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 |
|---|---|---|---|---|
| Laparo-vag hyst incl t/o CPT 58552 | $1,036.50 | $2,073.00 | not published | 0 |
| Laparo-vag hyst w/t/o compl CPT 58554 | $1,357.50 | $2,715.00 | not published | 0 |
| Lap close enterostomy with resect 44227 CPT 44227 | $1,785.00 | $3,570.00 | not published | 0 |
| Lap colectomy/coloproctostomy 44207 CPT 44207 | $1,933.50 | $3,867.00 | not published | 0 |
| Lap colectomy/coloproctostomy w/clst 44208 CPT 44208 | $2,102.50 | $4,205.00 | not published | 0 |
| Lap colectomy part w/ileum 44205 CPT 44205 | $1,435.00 | $2,870.00 | not published | 0 |
| Lap colostomy 44188 CPT 44188 | $1,319.00 | $2,638.00 | not published | 0 |
| Lap enterectomy 44202 CPT 44202 | $1,517.00 | $3,034.00 | not published | 0 |
| Lap enterolysis CPT 44180 | $1,016.00 | $2,032.00 | not published | 0 |
| Lap ing hernia repair init CPT 49650 | $488.00 | $976.00 | not published | 0 |
| Lap ing hernia repair recur CPT 49651 | $634.50 | $1,269.00 | not published | 0 |
| Lap insert tunnel ip cath CPT 49324 | $429.50 | $859.00 | not published | 0 |
| Lap mobil splenic fl add-on 44213 CPT 44213 | $196.50 | $393.00 | not published | 0 |
| Lap paraesophag hern repair CPT 43281 | $1,693.00 | $3,386.00 | not published | 0 |
| Lap part colectomy w/stoma 44206 CPT 44206 | $1,878.50 | $3,757.00 | not published | 0 |
| Lap rmvl gastr adj all parts CPT 43774 | $1,067.00 | $2,134.00 | not published | 0 |
| Lap sleeve gastrectomy CPT 43775 | $1,207.50 | $2,415.00 | not published | 0 |
| Laps pelvic lymphadec CPT 38573 | $1,264.00 | $2,528.00 | not published | 0 |
| Lap w/omentopexy add-on 49326 CPT 49326 | $205.00 | $410.00 | not published | 0 |
| Largsc w/rmvl foreign bdy(s) CPT 31577 | $136.50 | $273.00 | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $158.00 | $316.00 | not published | 0 |
| Laryngoscopy w/fb removal CPT 31530 | $199.50 | $399.00 | not published | 0 |
| Laser surgery eye strands CPT 67031 | $333.50 | $667.00 | not published | 0 |
| Laser surgery of prostate CPT 52648 | $602.00 | $1,204.00 | not published | 0 |
| Laser surg penis lesion(s) CPT 54057 | $100.50 | $201.00 | not published | 0 |
| Lat retinacular release open CPT 27425 | $491.00 | $982.00 | not published | 0 |
| Lavh >250 gms 58553 CPT 58553 | $1,152.00 | $2,304.00 | not published | 0 |
| Lb with mastopexy 15839 CPT 15839 | $772.00 | $1,544.00 | not published | 0 |
| Lead capillary CPT 83655 | $15.00 | $30.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $229.00 | $458.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $75.00 | $150.00 | not published | 0 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $256.50 | $513.00 | $299.15 – $299.15 | 1 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $2,607.50 | $5,215.00 | $2,581.59 – $2,581.59 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | $2.00 | $4.00 | $0.08 – $0.08 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $31.00 | $62.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $3.50 | $7.00 | $1.50 – $1.50 | 1 |
| Ligate leg veins open CPT 37761 | $577.50 | $1,155.00 | not published | 0 |
| Ligate leg veins radical 37760 CPT 37760 | $637.00 | $1,274.00 | not published | 0 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | $77.00 | $154.00 | not published | 0 |
| Ligate/strip long leg vein CPT 37722 | $506.00 | $1,012.00 | not published | 0 |
| Ligate/strip short leg vein CPT 37718 | $433.50 | $867.00 | not published | 0 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | $381.50 | $763.00 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $216.00 | $432.00 | not published | 0 |
| Ligation common iliac vein CPT 37660 | $1,448.50 | $2,897.00 | not published | 0 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $265.00 | $530.00 | not published | 0 |
| Ligation external carotid artery 37600 CPT 37600 | $765.50 | $1,531.00 | not published | 0 |
| Ligation internal/common carotid artery 37605 CPT 37605 | $818.50 | $1,637.00 | not published | 0 |
| Ligation internal jugular vein 37565 CPT 37565 | $760.00 | $1,520.00 | not published | 0 |
| Ligation major artery chest CPT 37616 | $1,256.00 | $2,512.00 | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | $427.50 | $855.00 | not published | 0 |
| Ligation major artery neck CPT 37615 | $529.00 | $1,058.00 | not published | 0 |
| Ligation of abdomen artery 37617 CPT 37617 | $1,433.00 | $2,866.00 | not published | 0 |
| Ligation of femoral vein CPT 37650 | $508.00 | $1,016.00 | not published | 0 |
| Ligation of inf vena cava CPT 37619 | $1,889.00 | $3,778.00 | not published | 0 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $273.00 | $546.00 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $406.50 | $813.00 | not published | 0 |
| Lig&div&compl strpg saph vn CPT 37735 | $643.50 | $1,287.00 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | $1,398.00 | $2,796.00 | $1,756.97 – $1,756.97 | 1 |
| Limited visual field xm CPT 92081 | $35.50 | $71.00 | not published | 0 |
| Lincomycin injection HCPCS J2010 | $23.00 | $46.00 | $16.24 – $16.24 | 1 |
| Lipase CPT 83690 | $45.00 | $90.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $64.50 | $129.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $30.50 | $61.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $22.00 | $44.00 | not published | 0 |
| Lip surgery procedure CPT 40799 | $213.50 | $427.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $46.00 | $92.00 | not published | 0 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | $1,336.00 | $2,672.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $340.00 | $680.00 | not published | 0 |
| Liver Function Test CPT 80076 | $38.00 | $76.00 | not published | 0 |
| Lmtd oph exam general anes CPT 92019 | $66.00 | $132.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $494.00 | $988.00 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $3.00 | $6.00 | $1.85 – $1.85 | 1 |
| Low back disk surgery CPT 63030 | $4,937.50 | $9,875.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,010.00 | $2,020.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $718.50 | $1,437.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $1,132.50 | $2,265.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,445.50 | $2,891.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $868.50 | $1,737.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $141.00 | $282.00 | not published | 0 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $849.50 | $1,699.00 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $127.00 | $254.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $260.00 | $520.00 | not published | 0 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $278.00 | $556.00 | $479.23 – $479.23 | 1 |
| Lymphocyte transformation mitogen CPT 86353 | $350.00 | $700.00 | not published | 0 |
| Lysis penil circumic lesion CPT 54162 | $208.50 | $417.00 | not published | 0 |
| Magnesium CPT 83735 | $44.50 | $89.00 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $127.50 | $255.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $127.50 | $255.00 | not published | 0 |
| Manipulat palm cord post inj CPT 26341 | $81.00 | $162.00 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $147.00 | $294.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $268.50 | $537.00 | not published | 0 |
| Mastectomy partial CPT 19301 | $733.50 | $1,467.00 | not published | 0 |
| Mast mod rad CPT 19307 | $1,306.00 | $2,612.00 | not published | 0 |
| Mastoids complete CPT 70130 | $209.50 | $419.00 | not published | 0 |
| Mast radical CPT 19305 | $1,270.50 | $2,541.00 | not published | 0 |
| Mast simple complete CPT 19303 | $1,065.00 | $2,130.00 | not published | 0 |
| Matrion 1 sq cm HCPCS Q4201 | $595.00 | $1,190.00 | $163.00 – $163.00 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $119.50 | $239.00 | $30.61 – $30.61 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $121.50 | $243.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $83.50 | $167.00 | 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.