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 |
|---|---|---|---|---|
| CT upper extremity without contrast (both sides) CPT 73200 | $299.00 | $598.00 | not published | 0 |
| CT uppr extremity w/o&w/dye CPT 73202 | $533.50 | $1,067.00 | not published | 0 |
| Culture aerobic additional method definitive id each CPT 87077 | $36.50 | $73.00 | not published | 0 |
| Culture afb any source CPT 87116 | $195.00 | $390.00 | not published | 0 |
| Culture anaerobic additional method definitive id each CPT 87076 | $57.50 | $115.00 | not published | 0 |
| Culture anaerobic except blood CPT 87075 | $57.50 | $115.00 | not published | 0 |
| Culture bact stool aero addl path ea CPT 87046 | $51.00 | $102.00 | not published | 0 |
| Culture body fluid CPT 87070 | $34.00 | $68.00 | not published | 0 |
| Culture fungi definitive id mold CPT 87107 | $48.00 | $96.00 | not published | 0 |
| Culture fungi definitive id yeast CPT 87106 | $50.00 | $100.00 | not published | 0 |
| Culture fungi other (except blood) CPT 87102 | $34.00 | $68.00 | not published | 0 |
| Culture mycobacteria definitive id each isolate CPT 87118 | $140.00 | $280.00 | not published | 0 |
| Culture screening strep group a CPT 87081 | $18.00 | $36.00 | not published | 0 |
| Culture typing immunologic CPT 87147 | $52.50 | $105.00 | not published | 0 |
| Culture typing nucleic acid probe amplified per culture/isolate 6 or more targets CPT 87154 | $363.00 | $726.00 | not published | 0 |
| Culture typing nucleic acid probe amplified per culture/isolate each organism CPT 87150 | $202.00 | $404.00 | not published | 0 |
| Curette/treat cornea CPT 65435 | $66.00 | $132.00 | not published | 0 |
| Curette/treat cornea CPT 65436 | $348.00 | $696.00 | not published | 0 |
| Cv line/pic reposition CPT 36597 | $61.00 | $122.00 | not published | 0 |
| Cv stress test i&r only 93018 CPT 93018 | $15.50 | $31.00 | not published | 0 |
| Cv stress test/supervision only 93016 CPT 93016 | $23.00 | $46.00 | not published | 0 |
| Cyanocobalamin (vit b-12) 1,000 mcg/ml injection solution HCPCS J3420 | $3.00 | $6.00 | $2.38 – $2.38 | 1 |
| Cyclic citrullinated peptide antibody CPT 86200 | $30.50 | $61.00 | not published | 0 |
| Cyclosporine 2 hour CPT 80158 | $39.50 | $79.00 | not published | 0 |
| Cygnus matrix, per sq cm HCPCS Q4199 | $221.50 | $443.00 | $207.00 – $207.00 | 1 |
| Cyp2c19 gene com variants CPT 81225 | $1,175.00 | $2,350.00 | not published | 0 |
| Cystatin c CPT 82610 | $31.00 | $62.00 | not published | 0 |
| Cystogram >= 3 views supervision & interpretation CPT 74430 | $17.00 | $34.00 | not published | 0 |
| Cysto, litho, vacuum kidney HCPCS C9761 | $399.00 | $798.00 | not published | 0 |
| Cystometrogram w/up 51727 CPT 51727 | $345.50 | $691.00 | not published | 0 |
| Cystorrhaphy wound comp 51865 CPT 51865 | $930.50 | $1,861.00 | not published | 0 |
| Cystorrhaphy wound simple 51860 CPT 51860 | $783.00 | $1,566.00 | not published | 0 |
| Cysto rx balo cath urtl strx CPT 52284 | $169.00 | $338.00 | not published | 0 |
| Cystoscopy and biopsy CPT 52007 | $170.50 | $341.00 | not published | 0 |
| Cystoscopy and treatment CPT 52214 | $177.50 | $355.00 | not published | 0 |
| Cystoscopy and treatment CPT 52224 | $205.00 | $410.00 | not published | 0 |
| Cystoscopy and treatment CPT 52234 | $250.50 | $501.00 | not published | 0 |
| Cystoscopy and treatment CPT 52235 | $294.50 | $589.00 | not published | 0 |
| Cystoscopy and treatment CPT 52240 | $399.00 | $798.00 | not published | 0 |
| Cystoscopy and treatment CPT 52260 | $215.00 | $430.00 | not published | 0 |
| Cystoscopy and treatment CPT 52265 | $167.00 | $334.00 | not published | 0 |
| Cystoscopy and treatment CPT 52276 | $270.00 | $540.00 | not published | 0 |
| Cystoscopy and treatment CPT 52301 | $295.50 | $591.00 | not published | 0 |
| Cystoscopy and treatment CPT 52310 | $155.50 | $311.00 | not published | 0 |
| Cystoscopy and treatment CPT 52315 | $281.00 | $562.00 | not published | 0 |
| Cystoscopy and treatment CPT 52320 | $250.50 | $501.00 | not published | 0 |
| Cystoscopy and treatment CPT 52330 | $268.00 | $536.00 | not published | 0 |
| Cystoscopy (Bladder Scope) CPT 52000 | $571.00 | $1,142.00 | not published | 0 |
| Cystoscopy chemodenervation CPT 52287 | $173.00 | $346.00 | not published | 0 |
| Cystoscopy implant stent CPT 52282 | $345.00 | $690.00 | not published | 0 |
| Cystoscopy removal of clots CPT 52001 | $2,881.00 | $5,762.00 | not published | 0 |
| Cystoscopy & revise urethra CPT 52275 | $253.50 | $507.00 | not published | 0 |
| Cystoscopy stone removal CPT 52325 | $327.00 | $654.00 | not published | 0 |
| Cystoscopy & ureter catheter CPT 52005 | $137.00 | $274.00 | not published | 0 |
| Cystostomy cystotomy w/drainage 51040 CPT 51040 | $305.50 | $611.00 | not published | 0 |
| Cystouretero & or pyeloscope CPT 52351 | $308.50 | $617.00 | not published | 0 |
| Cysto/uretero stricture tx CPT 52344 | $376.50 | $753.00 | not published | 0 |
| Cystouretero w/biopsy CPT 52354 | $425.50 | $851.00 | not published | 0 |
| Cystouretero w/excise tumor CPT 52355 | $476.00 | $952.00 | not published | 0 |
| Cysto/uretero w/lithotripsy CPT 52356 | $424.00 | $848.00 | not published | 0 |
| Cystouretero w/lithotripsy CPT 52353 | $399.00 | $798.00 | not published | 0 |
| Cystouretero w/renal strict CPT 52346 | $454.50 | $909.00 | not published | 0 |
| Cystouretero w/stone remove CPT 52352 | $361.50 | $723.00 | not published | 0 |
| Cystourethroscop/calib/dilat stric 52281 CPT 52281 | $157.00 | $314.00 | not published | 0 |
| Cystourethroscopy w/biopsy(s) 52204 CPT 52204 | $146.50 | $293.00 | not published | 0 |
| Cystourethro w/addl implant 52442 CPT 52442 | $51.50 | $103.00 | not published | 0 |
| Cystourethro w/implant CPT 52441 | $213.00 | $426.00 | not published | 0 |
| Cysto w/renal stricture tx CPT 52343 | $350.50 | $701.00 | not published | 0 |
| Cysto w/ureter stricture tx CPT 52341 | $289.50 | $579.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $58.00 | $116.00 | not published | 0 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $10.00 | $20.00 | not published | 0 |
| Cyto/molecular report CPT 88291 | $36.00 | $72.00 | not published | 0 |
| Cytopath fl nongyn filter CPT 88106 | $19.50 | $39.00 | not published | 0 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $29.00 | $58.00 | not published | 0 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | $89.00 | $178.00 | not published | 0 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | $90.00 | $180.00 | not published | 0 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $23.50 | $47.00 | not published | 0 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $29.50 | $59.00 | not published | 0 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $22.50 | $45.00 | not published | 0 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $72.50 | $145.00 | not published | 0 |
| Cytopath smear other source CPT 88162 | $40.50 | $81.00 | not published | 0 |
| Cytopath smear oth prep screen & interp CPT 88161 | $26.50 | $53.00 | not published | 0 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $13.50 | $27.00 | $25.23 – $25.23 | 1 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $0.50 | $1.00 | $0.07 – $0.07 | 1 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $11.50 | $23.00 | $4.83 – $4.83 | 1 |
| Darbepoetin alfa, esrd use HCPCS J0882 | $11.50 | $23.00 | $4.83 – $4.83 | 1 |
| D&c after delivery 59160 CPT 59160 | $199.00 | $398.00 | not published | 0 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | $240.50 | $481.00 | not published | 0 |
| Dch validity tests CPT 81002 | $19.50 | $39.00 | not published | 0 |
| Deamidated gliadin antibody iga CPT 86258 | $61.50 | $123.00 | not published | 0 |
| Debr g/per/abd wall 11006 CPT 11006 | $745.00 | $1,490.00 | not published | 0 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $28.00 | $56.00 | not published | 0 |
| Debridement (>20 cm) charge pt CPT 97598 | $25.50 | $51.00 | not published | 0 |
| Debridement bone <= 20 sq cm CPT 11044 | $234.00 | $468.00 | not published | 0 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $56.50 | $113.00 | not published | 0 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $101.00 | $202.00 | not published | 0 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $389.50 | $779.00 | not published | 0 |
| Debride nail1-5 11720 CPT 11720 | $57.00 | $114.00 | not published | 0 |
| Debride nail6 or more 11721 CPT 11721 | $92.00 | $184.00 | not published | 0 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $307.50 | $615.00 | 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.