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 |
|---|---|---|---|---|
| Organic acids total quant ea spec CPT 83918 | $279.00 | $558.00 | not published | 0 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | $61.50 | $123.00 | $67.52 – $67.52 | 1 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $40.00 | $80.00 | $45.54 – $45.54 | 1 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $6.50 | $13.00 | $13.00 – $13.00 | 1 |
| Orthovisc inj per dose HCPCS J7324 | $180.00 | $360.00 | $215.56 – $215.56 | 1 |
| Osmolality blood CPT 83930 | $15.00 | $30.00 | not published | 0 |
| Osmolality urine CPT 83935 | $15.00 | $30.00 | not published | 0 |
| Ostectomy complete 1st metatarsal head 28111 CPT 28111 | $337.50 | $675.00 | not published | 0 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | $46.00 | $92.00 | not published | 0 |
| Ot evaluation low complexity patient/family CPT 97165 | $106.50 | $213.00 | not published | 0 |
| Ot management orthotic(s)/prosthetic subsequent encounter each 15 minutes CPT 97763 | $58.50 | $117.00 | not published | 0 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $52.50 | $105.00 | not published | 0 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $9.00 | $18.00 | not published | 0 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $37.50 | $75.00 | not published | 0 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $29.50 | $59.00 | not published | 0 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $46.00 | $92.00 | not published | 0 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $76.00 | $152.00 | not published | 0 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $1.50 | $3.00 | $1.73 – $1.73 | 1 |
| Palb2 gene full gene seq CPT 81307 | $126.00 | $252.00 | not published | 0 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $21.50 | $43.00 | $23.63 – $23.63 | 1 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $2,731.00 | $5,462.00 | $560.47 – $560.47 | 1 |
| Parathormone (pth) intact CPT 83970 | $69.50 | $139.00 | not published | 0 |
| Parathyrd planar w/spect&ct CPT 78072 | $520.00 | $1,040.00 | not published | 0 |
| Parathyroid planar imaging CPT 78070 | $383.00 | $766.00 | not published | 0 |
| Parathyroid planar img w/tomo spect CPT 78071 | $61.00 | $122.00 | not published | 0 |
| Parial mast w/lymph removal 19302 CPT 19302 | $1,007.00 | $2,014.00 | not published | 0 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $296.00 | $592.00 | not published | 0 |
| Part hymenectomy/revi hymenal ring 56700 CPT 56700 | $205.00 | $410.00 | not published | 0 |
| Partial excision bone tars/metatars exc talus/calcaneus (both sides) (rest meth ii cah) CPT 28122 | $463.50 | $927.00 | not published | 0 |
| Partial hip replacement CPT 27125 | $1,185.00 | $2,370.00 | not published | 0 |
| Partial hysterectomy CPT 58180 | $1,008.50 | $2,017.00 | not published | 0 |
| Partial proctectomy; perineal 45123 CPT 45123 | $1,190.00 | $2,380.00 | not published | 0 |
| Partial removal finger bone CPT 26235 | $519.00 | $1,038.00 | not published | 0 |
| Partial removal finger bone CPT 26236 | $469.00 | $938.00 | not published | 0 |
| Partial removal foot fascia CPT 28060 | $381.50 | $763.00 | not published | 0 |
| Partial removal leg bone(s) CPT 27360 | $959.50 | $1,919.00 | not published | 0 |
| Partial removal of eye fluid CPT 67005 | $450.00 | $900.00 | not published | 0 |
| Partial removal of eye fluid CPT 67010 | $512.00 | $1,024.00 | not published | 0 |
| Partial removal of fibula CPT 27641 | $688.00 | $1,376.00 | not published | 0 |
| Partial removal of foot bone CPT 28288 | $458.50 | $917.00 | not published | 0 |
| Partial removal of heart sac 33030 CPT 33030 | $2,231.50 | $4,463.00 | not published | 0 |
| Partial removal of lung 32480 CPT 32480 | $1,656.50 | $3,313.00 | not published | 0 |
| Partial removal of thyroid CPT 60220 | $737.50 | $1,475.00 | not published | 0 |
| Partial removal of thyroid CPT 60225 | $978.50 | $1,957.00 | not published | 0 |
| Partial removal of toe CPT 28160 | $281.50 | $563.00 | not published | 0 |
| Partial thyroid excision CPT 60210 | $748.00 | $1,496.00 | not published | 0 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $8.00 | $16.00 | $4.21 – $4.21 | 1 |
| Part removal of metatarsal CPT 28110 | $311.50 | $623.00 | not published | 0 |
| Part removal of metatarsal CPT 28113 | $3,134.00 | $6,268.00 | not published | 0 |
| Part removal of metatarsal 28112 CPT 28112 | $328.50 | $657.00 | not published | 0 |
| Pcv21 vaccine im CPT 90684 | $333.50 | $667.00 | not published | 0 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $764.50 | $1,529.00 | not published | 0 |
| Pelvic CT scan (with contrast) CPT 72193 | $647.00 | $1,294.00 | not published | 0 |
| Pelvic CT scan (without contrast) CPT 72192 | $546.50 | $1,093.00 | not published | 0 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,808.00 | $3,616.00 | not published | 0 |
| Pelvic MRI (without contrast) CPT 72195 | $868.50 | $1,737.00 | not published | 0 |
| Pelvic Ultrasound (complete) CPT 76856 | $109.50 | $219.00 | not published | 0 |
| Pelvic Ultrasound (limited) CPT 76857 | $166.00 | $332.00 | not published | 0 |
| Peng benzathine/procaine inj HCPCS J0558 | $28.00 | $56.00 | $29.01 – $29.01 | 1 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $42.50 | $85.00 | $35.85 – $35.85 | 1 |
| Penile injection CPT 54235 | $77.00 | $154.00 | not published | 0 |
| Pericardiocentesis wwo imaging CPT 33016 | $246.00 | $492.00 | not published | 0 |
| Pericardiotomy/clot/for bod remove 33020 CPT 33020 | $923.00 | $1,846.00 | not published | 0 |
| Peri-implt capslc brst compl CPT 19371 | $734.50 | $1,469.00 | not published | 0 |
| Perineoplasty rpr per nonob CPT 56810 | $276.00 | $552.00 | not published | 0 |
| Peri-proc device eval icd CPT 93287 | $54.50 | $109.00 | not published | 0 |
| Peri-proc device eval pm CPT 93286 | $96.00 | $192.00 | not published | 0 |
| Peritoneal cath sub q resv per CPT 49419 | $458.00 | $916.00 | not published | 0 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $95.50 | $191.00 | not published | 0 |
| Perq skel fix ulnar styld fx CPT 25651 | $524.00 | $1,048.00 | not published | 0 |
| Perq tx big toe fracture w/manip 28496 CPT 28496 | $302.50 | $605.00 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $1,467.50 | $2,935.00 | not published | 0 |
| Pet CT whole body initial CPT 78816 | $1,467.50 | $2,935.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $23.00 | $46.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $33.00 | $66.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $12.00 | $24.00 | not published | 0 |
| Ph body fluid CPT 83986 | $60.00 | $120.00 | not published | 0 |
| Phencyclidine (pcp) CPT 83992 | $77.00 | $154.00 | not published | 0 |
| Phenobarbital therapeutic drug level CPT 80184 | $68.50 | $137.00 | not published | 0 |
| Phenytoin total therapeutic drug level CPT 80185 | $76.50 | $153.00 | not published | 0 |
| Phlebotomy therapeutic CPT 99195 | $127.50 | $255.00 | not published | 0 |
| Phleb veins 1 extrm 10-20 stab CPT 37765 | $291.00 | $582.00 | not published | 0 |
| Phleb veins 1 extrm >20 stab CPT 37766 | $359.00 | $718.00 | not published | 0 |
| Phosphorus CPT 84100 | $24.00 | $48.00 | not published | 0 |
| Phosphorus 24 hour urine CPT 84105 | $11.50 | $23.00 | not published | 0 |
| Photopheresis CPT 36522 | $89.50 | $179.00 | not published | 0 |
| Phys blood bank serv reactj CPT 86078 | $45.00 | $90.00 | not published | 0 |
| Physician standby services CPT 99360 | $58.50 | $117.00 | not published | 0 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $3.00 | $6.00 | $4.79 – $4.79 | 1 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $577.00 | $1,154.00 | $957.58 – $957.58 | 1 |
| Pin finger dislocation CPT 26776 | $477.00 | $954.00 | not published | 0 |
| Pin finger fracture each CPT 26756 | $454.00 | $908.00 | not published | 0 |
| Pin hand dislocation CPT 26676 | $538.00 | $1,076.00 | not published | 0 |
| Pin knuckle dislocation CPT 26706 | $461.50 | $923.00 | not published | 0 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $3.00 | $6.00 | $1.95 – $1.95 | 1 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $96.50 | $193.00 | not published | 0 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $83.50 | $167.00 | not published | 0 |
| Placement of seton CPT 46020 | $127.00 | $254.00 | not published | 0 |
| Place right device/marker pros CPT 55876 | $103.50 | $207.00 | not published | 0 |
| Place slctv cath subclavian art CPT 36225 | $357.00 | $714.00 | 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.