Established Patient Office Visit (level 4) at Berkeley Medical Center
2500 Hospital Dr, Martinsburg, WV · Wvumedicine · · NPI 1457389249
$96.00
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.
$192.00
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.
$58.23 with aetna vs $133.45 with coventry health care — 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 |
|---|---|---|---|
| aetna | better health va mgd medicaid | $58.23 | ↓ -39% |
| wellpoint wv | chip | $73.09 | ↓ -24% |
| wellpoint west virginia | mgd mcaid | $73.09 | ↓ -24% |
| highmark health options west va | mgd mcaid | $73.09 | ↓ -24% |
| highmark health options | chip | $73.09 | ↓ -24% |
| the health plan wv | mgd mcaid | $74.13 | ↓ -23% |
| aetna | better health wv mgd medicaid | $74.48 | ↓ -22% |
| aetna better health wv | chip | $74.48 | ↓ -22% |
| the health plan wv | chip | $74.48 | ↓ -22% |
| peak health medicare advantage | all plans | $84.46 | ↓ -12% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $84.46 | ↓ -12% |
| highmark wholecare pa medicare advantage | all pla | $86.99 | ↓ -9% |
| highmark wv medicare advantage | all plans | $87.84 | ↓ -9% |
| pa health & wellness medicare advantage | all plan | $88.68 | ↓ -8% |
| humana medicare advantage | all plans | $88.68 | ↓ -8% |
| senior life medicare advantage | all plans | $88.68 | ↓ -8% |
| aetna medicare advantage | all plans | $88.68 | ↓ -8% |
| valor health medicare advantage | all plans | $89.53 | ↓ -7% |
| the health plan wv medicare advantage | all plans | $89.53 | ↓ -7% |
| wv senior advantage | isnp | $89.53 | ↓ -7% |
| geisinger pa medicare advantage | all plans | $89.53 | ↓ -7% |
| unitedhealthcare medicare advantage | all plans | $92.06 | ↓ -4% |
| encova | worker's compensation | $126.69 | ↑ +32% |
| caresource oh exchange | caresource oh exchange | $126.69 | ↑ +32% |
| rockport healthcare group | worker's compensation | $130.91 | ↑ +36% |
| coventry health care | worker's compensation | $133.45 | ↑ +39% |
Visitor-reported prices
Comments
Established Patient Office Visit (level 4) at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jefferson Medical Center | Ranson | $105.50 | not published |
| West Virginia University Hospitals | Morgantown | $72.50 | $54.42 – $357.81 |
| Grant Memorial Hospital | Petersburg | $168.80 | not published |
| Reynolds Memorial Hospital | Glen Dale | $68.00 | $54.90 – $133.45 |
| Summersville Regional Medical Center | Summersville | $105.50 | not published |
| Braxton County Memorial Hospital | Gassaway | $105.50 | not published |
| Jackson General Hospital | Ripley | $200.00 | not published |
| Potomac Valley Hospital | Keyser | $145.00 | not published |