Braxton County Memorial Hospital
100 Hoylman Dr, Gassaway, WV · Wvumedicine · · NPI 1356304547
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 11-desoxycortisol - sendout CPT 82634 | $155.00 | $310.00 | not published | 0 |
| 17-hydroxypregnenolone CPT 84143 | $155.00 | $310.00 | not published | 0 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $92.50 | $185.00 | not published | 0 |
| 1st psyc collab care mgmt CPT 99492 | $94.00 | $188.00 | not published | 0 |
| 1st/sbsq psyc collab care CPT 99494 | $73.50 | $147.00 | not published | 0 |
| 2nd order venous cath CPT 36012 | $183.50 | $367.00 | not published | 0 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $38.50 | $77.00 | not published | 0 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $79.50 | $159.00 | not published | 0 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $77.50 | $155.00 | not published | 0 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $111.50 | $223.00 | not published | 0 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $116.00 | $232.00 | not published | 0 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $97.00 | $194.00 | not published | 0 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $89.50 | $179.00 | not published | 0 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $149.00 | $298.00 | not published | 0 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $106.00 | $212.00 | not published | 0 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $1,327.00 | $2,654.00 | not published | 0 |
| Abd/low ext cath 1st CPT 36245 | $247.00 | $494.00 | not published | 0 |
| Abd/low ext cath 2nd CPT 36246 | $267.50 | $535.00 | not published | 0 |
| Abd/low ext cath 3rd CPT 36247 | $308.50 | $617.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $820.00 | $1,640.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $669.00 | $1,338.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $621.00 | $1,242.00 | not published | 0 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,445.50 | $2,891.00 | not published | 0 |
| Abdominal MRI (with contrast) CPT 74182 | $637.00 | $1,274.00 | not published | 0 |
| Abdominal MRI (without contrast) CPT 74181 | $1,184.00 | $2,368.00 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $869.00 | $1,738.00 | not published | 0 |
| Abdominal Ultrasound (complete) CPT 76700 | $448.00 | $896.00 | not published | 0 |
| Abdominal Ultrasound (limited) CPT 76705 | $219.50 | $439.00 | not published | 0 |
| Abdominoplasty 15830 CPT 15830 | $1,217.50 | $2,435.00 | not published | 0 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,202.50 | $2,405.00 | not published | 0 |
| Ablate bone tumor(s) perq CPT 20982 | $6,540.00 | $13,080.00 | not published | 0 |
| Ablation cryo abd perit om CPT 49999 | $571.00 | $1,142.00 | not published | 0 |
| Ablation cryo pq chest wall tumor(s) w/guid CPT 23929 | $673.00 | $1,346.00 | not published | 0 |
| Ablation cryo retro lymph node CPT 38999 | $118.50 | $237.00 | not published | 0 |
| Ablation cryo thigh/knee CPT 27599 | $532.50 | $1,065.00 | not published | 0 |
| Ablation of upper extremity nerves rf CPT 64999 | $675.50 | $1,351.00 | not published | 0 |
| Abobotulinumtoxina HCPCS J0586 | $13.00 | $26.00 | $14.54 – $14.54 | 1 |
| Abscess drain retroperitoneal surg code CPT 49406 | $194.50 | $389.00 | not published | 0 |
| Acetaminophen level CPT 80143 | $195.50 | $391.00 | not published | 0 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $15.50 | $31.00 | $31.00 – $31.00 | 1 |
| Acetylcholine receptor modulating antibody CPT 86043 | $50.00 | $100.00 | not published | 0 |
| Acne surgery 10040 CPT 10040 | $48.50 | $97.00 | not published | 0 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $222.00 | $444.00 | not published | 0 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $206.00 | $412.00 | not published | 0 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $152.00 | $304.00 | not published | 0 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | $152.00 | $304.00 | not published | 0 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $54.50 | $109.00 | not published | 0 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $278.00 | $556.00 | not published | 0 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $153.00 | $306.00 | not published | 0 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $36.00 | $72.00 | not published | 0 |
| Acromp/acromionectomy prtl CPT 23130 | $660.00 | $1,320.00 | not published | 0 |
| Acup 1/> w/estim 1st 15 min CPT 97813 | $41.00 | $82.00 | not published | 0 |
| Acup 1/> wo estim 1st 15 min CPT 97810 | $41.00 | $82.00 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $221.00 | $442.00 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $72.00 | $144.00 | not published | 0 |
| Adh-sendout CPT 84588 | $31.00 | $62.00 | not published | 0 |
| Adj gastric band via subq port CPT 43999 | $943.50 | $1,887.00 | not published | 0 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $730.00 | $1,460.00 | not published | 0 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $4.00 | $8.00 | $0.92 – $0.92 | 1 |
| Admin ecg contrast agent CPT 93352 | $37.00 | $74.00 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $69.00 | $138.00 | not published | 0 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $69.00 | $138.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $316.50 | $633.00 | not published | 0 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $316.50 | $633.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $69.00 | $138.00 | not published | 0 |
| Administration immunization 1 vaccine CPT 90471 | $69.00 | $138.00 | not published | 0 |
| Administration immunization each additional component CPT 90461 | $14.00 | $28.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $26.00 | $52.00 | not published | 0 |
| Administration immunization first component each vaccine CPT 90460 | $14.00 | $28.00 | not published | 0 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $37.00 | $74.00 | not published | 0 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $41.00 | $82.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | $45.00 | $90.00 | not published | 0 |
| Administration vaccine influenza virus HCPCS G0008 | $45.00 | $90.00 | not published | 0 |
| Administration vaccine pneumococcal HCPCS G0009 | $45.00 | $90.00 | not published | 0 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $72.00 | $144.00 | not published | 0 |
| Aflibercept injection HCPCS J0178 | $847.00 | $1,694.00 | $1,422.76 – $1,422.76 | 1 |
| After cataract laser surgery CPT 66821 | $296.00 | $592.00 | not published | 0 |
| Air conduction bilat CPT 92552 | $127.50 | $255.00 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $13.00 | $26.00 | not published | 0 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $52.50 | $105.00 | $87.58 – $87.58 | 1 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $33.00 | $66.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $24.00 | $48.00 | not published | 0 |
| Albuterol ipratrop non-comp HCPCS J7620 | $1.00 | $2.00 | $0.28 – $0.28 | 1 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $67.00 | $134.00 | not published | 0 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | $36.00 | $72.00 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $25.50 | $51.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $66.50 | $133.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $138.00 | $276.00 | not published | 0 |
| Allergy injections; 2 or more 95117 CPT 95117 | $45.00 | $90.00 | not published | 0 |
| Allergy injection; single 95115 CPT 95115 | $45.00 | $90.00 | not published | 0 |
| Allergy Skin Testing CPT 95004 | $3.50 | $7.00 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $119.50 | $239.00 | $187.57 – $187.57 | 1 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $0.01 | $0.01 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $119.50 | $239.00 | $225.18 – $225.18 | 1 |
| All tstg perq&iq drugs/biol CPT 95018 | $64.50 | $129.00 | not published | 0 |
| Alpha-fetoprotein amniotic CPT 82106 | $28.50 | $57.00 | not published | 0 |
| Alpha-fetoprotein tumor marker CPT 82105 | $25.00 | $50.00 | not published | 0 |
| Alprostadil for injection HCPCS J0270 | $9.50 | $19.00 | $0.73 – $0.73 | 1 |
| Alteplase 100 mg infusion from pyxis vial HCPCS J2997 | $128.00 | $256.00 | $146.80 – $146.80 | 1 |
| Alt/sgpt CPT 84460 | $25.50 | $51.00 | not published | 0 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.