Aco annual medicare visit (awv), initial g0438aco at Berkeley Medical Center
2500 Hospital Dr, Martinsburg, WV · Wvumedicine · · NPI 1457389249
$182.00
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$364.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$121.21 with wellpoint wv vs $290.64 with alliance coal — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| wellpoint wv | chip | $121.21 | ↓ -33% |
| highmark health options west va | mgd mcaid | $121.21 | ↓ -33% |
| highmark health options | chip | $121.21 | ↓ -33% |
| wellpoint west virginia | mgd mcaid | $121.21 | ↓ -33% |
| the health plan wv | mgd mcaid | $122.94 | ↓ -32% |
| aetna | better health wv mgd medicaid | $123.52 | ↓ -32% |
| the health plan wv | chip | $123.52 | ↓ -32% |
| aetna better health wv | chip | $123.52 | ↓ -32% |
| peak health medicare advantage | all plans | $166.08 | ↓ -9% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $166.08 | ↓ -9% |
| highmark wholecare pa medicare advantage | all pla | $171.06 | ↓ -6% |
| highmark wv medicare advantage | all plans | $172.72 | ↓ -5% |
| pa health & wellness medicare advantage | all plan | $174.38 | ↓ -4% |
| humana medicare advantage | all plans | $174.38 | ↓ -4% |
| senior life medicare advantage | all plans | $174.38 | ↓ -4% |
| aetna medicare advantage | all plans | $174.38 | ↓ -4% |
| valor health medicare advantage | all plans | $176.04 | ↓ -3% |
| the health plan wv medicare advantage | all plans | $176.04 | ↓ -3% |
| wv senior advantage | isnp | $176.04 | ↓ -3% |
| geisinger pa medicare advantage | all plans | $176.04 | ↓ -3% |
| unitedhealthcare medicare advantage | all plans | $181.03 | ↓ -1% |
| encova | worker's compensation | $249.12 | ↑ +37% |
| caresource oh exchange | caresource oh exchange | $249.12 | ↑ +37% |
| rockport healthcare group | worker's compensation | $257.42 | ↑ +41% |
| coventry health care | worker's compensation | $262.41 | ↑ +44% |
| alliance coal | alliance coal | $290.64 | ↑ +60% |
Visitor-reported prices
Comments
Aco annual medicare visit (awv), initial g0438aco at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jefferson Medical Center | Ranson | $190.00 | not published |
| West Virginia University Hospitals | Morgantown | $234.50 | $107.95 – $703.60 |
| Grant Memorial Hospital | Petersburg | $304.00 | not published |
| Reynolds Memorial Hospital | Glen Dale | $176.00 | $107.95 – $290.64 |
| Summersville Regional Medical Center | Summersville | $310.00 | not published |
| Braxton County Memorial Hospital | Gassaway | $222.00 | not published |
| United Hospital Center | Bridgeport | $206.50 | $121.21 – $290.64 |
| Jackson General Hospital | Ripley | $213.00 | not published |