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 |
|---|---|---|---|---|
| Sigmoidoscopy for bleeding CPT 45334 | $120.00 | $240.00 | not published | 0 |
| Sigmoidoscopy/submucosal injection 45335 CPT 45335 | $70.00 | $140.00 | not published | 0 |
| Sigmoidoscopy w/ablation CPT 45346 | $163.50 | $327.00 | not published | 0 |
| Sigmoidoscopy w/fb removal 45332 CPT 45332 | $108.50 | $217.00 | not published | 0 |
| Sigmoidoscopy w/resection CPT 45349 | $200.00 | $400.00 | not published | 0 |
| Sigmoidoscopy w/tumr remove CPT 45338 | $130.00 | $260.00 | not published | 0 |
| Sigmoid/rmv tumor/polyp/hot bx for 45333 CPT 45333 | $98.50 | $197.00 | not published | 0 |
| Sig w/tndsc balloon dilation CPT 45340 | $82.00 | $164.00 | not published | 0 |
| Simple cystometrogram 51725 CPT 51725 | $209.00 | $418.00 | not published | 0 |
| Sinus CT scan (with and without contrast) CPT 70488 | $542.50 | $1,085.00 | not published | 0 |
| Sinus CT scan (with contrast) CPT 70487 | $442.50 | $885.00 | not published | 0 |
| Sinus CT scan (without contrast) CPT 70486 | $304.00 | $608.00 | not published | 0 |
| Skel musc relaxant 3 or more CPT 80370 | $5.00 | $10.00 | not published | 0 |
| Skin Biopsy CPT 11102 | $319.50 | $639.00 | not published | 0 |
| Skin full graft 20sq cm less 15200 CPT 15200 | $679.00 | $1,358.00 | not published | 0 |
| Skin split graft addl 100sq cm 15101 CPT 15101 | $116.50 | $233.00 | not published | 0 |
| Skyla, 13.5 mg HCPCS J7301 | $1,517.50 | $3,035.00 | $1,907.17 – $1,907.17 | 1 |
| Sleep study unattended CPT 95806 | $50.00 | $100.00 | not published | 0 |
| Slitting of prepuce CPT 54001 | $145.50 | $291.00 | not published | 0 |
| Slp pure tone screening CPT 92551 | $13.50 | $27.00 | not published | 0 |
| Small bowel endoscopy/biopsy CPT 44361 | $159.50 | $319.00 | not published | 0 |
| Small bowel endoscopy/biopsy CPT 44377 | $298.50 | $597.00 | not published | 0 |
| Smear fluorescent and/or acid fast stain CPT 87206 | $18.50 | $37.00 | not published | 0 |
| Smear gram stain CPT 87205 | $15.50 | $31.00 | not published | 0 |
| Smear special stain inclusion bodies/parasites CPT 87207 | $22.50 | $45.00 | not published | 0 |
| Smear wet mount CPT 87210 | $11.00 | $22.00 | not published | 0 |
| Sodium 24 hour urine CPT 84300 | $20.50 | $41.00 | not published | 0 |
| Sodium chloride 0.9 % intravenous solution HCPCS J7030 | $7.00 | $14.00 | $4.44 – $4.44 | 1 |
| Sodium chloride 0.9 % IV bolus HCPCS J7040 | $6.00 | $12.00 | $2.23 – $2.23 | 1 |
| Sodium ferric gluconate complex in sucrose 62.5 mg/5 ml intravenous HCPCS J2916 | $2.50 | $5.00 | $3.91 – $3.91 | 1 |
| Sodium hyaluronate 20 mg/2 ml syringe HCPCS J7321 | $360.50 | $721.00 | $120.62 – $120.62 | 1 |
| Sodium serum/plasma/whole blood CPT 84295 | $24.00 | $48.00 | not published | 0 |
| Sp bone agrft morsel add-on CPT 20937 | $177.00 | $354.00 | not published | 0 |
| Special supplies phys/qhp CPT 99070 | $2.50 | $5.00 | not published | 0 |
| Specific gravity body fluid CPT 84315 | $9.50 | $19.00 | not published | 0 |
| Speech audiometry complete CPT 92556 | $80.50 | $161.00 | not published | 0 |
| Speech recep thresh CPT 92555 | $30.00 | $60.00 | not published | 0 |
| Spinal puncture lumbar diagnostic w/fluoroscopic or CT guidance CPT 62328 | $85.50 | $171.00 | not published | 0 |
| Spirometry bronchodilation responsiveness pre/post bronchodilator administration CPT 94060 | $411.50 | $823.00 | not published | 0 |
| Splenectomy total open 38100 CPT 38100 | $1,267.00 | $2,534.00 | not published | 0 |
| Splice spleen/kidney veins CPT 37181 | $2,547.00 | $5,094.00 | not published | 0 |
| Split atogrft f/s/n/h/f/g/m/d gt 1st 100sqcm/</1 % CPT 15120 | $696.00 | $1,392.00 | not published | 0 |
| Sprchoroidal spc njx rx agt CPT 67516 | $316.50 | $633.00 | not published | 0 |
| Sputum specimen collection CPT 89220 | $163.50 | $327.00 | not published | 0 |
| St evaluation swallow function CPT 92610 | $130.50 | $261.00 | not published | 0 |
| Strapping of ankle and/or ft 29540 CPT 29540 | $18.00 | $36.00 | not published | 0 |
| Strapping of knee CPT 29530 | $17.50 | $35.00 | not published | 0 |
| Strapping of toes 29550 CPT 29550 | $11.50 | $23.00 | not published | 0 |
| Strep a ag ia CPT 87430 | $27.00 | $54.00 | not published | 0 |
| Strep b dna amp probe CPT 87653 | $18.00 | $36.00 | not published | 0 |
| Stress test pulmonary CPT 94618 | $197.00 | $394.00 | not published | 0 |
| Stress tte complete CPT 93351 | $90.50 | $181.00 | not published | 0 |
| Str markers specimen anal CPT 81265 | $751.50 | $1,503.00 | not published | 0 |
| St treatment speech individual CPT 92507 | $112.50 | $225.00 | not published | 0 |
| St treatment swallow dysfunction/oral CPT 92526 | $112.50 | $225.00 | not published | 0 |
| Subq njx filling matrl 1cc/< CPT 11950 | $51.50 | $103.00 | not published | 0 |
| Sugars single quant CPT 84378 | $520.00 | $1,040.00 | not published | 0 |
| Sulbactam 1 gram-durlobactam 1 gram (0.5 gram x2) intravenous solution HCPCS C9399 | $236.50 | $473.00 | not published | 0 |
| Sulfonylurea screen qn-sendout CPT 80377 | $110.00 | $220.00 | not published | 0 |
| Sumatriptan 6 mg/0.5 ml subcutaneous solution HCPCS J3030 | $8.50 | $17.00 | $17.00 – $17.00 | 1 |
| Supprelin la implant HCPCS J9226 | $75,271.50 | $150,543.00 | $73,550.30 – $73,550.30 | 1 |
| Surg dx exam anorectal CPT 45990 | $115.50 | $231.00 | not published | 0 |
| Surgical pathology level 1 gross examination only CPT 88300 | $37.00 | $74.00 | not published | 0 |
| Surgical pathology level 2 gross & microscopic examination CPT 88302 | $53.50 | $107.00 | not published | 0 |
| Surgical pathology level 3 gross & microscopic examination CPT 88304 | $72.00 | $144.00 | not published | 0 |
| Surgical pathology level 4 gross & microscopic examination CPT 88305 | $106.50 | $213.00 | not published | 0 |
| Surgical pathology level 5 gross & microscopic examination CPT 88307 | $211.50 | $423.00 | not published | 0 |
| Surgical pathology level 6 gross & microscopic examination CPT 88309 | $412.00 | $824.00 | not published | 0 |
| Surgical repair stomach bleedin ulcer 43501 CPT 43501 | $1,498.50 | $2,997.00 | not published | 0 |
| Surg tx anal fistula 2nd stage 46285 CPT 46285 | $472.50 | $945.00 | not published | 0 |
| Susceptibility enzyme detection per enzyme CPT 87185 | $13.00 | $26.00 | not published | 0 |
| Susceptibility mic per plate CPT 87186 | $462.00 | $924.00 | not published | 0 |
| Sutr lg intestine 1/mult perf without colostomy 44604 CPT 44604 | $1,150.50 | $2,301.00 | not published | 0 |
| Synch audio-only est high 40 CPT 98015 | $127.00 | $254.00 | not published | 0 |
| Synch audio-only est low 20 CPT 98013 | $59.50 | $119.00 | not published | 0 |
| Synch audio-only est mod 30 CPT 98014 | $88.50 | $177.00 | not published | 0 |
| Synch audio-only est sf 10 CPT 98012 | $33.00 | $66.00 | not published | 0 |
| Synch audio-only new high 60 CPT 98011 | $156.50 | $313.00 | not published | 0 |
| Synch audio-only new low 30 CPT 98009 | $75.50 | $151.00 | not published | 0 |
| Synch audio-only new mod 45 CPT 98010 | $118.50 | $237.00 | not published | 0 |
| Synch audio-only new sf 15 CPT 98008 | $44.50 | $89.00 | not published | 0 |
| Synvisc or synvisc-one HCPCS J7325 | $20.00 | $40.00 | $15.05 – $15.05 | 1 |
| Syphilis test non-treponemal antibody quantitative rpr CPT 86593 | $33.00 | $66.00 | not published | 0 |
| T3 (triiodothyronine) free CPT 84481 | $95.50 | $191.00 | not published | 0 |
| T3 (triiodothyronine) total CPT 84480 | $29.00 | $58.00 | not published | 0 |
| T4 (thyroxine) free CPT 84439 | $24.00 | $48.00 | not published | 0 |
| T4 (thyroxine) total CPT 84436 | $12.50 | $25.00 | not published | 0 |
| Tacrol envarsus ex rel oral HCPCS J7503 | $2.50 | $5.00 | $2.85 – $2.85 | 1 |
| Tacrolimus therapeutic drug level CPT 80197 | $59.50 | $119.00 | not published | 0 |
| Tap block bilat cont infusion 64489 CPT 64489 | $3,051.00 | $6,102.00 | not published | 0 |
| Tap block uni by cont infusion 64487 CPT 64487 | $1,112.50 | $2,225.00 | not published | 0 |
| Target gsa panel hmtlmph neop CPT 81450 | $2,600.00 | $5,200.00 | not published | 0 |
| Target gsa panel organ neop CPT 81445 | $1,100.00 | $2,200.00 | not published | 0 |
| Tb test cell mediated immunity antigen response enumeration gamma interferon t-cells CPT 86481 | $139.00 | $278.00 | not published | 0 |
| Tb test cell mediated immunity antigen response gamma interferon CPT 86480 | $202.50 | $405.00 | not published | 0 |
| Tc-99m maa HCPCS A9540 | $381.50 | $763.00 | $52.95 – $52.95 | 1 |
| Tc-99m mebrofenin HCPCS A9537 | $92.00 | $184.00 | $184.00 – $184.00 | 1 |
| Tc-99m medronate HCPCS A9503 | $109.50 | $219.00 | $61.59 – $61.59 | 1 |
| Tc-99m pentetate dtpa aerosol HCPCS A9567 | $111.00 | $222.00 | $34.04 – $34.04 | 1 |
| Tc-99m sestamibi p study dose HCPCS A9500 | $363.50 | $727.00 | $727.00 – $727.00 | 1 |
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.