 | $126.00 | — | 41% below | 50% |
| Calcium blood test, total CPT 82310 ASSAY OF CALCIUM | $24.00 | $48.00 | — | 5% below | 50% |
| Carcinoembryonic antigen (CEA) test CPT 82378 CARCINOEMBRYONIC ANTIGEN | $76.50 | $153.00 | — | 26% below | 50% |
| Chickenpox (varicella) immunity blood test CPT 86787 VARICELLA-ZOSTER ANTIBODY | $17.50 | $35.00 | — | 54% below | 50% |
| Chlamydia test by nucleic acid amplification (NAAT, PCR-type) CPT 87491 CHLMYD TRACH DNA AMP PROBE | $37.00 | $74.00 | — | 35% below | 50% |
| Cholesterol and triglycerides (lipid panel) blood test CPT 80061 LIPID PANEL | $62.50 | $125.00 | — | at median | 50% |
| Complete blood count (CBC) with differential CPT 85025 COMPLETE CBC W/AUTO DIFF WBC | $35.50 | $71.00 | — | 14% below | 50% |
| Complete blood count (CBC), no differential CPT 85027 COMPLETE CBC AUTOMATED | $35.00 | $70.00 | — | at median | 50% |
| Comprehensive metabolic panel (blood test) CPT 80053 COMPREHEN METABOLIC PANEL | $49.00 | $98.00 | — | at median | 50% |
| Cortisol blood test, total CPT 82533 TOTAL CORTISOL | $155.00 | $310.00 | — | 161% above | 50% |
| Creatine kinase (CK) blood test, total CPT 82550 ASSAY OF CK (CPK) | $25.50 | $51.00 | — | 41% below | 50% |
| Creatinine blood test CPT 82565 ASSAY OF CREATININE | $27.50 | $55.00 | — | 7% below | 50% |
| Cytomegalovirus (CMV) antibody test CPT 86644 CMV ANTIBODY | $58.00 | $116.00 | — | 15% above | 50% |
| D-dimer blood test (blood clot marker) CPT 85379 FIBRIN DEGRADATION QUANT | $55.00 | $110.00 | — | 14% below | 50% |
| DHEA sulfate (DHEA-S) blood test CPT 82627 DEHYDROEPIANDROSTERONE | $30.50 | $61.00 | — | 67% below | 50% |
| Drug screen by lab instrument (any number of drug classes) CPT 80307 DRUG TEST PRSMV CHEM ANLYZR | $28.00 | $56.00 | — | 8% below | 50% |
| Electrolyte panel (sodium, potassium, chloride, CO2) CPT 80051 ELECTROLYTE PANEL | $32.50 | $65.00 | — | at median | 50% |
| Epstein-Barr virus (EBV) antibody test CPT 86665 EPSTEIN-BARR CAPSID VCA | $29.50 | $59.00 | — | 51% below | 50% |
| Estradiol blood test CPT 82670 ASSAY OF TOTAL ESTRADIOL | $47.50 | $95.00 | — | 45% below | 50% |
| FSH (follicle-stimulating hormone) test CPT 83001 ASSAY OF GONADOTROPIN (FSH) | $35.00 | $70.00 | — | 58% below | 50% |
| Fecal calprotectin (stool inflammation test) CPT 83993 ASSAY FOR CALPROTECTIN FECAL | $30.00 | $60.00 | — | 67% below | 50% |
| Ferritin blood test (iron stores) CPT 82728 ASSAY OF FERRITIN | $30.50 | $61.00 | — | 57% below | 50% |
| Fibrinogen blood test CPT 85384 FIBRINOGEN ACTIVITY | $25.50 | $51.00 | — | 50% below | 50% |
| Folate (folic acid) blood test CPT 82746 ASSAY OF FOLIC ACID SERUM | $51.50 | $103.00 | — | 27% below | 50% |
| Free T3 thyroid hormone test CPT 84481 FREE ASSAY (FT-3) | $95.50 | $191.00 | — | 5% above | 50% |
| Free T4 (free thyroxine) thyroid blood test CPT 84439 ASSAY OF FREE THYROXINE | $24.00 | $48.00 | — | 59% below | 50% |
| Free testosterone test CPT 84402 ASSAY OF FREE TESTOSTERONE | $54.00 | $108.00 | — | 23% below | 50% |
| Gamma-glutamyl transferase (GGT) blood test CPT 82977 ASSAY OF GGT | $15.00 | $30.00 | — | 57% below | 50% |
| General health panel: metabolic panel, blood count and TSH in one order CPT 80050 GENERAL HEALTH PANEL | $234.50 | $469.00 | — | 3% above | 50% |
| Glucose challenge test (1-hour glucose after a sugar drink) CPT 82950 GLUCOSE TEST | $33.00 | $66.00 | — | 1% below | 50% |
| Glucose tolerance test, 3 samples CPT 82951 GLUCOSE TOLERANCE TEST (GTT) | $48.50 | $97.00 | — | 25% below | 50% |
| Gonorrhea test by nucleic acid amplification (NAAT, PCR-type) CPT 87591 N.GONORRHOEAE DNA AMP PROB | $76.00 | $152.00 | — | 25% above | 50% |
| H. pylori stool antigen test CPT 87338 HPYLORI STOOL AG IA | $32.50 | $65.00 | — | 45% below | 50% |
| HIV viral load test (HIV-1 RNA, quantitative) CPT 87536 HIV-1 QUANT&REVRSE TRNSCRPJ | $131.00 | $262.00 | — | 48% below | 50% |
| HPV test for high-risk types, one combined (pooled) result CPT 87624 HPV HI-RISK TYP POOLED RSLT | $50.00 | $100.00 | — | 22% below | 50% |
| Hemoglobin A1C blood test (average blood sugar over about 3 months) CPT 83036 HEMOGLOBIN GLYCOSYLATED A1C | $62.00 | $124.00 | — | 24% above | 50% |
| Hemoglobin blood test CPT 85018 HEMOGLOBIN | $12.50 | $25.00 | — | 11% below | 50% |
| Hepatitis B core antibody test (total) CPT 86704 HEP B CORE ANTIBODY TOTAL | $24.00 | $48.00 | — | 52% below | 50% |
| Hepatitis B surface antibody (anti-HBs) test, immunity check CPT 86706 HEP B SURFACE ANTIBODY | $25.50 | $51.00 | — | 46% below | 50% |
| Hepatitis B surface antigen (HBsAg) test CPT 87340 HEPATITIS B SURFACE AG IA | $5.50 | $11.00 | — | 84% below | 50% |
| Hepatitis C antibody blood test (screening) CPT 86803 HEPATITIS C AB TEST | $39.00 | $78.00 | — | 33% below | 50% |
| Hepatitis C viral load (HCV RNA) test CPT 87522 HEPATITIS C REVRS TRNSCRPJ | $265.50 | $531.00 | — | 33% above | 50% |
| Herpes blood test, HSV-1 antibody CPT 86695 HERPES SIMPLEX TYPE 1 TEST | $49.50 | $99.00 | — | 13% above | 50% |
| Herpes blood test, HSV-2 antibody CPT 86696 HERPES SIMPLEX TYPE 2 TEST | $49.50 | $99.00 | — | 3% above | 50% |
| High-sensitivity CRP (hs-CRP) test CPT 86141 C-REACTIVE PROTEIN HS | $35.00 | $70.00 | — | 43% below | 50% |
| Homocysteine blood test CPT 83090 ASSAY OF HOMOCYSTEINE | $92.50 | $185.00 | — | 5% above | 50% |
| Insulin blood test CPT 83525 ASSAY OF INSULIN | $22.50 | $45.00 | — | 59% below | 50% |
| Iron blood test (serum iron) CPT 83540 ASSAY OF IRON | $25.50 | $51.00 | — | 40% below | 50% |
| Kidney function blood test panel CPT 80069 RENAL FUNCTION PANEL | $40.00 | $80.00 | — | 7% below | 50% |
| LH (luteinizing hormone) test CPT 83002 ASSAY OF GONADOTROPIN (LH) | $22.50 | $45.00 | — | 73% below | 50% |
| Lactate (lactic acid) blood test CPT 83605 ASSAY OF LACTIC ACID | $26.50 | $53.00 | — | 53% below | 50% |
| Lactate dehydrogenase (LDH) blood test CPT 83615 LACTATE (LD) (LDH) ENZYME | $21.50 | $43.00 | — | 13% above | 50% |
| Lipase blood test (pancreas enzyme) CPT 83690 ASSAY OF LIPASE | $45.00 | $90.00 | — | 12% above | 50% |
| Liver function blood test panel CPT 80076 HEPATIC FUNCTION PANEL | $38.00 | $76.00 | — | 20% below | 50% |
| Lyme disease antibody test CPT 86618 LYME DISEASE ANTIBODY | $30.50 | $61.00 | — | 3% below | 50% |
| Magnesium blood test CPT 83735 ASSAY OF MAGNESIUM | $19.50 | $39.00 | — | at median | 50% |
| Measles (rubeola) antibody test CPT 86765 RUBEOLA ANTIBODY | $49.50 | $99.00 | — | 26% above | 50% |
| Mono test (heterophile antibody, Monospot) CPT 86308 HETEROPHILE ANTIBODY SCREEN | $31.00 | $62.00 | — | 11% below | 50% |
| Mumps immunity blood test CPT 86735 MUMPS ANTIBODY | $44.50 | $89.00 | — | at median | 50% |
| PSA (prostate-specific antigen) blood test, free CPT 84154 ASSAY OF PSA FREE | $49.00 | $98.00 | — | 18% below | 50% |
| PSA (prostate-specific antigen) blood test, total CPT 84153 ASSAY OF PSA TOTAL | $42.50 | $85.00 | — | 33% below | 50% |
| Pap test (liquid-based, automated screening with review) CPT 88175 CYTOPATH C/V AUTO FLUID REDO | $89.00 | $178.00 | — | 9% above | 50% |
| Pap test lab reading: liquid-based cervical sample, manual screening CPT 88142 CYTOPATH C/V THIN LAYER | $50.00 | $100.00 | — | at median | 50% |
| Parathyroid hormone (PTH) blood test CPT 83970 ASSAY OF PARATHORMONE | $69.50 | $139.00 | — | 54% below | 50% |
| Partial thromboplastin time (PTT) clotting test CPT 85730 THROMBOPLASTIN TIME PARTIAL | $56.50 | $113.00 | — | 36% above | 50% |
| Phosphorus (phosphate) blood test CPT 84100 ASSAY OF PHOSPHORUS | $24.00 | $48.00 | — | 23% below | 50% |
| Potassium blood test CPT 84132 ASSAY OF SERUM POTASSIUM | $24.00 | $48.00 | — | 11% below | 50% |
| Progesterone blood test CPT 84144 ASSAY OF PROGESTERONE | $155.00 | $310.00 | — | 56% above | 50% |
| Prolactin blood test CPT 84146 ASSAY OF PROLACTIN | $42.50 | $85.00 | — | 34% below | 50% |
| Prothrombin time (PT/INR) clotting test CPT 85610 PROTHROMBIN TIME | $35.00 | $70.00 | — | 22% above | 50% |
| Rapid drug screen read by eye (cup, dipstick or card), per day CPT 80305 DRUG TEST PRSMV DIR OPT OBS | $32.50 | $65.00 | — | 11% below | 50% |
| Rapid flu test (influenza antigen) CPT 87804 INFLUENZA ASSAY W/OPTIC | $28.50 | $57.00 | — | 39% below | 50% |
| Rapid strep A antigen test from a throat swab, read visually CPT 87880 STREP A ASSAY W/OPTIC | $26.50 | $53.00 | — | 35% below | 50% |
| Renin blood test CPT 84244 ASSAY OF RENIN | $12.50 | $25.00 | — | 78% below | 50% |
| Rh blood typing CPT 86901 BLOOD TYPING SEROLOGIC RH(D) | $22.00 | $44.00 | — | 23% below | 50% |
| Rheumatoid factor (RF) test CPT 86431 RHEUMATOID FACTOR QUANT | $33.00 | $66.00 | — | 8% below | 50% |
| Rubella antibody test (immunity check) CPT 86762 RUBELLA ANTIBODY | $37.50 | $75.00 | — | 24% below | 50% |
| Sed rate (ESR, erythrocyte sedimentation rate) CPT 85652 RBC SED RATE AUTOMATED | $18.00 | $36.00 | — | 7% above | 50% |
| Sodium blood test CPT 84295 ASSAY OF SERUM SODIUM | $24.00 | $48.00 | — | 8% below | 50% |
| Stool ova and parasites exam CPT 87177 OVA AND PARASITES SMEARS | $35.00 | $70.00 | — | 27% below | 50% |
| Stool test for hidden blood (guaiac FOBT) CPT 82270 OCCULT BLOOD FECES | $8.00 | $16.00 | — | 50% below | 50% |
| Stool test for hidden blood by immunoassay (FIT) CPT 82274 ASSAY TEST FOR BLOOD FECAL | $35.50 | $71.00 | — | 3% below | 50% |
| Syphilis antibody test (Treponema pallidum) CPT 86780 TREPONEMA PALLIDUM | $31.00 | $62.00 | — | at median | 50% |
| Syphilis screening blood test, non-treponemal (RPR or VDRL), yes/no result CPT 86592 SYPHILIS TEST NON-TREP QUAL | $51.00 | $102.00 | — | 89% above | 50% |
| TB blood test measuring immune response (IGRA, gamma interferon) CPT 86480 TB TEST CELL IMMUN MEASURE | $202.50 | $405.00 | — | 7% above | 50% |
| Testosterone blood test, total (not free testosterone) CPT 84403 ASSAY OF TOTAL TESTOSTERONE | $39.00 | $78.00 | — | 56% below | 50% |
| Thyroid peroxidase (TPO) antibody test CPT 86376 MICROSOMAL ANTIBODY EACH | $36.00 | $72.00 | — | 51% below | 50% |
| Thyroid-stimulating hormone (TSH) blood test CPT 84443 ASSAY THYROID STIM HORMONE | $53.00 | $106.00 | — | 18% below | 50% |
| Total IgE blood test CPT 82785 ASSAY OF IGE | $33.00 | $66.00 | — | 39% below | 50% |
| Total cholesterol blood test CPT 82465 ASSAY BLD/SERUM CHOLESTEROL | $42.00 | $84.00 | — | 79% above | 50% |
| Total thyroxine (T4) blood test CPT 84436 ASSAY OF TOTAL THYROXINE | $12.50 | $25.00 | — | 73% below | 50% |
| Total triiodothyronine (T3) blood test CPT 84480 ASSAY TRIIODOTHYRONINE (T3) | $29.00 | $58.00 | — | 63% below | 50% |
| Transferrin blood test CPT 84466 ASSAY OF TRANSFERRIN | $47.50 | $95.00 | — | 15% below | 50% |
| Trichomonas test (NAAT) CPT 87661 TRICHOMONAS VAGINALIS AMPLIF | $76.00 | $152.00 | — | 2% below | 50% |
| Triglycerides blood test CPT 84478 ASSAY OF TRIGLYCERIDES | $20.50 | $41.00 | — | 30% below | 50% |
| Troponin test, quantitative CPT 84484 ASSAY OF TROPONIN QUANT | $69.50 | $139.00 | — | 7% below | 50% |
| Uric acid blood test CPT 84550 ASSAY OF BLOOD/URIC ACID | $24.00 | $48.00 | — | 27% below | 50% |
| Urinalysis with microscope exam, automated CPT 81001 URINALYSIS AUTO W/SCOPE | $22.50 | $45.00 | — | 25% below | 50% |
| Urinalysis without microscope exam, automated CPT 81003 URINALYSIS AUTO W/O SCOPE | $20.50 | $41.00 | — | 32% above | 50% |
| Urinalysis without microscope exam, manual CPT 81002 URINALYSIS NONAUTO W/O SCOPE | $14.00 | $28.00 | — | 12% above | 50% |
| Urine culture for bacteria, with colony count CPT 87086 URINE CULTURE/COLONY COUNT | $31.50 | $63.00 | — | 46% below | 50% |
| Urine microalbumin (albumin) test CPT 82043 UR ALBUMIN QUANTITATIVE | $33.00 | $66.00 | — | at median | 50% |
| Urine pregnancy test, read by color change CPT 81025 URINE PREGNANCY TEST | $20.50 | $41.00 | — | 8% below | 50% |
| Vitamin B12 (cobalamin) blood test CPT 82607 VITAMIN B-12 | $55.50 | $111.00 | — | 31% below | 50% |
| Vitamin D blood test, 25-hydroxy (the standard vitamin D level test) CPT 82306 VITAMIN D 25 HYDROXY | $55.50 | $111.00 | — | 35% below | 50% |
| Vitamin D, 1,25-dihydroxy blood test CPT 82652 VIT D 1 25-DIHYDROXY | $14.00 | $28.00 | — | 82% below | 50% |
| Zinc blood test CPT 84630 ASSAY OF ZINC | $6.00 | $12.00 | — | 85% below | 50% |
| hCG pregnancy hormone blood test, quantitative (measures the level) CPT 84702 CHORIONIC GONADOTROPIN TEST | $25.00 | $50.00 | — | 66% below | 50% |
Surgery and procedures
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Broken ankle (outer ankle bone) treatment without surgery or setting CPT 27786 TREATMENT OF ANKLE FRACTURE | $425.00 | $850.00 | — | 40% above | 50% |
| Broken foot (metatarsal) treatment without surgery or setting CPT 28470 TREAT METATARSAL FRACTURE | $236.50 | $473.00 | — | at median | 50% |
| Cardioversion, elective (restoring heart rhythm) CPT 92960 CARDIOVERSION ELECTRIC EXT | $1,112.50 | $2,225.00 | — | 5% above | 50% |
| Cervical biopsy CPT 57500 BIOPSY OF CERVIX | $882.50 | $1,765.00 | — | 19% below | 50% |
| Closed treatment of a wrist (distal radius) fracture, no resetting CPT 25600 CLTX DST RDL FX/EPHYS SEP WO | $425.00 | $850.00 | — | 34% above | 50% |
| Colonoscopy with polyp removal CPT 45385 COLONOSCOPY W/LESION REMOVAL | $1,455.50 | $2,911.00 | — | at median | 50% |
| Colposcopy with cervical biopsy and scraping of the cervical canal CPT 57454 BX/CURETT OF CERVIX W/SCOPE | $292.00 | $584.00 | — | 12% below | 50% |
| Cystoscopy, diagnostic look inside the bladder and urethra CPT 52000 CYSTOURETHROSCOPY | $571.00 | $1,142.00 | — | 31% below | 50% |
| Earwax removal by irrigation (rinsing), one ear CPT 69209 REMOVE IMPACTED EAR WAX UNI | $114.50 | $229.00 | — | 36% above | 50% |
| Earwax removal with instruments, one ear CPT 69210 REMOVE IMPACTED EAR WAX UNI | $60.50 | $121.00 | — | 14% below | 50% |
| Endometrial biopsy (uterine lining sample) without dilating the cervix CPT 58100 BIOPSY OF UTERUS LINING | $275.00 | $550.00 | — | 36% above | 50% |
| Epidural steroid injection, neck or mid back, with imaging guidance CPT 62321 NJX INTERLAMINAR CRV/THRC | $681.00 | $1,362.00 | — | 32% below | 50% |
| Facet joint injection, lower back, one level, with imaging guidance CPT 64493 INJ PARAVERT F JNT L/S 1 LEV | $898.00 | $1,796.00 | — | 12% below | 50% |
| IUD insertion (the device itself billed separately) CPT 58300 INSERT INTRAUTERINE DEVICE | $154.00 | $308.00 | — | 6% below | 50% |
| Incision and drainage of a simple or single skin abscess CPT 10060 I&D ABSCESS SIMPLE/SINGLE | $220.50 | $441.00 | — | 6% below | 50% |
| Injection into a tendon sheath or ligament (for example trigger finger) CPT 20550 INJ TENDON SHEATH/LIGAMENT | $294.00 | $588.00 | — | 11% below | 50% |
| Injection or fluid drainage of a major joint (knee, shoulder, hip), no ultrasound CPT 20610 DRAIN/INJ JOINT/BURSA W/O US | $321.50 | $643.00 | — | 6% below | 50% |
| Insertion of a drug-delivery implant, such as the arm birth control implant CPT 11981 INSERTION DRUG DLVR IMPLANT | $215.50 | $431.00 | — | 30% above | 50% |
| Joint injection or drainage, medium joint (wrist, elbow, ankle) CPT 20605 DRAIN/INJ JOINT/BURSA W/O US | $432.50 | $865.00 | — | 26% above | 50% |
| Joint injection or drainage, small joint (fingers, toes) CPT 20600 DRAIN/INJ JOINT/BURSA W/O US | $306.00 | $612.00 | — | 13% below | 50% |
| Layered stitches for a cut up to 2.5 cm, intermediate repair, scalp, body, arms or legs CPT 12031 INTMD RPR S/A/T/EXT 2.5 CM/< | $389.50 | $779.00 | — | 8% below | 50% |
| Lower-back epidural injection, with imaging guidance CPT 62323 NJX INTERLAMINAR LMBR/SAC | $1,219.50 | $2,439.00 | — | 10% above | 50% |
| Lower-back epidural injection, without imaging guidance CPT 62322 NJX INTERLAMINAR LMBR/SAC | $963.00 | $1,926.00 | — | 17% below | 50% |
| Lumbar discectomy or laminotomy to free a nerve root, one level CPT 63030 LOW BACK DISK SURGERY | $4,937.50 | $9,875.00 | — | 14% below | 50% |
| Mole or benign skin lesion removal (excision), body, arms or legs, up to 0.5 cm CPT 11400 EXC TR-EXT B9+MARG 0.5 CM< | $693.00 | $1,386.00 | — | 5% above | 50% |
| Nail removal (partial or complete), one nail CPT 11730 REMOVAL OF NAIL PLATE | $362.50 | $725.00 | — | 35% above | 50% |
| Paracentesis with imaging guidance CPT 49083 ABD PARACENTESIS W/IMAGING | $869.00 | $1,738.00 | — | 39% below | 50% |
| Permanent removal of a nail and nail root (partial or complete) CPT 11750 REMOVAL OF NAIL BED | $393.50 | $787.00 | — | 16% below | 50% |
| Radiofrequency ablation of facet joint nerves, lower back, one level CPT 64635 DESTROY LUMB/SAC FACET JNT | $1,902.00 | $3,804.00 | — | 13% below | 50% |
| Removal of a foreign object under the skin, simple CPT 10120 INC&RMVL FB SUBQ TISS SMPL | $393.00 | $786.00 | — | 1% above | 50% |
| Short arm cast (elbow to hand) CPT 29075 APPLICATION OF FOREARM CAST | $268.00 | $536.00 | — | 7% below | 50% |
| Short arm splint (forearm and hand) CPT 29125 APPLY FOREARM SPLINT | $184.50 | $369.00 | — | at median | 50% |
| Short leg cast (below the knee) CPT 29405 APPLY SHORT LEG CAST | $454.00 | $908.00 | — | 43% above | 50% |
| Short leg splint (calf to foot) CPT 29515 APPLICATION LOWER LEG SPLINT | $278.00 | $556.00 | — | 20% above | 50% |
| Simple repair of a superficial wound 2.5 cm or less, scalp, neck, body or limbs CPT 12001 RPR S/N/AX/GEN/TRNK 2.5CM/< | $287.00 | $574.00 | — | 1% above | 50% |
| Skin biopsy, punch, one lesion CPT 11104 PUNCH BX SKIN SINGLE LESION | $389.50 | $779.00 | — | 1% above | 50% |
| Skin tag removal, up to 15 tags CPT 11200 RMVL SKIN TAGS UP TO&INC 15 | $196.00 | $392.00 | — | at median | 50% |
| Stitches for a cut 2.6 to 7.5 cm (1 to 3 inches), simple repair, scalp, body, arms or legs CPT 12002 RPR S/N/AX/GEN/TRNK2.6-7.5CM | $287.00 | $574.00 | — | 11% above | 50% |
| Stitches for a cut on the face up to 2.5 cm (1 inch), simple repair CPT 12011 RPR F/E/E/N/L/M 2.5 CM/< | $385.00 | $770.00 | — | 33% above | 50% |
| Thoracentesis with imaging guidance CPT 32555 ASPIRATE PLEURA W/ IMAGING | $601.00 | $1,202.00 | — | 52% below | 50% |
| Trigger point injections, 1 or 2 muscles CPT 20552 INJ TRIGGER POINT 1/2 MUSCL | $294.00 | $588.00 | — | at median | 50% |
| Wart removal, up to 14 warts CPT 17110 DESTRUCT B9 LESION 1-14 | $207.00 | $414.00 | — | at median | 50% |
| Wound debridement, skin and tissue under it, first 20 sq cm CPT 11042 DBRDMT SUBQ TIS 1ST 20SQCM/< | $389.50 | $779.00 | — | 3% above | 50% |
Doctor visits and therapy
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Blood transfusion (giving blood or blood components) CPT 36430 TRANSFUSION BLD/BLD COMPNT | $439.50 | $879.00 | — | 31% below | 50% |
| Breathing treatment (nebulizer or inhaler) for airway obstruction inpatient CPT 94640 AIRWAY INHALATION TREATMENT | $124.00 | $248.00 | $2,139.37–$9,250.00 | — | 50% |
| Chemotherapy IV infusion, first hour CPT 96413 CHEMO IV INFUSION 1 HR | $316.50 | $633.00 | — | 48% below | 50% |
| Critical care, first 30 to 74 minutes CPT 99291 CRITICAL CARE FIRST HOUR | $465.50 | $931.00 | — | 63% below | 50% |
| Electrocardiogram (ECG/EKG) with interpretation CPT 93000 ELECTROCARDIOGRAM COMPLETE | $170.00 | $340.00 | — | 14% above | 50% |
| Electrocardiogram (ECG/EKG), tracing only, the hospital charge CPT 93005 ELECTROCARDIOGRAM TRACING | $96.00 | $192.00 | — | 20% below | 50% |
| Emergency room visit, level 1 of 5, minor problem that may not need a doctor CPT 99281 EMR DPT VST MAYX REQ PHY/QHP | $82.00 | $164.00 | — | 48% below | 50% |
| Emergency room visit, level 2 of 5, straightforward problem CPT 99282 EMERGENCY DEPT VISIT SF MDM | $142.00 | $284.00 | — | 44% below | 50% |
| Emergency room visit, level 3 of 5, low-complexity problem CPT 99283 EMERGENCY DEPT VISIT LOW MDM | $207.00 | $414.00 | — | 49% below | 50% |
| Emergency room visit, level 4 of 5, moderate-complexity problem CPT 99284 EMERGENCY DEPT VISIT MOD MDM | $331.00 | $662.00 | — | 52% below | 50% |
| Emergency room visit, level 5 of 5, high-complexity problem CPT 99285 EMERGENCY DEPT VISIT HI MDM | $496.00 | $992.00 | — | 48% below | 50% |
| Exercise stress test, tracing only, the hospital charge CPT 93017 CARDIOVASCULAR STRESS TEST | $207.00 | $414.00 | — | 68% below | 50% |
| Family therapy with the patient, 50 minutes CPT 90847 FAMILY PSYTX W/PT 50 MIN | $170.50 | $341.00 | — | 11% below | 50% |
| Family therapy without the patient, 50 minutes CPT 90846 FAMILY PSYTX W/O PT 50 MIN | $170.50 | $341.00 | — | 13% below | 50% |
| IV hydration (fluids through a vein), first 31 to 60 minutes CPT 96360 HYDRATION IV INFUSION INIT | $290.50 | $581.00 | $336.96 | 29% above | 50% |
| IV infusion of a medicine, first hour CPT 96365 THER/PROPH/DIAG IV INF INIT | $204.00 | $408.00 | — | 18% below | 50% |
| IV push of a medicine, first drug CPT 96374 THER/PROPH/DIAG INJ IV PUSH | $204.00 | $408.00 | — | at median | 50% |
| Injection under the skin or into a muscle, for treatment or testing CPT 96372 THER/PROPH/DIAG INJ SC/IM | $69.00 | $138.00 | — | 3% below | 50% |
| Neuromuscular re-education, 15 minutes CPT 97112 NEUROMUSCULAR REEDUCATION | $46.00 | $92.00 | — | 41% below | 50% |
| New patient office visit, straightforward problem or 15+ minutes CPT 99202 OFFICE O/P NEW SF 15 MIN | $25.00 | $50.00 | — | 64% below | 50% |
| Occupational therapy evaluation, low complexity CPT 97165 OT EVAL LOW COMPLEX 30 MIN | $106.50 | $213.00 | — | 42% below | 50% |
| Physical therapy evaluation, low complexity (typically about 20 minutes) CPT 97161 PT EVAL LOW COMPLEX 20 MIN | $106.50 | $213.00 | — | 42% below | 50% |
| Physical therapy, hands-on manual therapy (15-minute unit) CPT 97140 MANUAL THERAPY 1/> REGIONS | $52.50 | $105.00 | — | 21% below | 50% |
| Physical therapy, therapeutic exercise (15-minute unit) CPT 97110 THERAPEUTIC EXERCISES | $29.50 | $59.00 | — | 58% below | 50% |
| Preventive checkup, new patient aged 18–39 CPT 99385 PREV VISIT NEW AGE 18-39 | $51.50 | $103.00 | — | 38% below | 50% |
| Preventive checkup, new patient aged 40–64 CPT 99386 PREV VISIT NEW AGE 40-64 | $59.50 | $119.00 | — | 34% below | 50% |
| Preventive checkup, new patient aged 65 or older CPT 99387 INIT PM E/M NEW PAT 65+ YRS | $94.50 | $189.00 | — | 14% below | 50% |
| Preventive checkup, returning patient aged 18–39 CPT 99395 PREV VISIT EST AGE 18-39 | $44.00 | $88.00 | — | 33% below | 50% |
| Preventive checkup, returning patient aged 40–64 CPT 99396 PREV VISIT EST AGE 40-64 | $86.50 | $173.00 | — | 16% above | 50% |
| Preventive checkup, returning patient aged 65 or older CPT 99397 PER PM REEVAL EST PAT 65+ YR | $23.00 | $46.00 | — | 66% below | 50% |
| Quit-smoking counseling, 3 to 10 minutes CPT 99406 BEHAV CHNG SMOKING 3-10 MIN | $36.50 | $73.00 | — | at median | 50% |
| Returning patient office visit, straightforward problem or 10+ minutes CPT 99212 OFFICE O/P EST SF 10 MIN | $25.00 | $50.00 | — | 61% below | 50% |
| Speech therapy session, individual CPT 92507 TX SP LANG VOICE COMM INDIV | $112.50 | $225.00 | — | 27% below | 50% |
| Spirometry (breathing test) CPT 94010 BREATHING CAPACITY TEST | $260.00 | $520.00 | — | 25% above | 50% |
| Spirometry before and after a bronchodilator CPT 94060 EVALUATION OF WHEEZING | $411.50 | $823.00 | — | 6% above | 50% |
| Therapeutic activities (functional training), 15 minutes CPT 97530 THERAPEUTIC ACTIVITIES | $29.50 | $59.00 | — | 61% below | 50% |
| Therapeutic phlebotomy (removing blood as treatment) CPT 99195 PHLEBOTOMY | $127.50 | $255.00 | — | 15% below | 50% |
Vaccines
| Procedure | Cash price | List price | Insurers pay | vs West Virginia | Off list |
|---|---|---|---|---|---|
| Adjuvanted flu shot (with an immune booster ingredient), for age 65 and older CPT 90653 IIV ADJUVANT VACCINE IM | $109.50 | $219.00 | — | 50% above | 50% |
| COVID-19 vaccine (Moderna), age 12 and older CPT 91322 SARSCOV2 VAC 50 MCG/0.5ML IM | $186.00 | $372.00 | $240.77 | 20% above | 50% |
| COVID-19 vaccine (Pfizer-BioNTech), age 12 and older CPT 91320 SARSCV2 VAC 30MCG TRS-SUC IM | $150.50 | $301.00 | $216.32 | at median | 50% |
| Chickenpox (varicella) vaccine, live (Varivax) CPT 90716 VAR VACCINE LIVE SUBQ | $274.00 | $548.00 | $344.92 | 38% above | 50% |
| DTaP and polio booster for ages 4 to 6 (Kinrix, Quadracel) CPT 90696 DTAP-IPV VACCINE 4-6 YRS IM | $86.00 | $172.00 | $172.00 | 31% above | 50% |
| DTaP vaccine (diphtheria, tetanus and whooping cough), under age 7 CPT 90700 DTAP VACCINE < 7 YRS IM | $41.00 | $82.00 | $56.96 | 30% above | 50% |
| DTaP, hepatitis B and polio combination vaccine (Pediarix) CPT 90723 DTAP-HEP B-IPV VACCINE IM | $94.50 | $189.00 | $187.79 | 3% above | 50% |
| DTaP, polio and Hib combination vaccine (Pentacel) CPT 90698 DTAP-IPV/HIB VACCINE IM | $159.00 | $318.00 | $217.26 | 50% above | 50% |
| Flu shot, standard dose, preservative-free, for age 6 months and older CPT 90656 IIV3 VACC NO PRSV 0.5 ML IM | $29.00 | $58.00 | $21.07 | 49% above | 50% |
| HPV vaccine, 9-valent (Gardasil 9) CPT 90651 9VHPV VACCINE 2/3 DOSE IM | $435.50 | $871.00 | $569.07 | 37% above | 50% |
| Hepatitis A and B combination vaccine, adult (Twinrix) CPT 90636 HEP A/HEP B VACC ADULT IM | $143.00 | $286.00 | $213.39 | at median | 50% |
| Hepatitis A vaccine, adult dose CPT 90632 HEPA VACCINE ADULT IM | $102.00 | $204.00 | $115.93 | 5% above | 50% |
| Hepatitis A vaccine, child and teen dose (2-dose schedule) CPT 90633 HEPA VACC PED/ADOL 2 DOSE IM | $49.00 | $98.00 | $68.72 | 36% above | 50% |
| Hepatitis B vaccine, adult dose (3-dose schedule) CPT 90746 HEPB VACCINE 3 DOSE ADULT IM | $65.50 | $131.00 | $116.13 | 2% below | 50% |
| Hepatitis B vaccine, adult, 2-dose schedule (Heplisav-B) CPT 90739 HEPB VACC 2/4 DOSE ADULT IM | $190.00 | $380.00 | $264.46 | 50% above | 50% |
| Hepatitis B vaccine, child and teen dose (3-dose schedule) CPT 90744 HEPB VACC 3 DOSE PED/ADOL IM | $32.00 | $64.00 | $50.77 | at median | 50% |
| Hib vaccine (Haemophilus influenzae type b), 3-dose schedule (PedvaxHIB) CPT 90647 HIB PRP-OMP VACC 3 DOSE IM | $41.50 | $83.00 | $58.58 | 48% above | 50% |
| Hib vaccine (Haemophilus influenzae type b), 4-dose schedule (ActHIB, Hiberix) CPT 90648 HIB PRP-T VACCINE 4 DOSE IM | $17.00 | $34.00 | $25.21 | at median | 50% |
| High-dose flu shot, preservative-free, mainly for age 65 and older CPT 90662 IIV NO PRSV INCREASED AG IM | $119.00 | $238.00 | $121.11 | 49% above | 50% |
| Japanese encephalitis vaccine (Ixiaro), 2-dose schedule CPT 90738 INACTIVATED JE VACC IM | $531.50 | $1,063.00 | $504.42 | 50% above | 50% |
| MMR vaccine (measles, mumps and rubella), live CPT 90707 MMR VACCINE SC | $116.50 | $233.00 | $182.39 | 1% below | 50% |
| MMRV vaccine (measles, mumps, rubella and chickenpox), live (ProQuad) CPT 90710 MMRV VACCINE SC | $404.00 | $808.00 | $218.94 | 34% above | 50% |
| Meningococcal ACWY (MenACWY) vaccine CPT 90734 MENACWYD/MENACWYCRM VACC IM | $156.50 | $313.00 | $299.95 | at median | 50% |
| Meningococcal ACWY vaccine (MenQuadfi) CPT 90619 MENACWY-TT VACCINE IM | $220.50 | $441.00 | $330.38 | 27% above | 50% |
| Meningococcal B vaccine (Bexsero), 2-dose schedule CPT 90620 MENB-4C VACCINE IM | $229.00 | $458.00 | $411.10 | at median | 50% |
| Meningococcal B vaccine (Trumenba) CPT 90621 MENB-FHBP VACC 2/3 DOSE IM | $254.50 | $509.00 | $376.46 | 50% above | 50% |
| Nasal spray flu vaccine, live (FluMist) CPT 90660 LAIV3 VACCINE INTRANASAL | $36.50 | $73.00 | $27.56 | 49% above | 50% |
| Pneumonia vaccine, 15-valent conjugate (Vaxneuvance) CPT 90671 PCV15 VACCINE IM | $272.50 | $545.00 | $418.37 | 50% above | 50% |
| Pneumonia vaccine, 20-valent conjugate (Prevnar 20) CPT 90677 PCV20 VACCINE IM | $363.50 | $727.00 | $476.29 | at median | 50% |
| Pneumonia vaccine, 21-valent conjugate (Capvaxive) CPT 90684 PCV21 VACCINE IM | $333.50 | $667.00 | — | 42% above | 50% |
| Pneumonia vaccine, 23-valent polysaccharide (Pneumovax 23) CPT 90732 PPSV23 VACC 2 YRS+ SUBQ/IM | $158.00 | $316.00 | $220.23 | 44% above | 50% |
| Polio vaccine, inactivated (IPV) CPT 90713 POLIOVIRUS IPV SC/IM | $61.50 | $123.00 | $84.18 | 50% above | 50% |
| RSV antibody shot for infants and toddlers, larger dose (1 mL, 100 mg) CPT 90381 RSV MONOC ANTB SEASN 1 ML IM | $789.00 | $1,578.00 | $980.10 | at median | 50% |
| RSV antibody shot for infants, seasonal dose (0.5 mL) CPT 90380 RSV MONOC ANTB SEASN .5ML IM | $789.00 | $1,578.00 | $1,578.00 | at median | 50% |
| RSV vaccine (Abrysvo), one dose for older adults or during pregnancy CPT 90678 RSV VACC PREF BIVALENT IM | $406.00 | $812.00 | $584.10 | 50% above | 50% |
| RSV vaccine with adjuvant (Arexvy), one dose for older adults CPT 90679 RSV VACC PREF RECOMB ADJT IM | $342.00 | $684.00 | $554.40 | 50% above | 50% |
| Rabies vaccine, one dose CPT 90675 RABIES VACCINE IM | $569.00 | $1,138.00 | $535.82 | 16% above | 50% |
| Rotavirus vaccine, oral, 2-dose schedule (Rotarix) CPT 90681 RV1 VACC 2 DOSE LIVE ORAL | $154.50 | $309.00 | $182.97 | 3% above | 50% |
| Rotavirus vaccine, oral, 3-dose schedule (RotaTeq) CPT 90680 RV5 VACC 3 DOSE LIVE ORAL | $126.50 | $253.00 | $189.75 | 29% above | 50% |
| Shingles vaccine (Shingrix), recombinant, one dose CPT 90750 HZV VACC RECOMBINANT IM | $261.50 | $523.00 | — | 23% above | 50% |
| Td vaccine (tetanus and diphtheria booster), age 7 and older CPT 90714 TD VACC NO PRESV 7 YRS+ IM | $58.50 | $117.00 | $50.06 | 14% above | 50% |
| Tdap vaccine (tetanus, diphtheria and whooping cough), age 7 and older CPT 90715 TDAP VACCINE 7 YRS/> IM | $68.00 | $136.00 | $63.21 | 32% above | 50% |
| Typhoid vaccine, injectable (Vi polysaccharide) CPT 90691 TYPHOID VACCINE IM | $212.50 | $425.00 | $180.23 | 50% above | 50% |
| Vaccine administration fee (giving the shot), first vaccine of the visit CPT 90471 IMMUNIZATION ADMIN | $69.00 | $138.00 | — | 59% above | 50% |
| Vaccine administration fee, each additional vaccine at the same visit CPT 90472 IMMUNIZATION ADMIN EACH ADD | $26.00 | $52.00 | — | 6% above | 50% |
| Yellow fever vaccine, live CPT 90717 YELLOW FEVER VACCINE SUBQ | $308.50 | $617.00 | $263.36 | 50% above | 50% |
Procedure The service, with its billing code (CPT or HCPCS) and, in small type, the line exactly as the hospital wrote it in its price file. More
Cash price The hospital's own price for a patient paying without insurance (“discounted cash” in its price file). Hospitals must publish it under federal law, 45 CFR 180.50. Call to confirm it before booking. More
List price The hospital's full chargemaster price (“gross charge”) before any discount. Almost nobody pays it; the gap to the cash price shows what the self-pay discount is worth. More
Insurers pay The lowest and highest rates this hospital has agreed with insurance plans for the same item, from its price file. If the cash price is below what your plan pays and you have not met your deductible, paying cash can cost you less. More
Against the state median This hospital's cash price compared with the median cash price of hospitals in the state for the same code. Shown when at least three hospitals in the state price it.
Off list How much lower the cash price is than the list price.
No cash discount This line's cash price equals the hospital's full list price. Many hospitals still reduce bills for uninsured patients: ask the billing office for its self-pay discount in writing. More
At or below Medicare This cash price is at or below what Medicare pays a hospital for the same service, which is unusually low. It is what the hospital's file says; confirm it and what it includes before booking. More
Check the item The description in the hospital file looks like a supply or device (a catheter, a brace, an implant), not this procedure. The hospital may have filed it under the wrong code: ask before relying on this price.
Source file: https://wvumedicine.org/wp-content/uploads/2026/08/550611919_Braxton-County-Memorial-Hospital_standardcharges.csv