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 |
|---|---|---|---|---|
| Ghs nerve block lumbar or thoracic symp CPT 64520 | $85.50 | $171.00 | not published | 0 |
| Ghs nerve block sciatic nerve CPT 64445 | $1,185.00 | $2,370.00 | not published | 0 |
| Ghs nerve block suprascapular CPT 64418 | $681.50 | $1,363.00 | not published | 0 |
| Ghs ng placement w fluoro guidance CPT 43752 | $40.00 | $80.00 | not published | 0 |
| Ghs opcc repair cvp w subq port CPT 36576 | $196.50 | $393.00 | not published | 0 |
| Ghs optokenetic CPT 92544 | $123.00 | $246.00 | not published | 0 |
| Ghs oscillating trac CPT 92545 | $207.00 | $414.00 | not published | 0 |
| Ghs osteopathic manipulative tx, 1-2 regions CPT 98925 | $22.50 | $45.00 | not published | 0 |
| Ghs osteopathic manipulative tx, 3-4 regions CPT 98926 | $34.00 | $68.00 | not published | 0 |
| Ghs ot group caregiver training CPT 97552 | $22.00 | $44.00 | not published | 0 |
| Ghs paravert facet/nerve cerv ea add bil CPT 64492 | $58.50 | $117.00 | not published | 0 |
| Ghs paravert facet/nerve lumb ea add bil CPT 64495 | $51.50 | $103.00 | not published | 0 |
| Ghs path - pap (papanicolau) smear - vagina CPT 88141 | $25.50 | $51.00 | not published | 0 |
| Ghs peritonsillar abscess i andd CPT 42700 | $330.50 | $661.00 | not published | 0 |
| Ghs phenylketonurid CPT 84030 | $175.00 | $350.00 | not published | 0 |
| Ghs plngl fx pm cl CPT 26725 | $446.50 | $893.00 | not published | 0 |
| Ghs ppd (tb intradermal) CPT 86580 | $15.00 | $30.00 | not published | 0 |
| Ghs protoporphyrins fract CPT 84202 | $8.00 | $16.00 | not published | 0 |
| Ghs quinidine CPT 80194 | $167.50 | $335.00 | not published | 0 |
| Ghs refill of implantable pump CPT 95990 | $350.00 | $700.00 | not published | 0 |
| Ghs removal intranasal foreign body CPT 30300 | $184.50 | $369.00 | not published | 0 |
| Ghs removal pharyngeal foreign body CPT 42809 | $131.50 | $263.00 | not published | 0 |
| Ghs repair extensor tendon hand, ea tendon CPT 26410 | $1,587.00 | $3,174.00 | not published | 0 |
| Ghs repair tendon ext forearm/wrist ea CPT 25270 | $524.50 | $1,049.00 | not published | 0 |
| Ghs sensitivity (per antimicro) CPT 87184 | $37.00 | $74.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12005 CPT 12005 | $593.00 | $1,186.00 | not published | 0 |
| Ghs simple repair 12.6 - 20.0 cm - 12016 CPT 12016 | $148.00 | $296.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12006 CPT 12006 | $131.50 | $263.00 | not published | 0 |
| Ghs simple repair 20.1 - 30.0 cm - 12017 CPT 12017 | $186.00 | $372.00 | not published | 0 |
| Ghs simple repair 5.1 - 7.5 cm - 12014 CPT 12014 | $362.50 | $725.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12004 CPT 12004 | $362.50 | $725.00 | not published | 0 |
| Ghs simple repair 7.6 - 12.5 cm - 12015 CPT 12015 | $287.00 | $574.00 | not published | 0 |
| Ghs simple repair over 30 cm - 12007 CPT 12007 | $161.00 | $322.00 | not published | 0 |
| Ghs sleep study unattended CPT 95800 | $146.00 | $292.00 | not published | 0 |
| Ghs sphenopalatine ganglion block CPT 64505 | $112.00 | $224.00 | not published | 0 |
| Ghs st - eval for alt comm CPT 92567 | $10.00 | $20.00 | not published | 0 |
| Ghs superficial wnd dehiscence simp12020 CPT 12020 | $979.50 | $1,959.00 | not published | 0 |
| Ghs superficial wnd dehis w packing12021 CPT 12021 | $513.00 | $1,026.00 | not published | 0 |
| Ghs tx distal phalangeal fx with manipulation CPT 26755 | $328.50 | $657.00 | not published | 0 |
| Ghs urine, porphyrins quant CPT 84120 | $13.50 | $27.00 | not published | 0 |
| Ghs vaginal delivery only CPT 59409 | $3,101.00 | $6,202.00 | not published | 0 |
| Gi inhouse confirmation CPT 87045 | $24.00 | $48.00 | not published | 0 |
| Gi tract capsule endoscopy (pillcam) 91110 CPT 91110 | $812.00 | $1,624.00 | not published | 0 |
| Glucagon 1 mg solution for injection HCPCS J1610 | $205.00 | $410.00 | $310.81 – $310.81 | 1 |
| Glucose 1 hr post dose CPT 82950 | $33.00 | $66.00 | not published | 0 |
| Glucose blood by monitoring device cleared by fda for home use CPT 82962 | $31.00 | $62.00 | not published | 0 |
| Glucose blood quantitative CPT 82947 | $29.50 | $59.00 | not published | 0 |
| Glucose body fluid CPT 82945 | $81.00 | $162.00 | not published | 0 |
| Glucose tolerance test (gtt) 3 specimens CPT 82951 | $48.50 | $97.00 | not published | 0 |
| Gonadotropin follicle stimulating hormone (fsh) CPT 83001 | $35.00 | $70.00 | not published | 0 |
| Gonadotropin luteinizing hormone (lh) CPT 83002 | $22.50 | $45.00 | not published | 0 |
| Gonioscopy CPT 92020 | $18.50 | $37.00 | not published | 0 |
| Goniotomy CPT 65820 | $778.50 | $1,557.00 | not published | 0 |
| Goserelin 10.8 mg subcutaneous implant HCPCS J9202 | $1,686.00 | $3,372.00 | $1,004.87 – $1,004.87 | 1 |
| Graft apligraf 3in 44sqcm-q4101-cost per sq cm HCPCS Q4101 | $119.50 | $239.00 | $50.16 – $50.16 | 1 |
| Graft axiofill 1000mg HCPCS J3590 | $10.00 | $20.00 | not published | 0 |
| Graft fish skin 16mm round marigen 2units-cost per sq cm HCPCS Q4158 | $119.50 | $239.00 | $239.00 – $239.00 | 1 |
| Graft impl ult thck 6x12cm -cost per sq cm HCPCS Q4116 | $119.50 | $239.00 | not published | 0 |
| Graft primatrix xcr 6cm x6cm n-q4110-cost per sq cm HCPCS Q4110 | $119.50 | $239.00 | $64.45 – $64.45 | 1 |
| Graft puraplyam antimicrob 1.6-q4196-cost per sq cm HCPCS Q4196 | $119.50 | $239.00 | $171.22 – $171.22 | 1 |
| Graft sft tiss grafix amnio prime 3x4cm 12sqcm-q4133-cost per sq cm HCPCS Q4133 | $119.50 | $239.00 | $224.93 – $224.93 | 1 |
| Graft sft tiss theraskin lg 5.1x7.6cm meshed 39 sq cm-q4121-cost per sq cm HCPCS Q4121 | $119.50 | $239.00 | $74.25 – $74.25 | 1 |
| Graft wnd mtrx grfx core 1.5x2cm-q4132-cost per sq cm HCPCS Q4132 | $119.50 | $239.00 | $239.00 – $239.00 | 1 |
| Graft xenmtrx sft rect 15x20cm HCPCS C1781 | $2,073.00 | $4,146.00 | not published | 0 |
| Great toe with reduction 28495 CPT 28495 | $166.00 | $332.00 | not published | 0 |
| Gstrct prtl dstl w/roux-en-y rcnstj 43633 CPT 43633 | $2,105.50 | $4,211.00 | not published | 0 |
| Gstrst open wo constj tube CPT 43830 | $783.50 | $1,567.00 | not published | 0 |
| Guided cath fluid drainage 10030 CPT 10030 | $138.50 | $277.00 | not published | 0 |
| Gynecomastia (males) 19300 CPT 19300 | $476.00 | $952.00 | not published | 0 |
| Haloperidol lactate 5 mg/ml injection solution HCPCS J1630 | $1.50 | $3.00 | $2.34 – $2.34 | 1 |
| Handle/convey/speciman/office-lab 99000 CPT 99000 | $16.00 | $32.00 | not published | 0 |
| Hand X-ray CPT 73130 | $121.00 | $242.00 | not published | 0 |
| Haptoglobin quantitative CPT 83010 | $77.00 | $154.00 | not published | 0 |
| Harvest auto stem cells CPT 38206 | $76.50 | $153.00 | not published | 0 |
| Harvest femoropopliteal vein 35572 CPT 35572 | $375.00 | $750.00 | not published | 0 |
| Harvest vein for bypass 35500 CPT 35500 | $351.00 | $702.00 | not published | 0 |
| Hba1/hba2 full gene sequence CPT 81259 | $827.50 | $1,655.00 | not published | 0 |
| Hbb full gene sequence CPT 81364 | $707.00 | $1,414.00 | not published | 0 |
| Hbb gene dup/del variants CPT 81363 | $675.00 | $1,350.00 | not published | 0 |
| Hb glycosylated a1c home dev CPT 83037 | $16.50 | $33.00 | not published | 0 |
| Hcg qualitative CPT 84703 | $15.00 | $30.00 | not published | 0 |
| Hcg quantitative CPT 84702 | $25.00 | $50.00 | not published | 0 |
| Hc metata joint dislocation anes CPT 28635 | $137.00 | $274.00 | not published | 0 |
| Hc mohs micrographic h/n/h/f/g 1st stage 5 blocks CPT 17311 | $328.50 | $657.00 | not published | 0 |
| Head CT scan (with and without contrast) CPT 70470 | $807.00 | $1,614.00 | not published | 0 |
| Head CT scan (with contrast) CPT 70460 | $657.00 | $1,314.00 | not published | 0 |
| Head CT scan (without contrast) CPT 70450 | $605.00 | $1,210.00 | not published | 0 |
| Hemoglobin CPT 85018 | $12.50 | $25.00 | not published | 0 |
| Hemoglobin methemoglobin quantitative CPT 83050 | $69.00 | $138.00 | not published | 0 |
| Hemorrhoidectomy intrnl lig rbbr band ligations CPT 46221 | $215.50 | $431.00 | not published | 0 |
| Hemorrhoidopexy stapling 46947 CPT 46947 | $431.00 | $862.00 | not published | 0 |
| Heparin assay CPT 85520 | $313.00 | $626.00 | not published | 0 |
| Heparin, porcine (pf) 10 unit/ml flush (wrapper) HCPCS J1642 | $1.00 | $2.00 | $0.03 – $0.03 | 1 |
| Hepatitis a antibody igm CPT 86709 | $119.50 | $239.00 | not published | 0 |
| Hepatitis b core antibody igm CPT 86705 | $30.00 | $60.00 | not published | 0 |
| Hepatitis b core antibody total CPT 86704 | $24.00 | $48.00 | not published | 0 |
| Hepatitis b immune globulin greater than 1,560 units/5 ml im solution CPT 90371 | $249.00 | $498.00 | $227.52 – $227.52 | 1 |
| Hepatitis b surface antibody CPT 86706 | $25.50 | $51.00 | not published | 0 |
| Hepatitis c antibody CPT 86803 | $39.00 | $78.00 | not published | 0 |
| Hepatobiliary system imaging CPT 78226 | $383.00 | $766.00 | 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.