Nasal/sinus endo w/ethmoidectomy part 31254 at West Virginia University Hospitals
1 Medical Center Dr, Morgantown, WV · Wvumedicine · · NPI 1841271459
$19,997.00
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.
$39,994.00
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.
$205.80 with wellpoint west virginia vs $28,779.14 with blue cross blue shield ppo — 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 west virginia | mgd mcaid | $205.80 | ↓ -99% |
| highmark health options west va | mgd mcaid | $205.80 | ↓ -99% |
| highmark health options | chip | $205.80 | ↓ -99% |
| wellpoint wv | chip | $205.80 | ↓ -99% |
| the health plan wv | mgd mcaid | $208.74 | ↓ -99% |
| aetna better health wv | chip | $209.72 | ↓ -99% |
| the health plan wv | chip | $209.72 | ↓ -99% |
| aetna | better health mgd medicaid | $209.72 | ↓ -99% |
| aetna better health pa | chip | $776.00 | ↓ -96% |
| uhc community pa chip | unison kids | $799.28 | ↓ -96% |
| upmc for you medicaid | upmc for you medicaid | $814.80 | ↓ -96% |
| pennsylvania health and wellness | mgd medicaid | $853.60 | ↓ -96% |
| upmc for kids | chip | $853.60 | ↓ -96% |
| pennsylvania health & wellness | medicaid | $853.60 | ↓ -96% |
| geisinger pennsylvania | mgd medicaid | $931.20 | ↓ -95% |
| highmark wholecare pennsylvania medicaid | highmark wholecare pennsylvania medicaid | $4,415.54 | ↓ -78% |
| molina oh medicare advantage | all plans | $6,793.14 | ↓ -66% |
| highmark pa medicare advantage | hmo | $6,793.14 | ↓ -66% |
| anthem pathway | anthem pathway | $6,793.14 | ↓ -66% |
| peak health medicare advantage | all plans | $6,793.14 | ↓ -66% |
| caresource oh medicare advantage | all plans | $6,793.14 | ↓ -66% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $6,793.14 | ↓ -66% |
| upmc for life medicare advantage | all plans | $6,793.14 | ↓ -66% |
| anthem oh medicare advantage | hmo | $6,996.93 | ↓ -65% |
| highmark wholecare pa medicare advantage | all pla | $6,996.93 | ↓ -65% |
| highmark wv medicare advantage | all plans | $7,064.87 | ↓ -65% |
| humana medicare advantage | all plans | $7,132.80 | ↓ -64% |
| aetna medicare advantage | all plans | $7,132.80 | ↓ -64% |
| pa health & wellness medicare advantage | all plan | $7,132.80 | ↓ -64% |
| buckeye oh medicare advantage | all plans | $7,132.80 | ↓ -64% |
| senior life pa - ma | certain hospitals | $7,132.80 | ↓ -64% |
| the health plan wv medicare advantage | all plans | $7,200.73 | ↓ -64% |
| wv senior advantage | isnp | $7,200.73 | ↓ -64% |
| valor health medicare advantage | all plans | $7,200.73 | ↓ -64% |
| geisinger pa medicare advantage | all plans | $7,200.73 | ↓ -64% |
| unitedhealthcare medicare advantage | all plans | $7,404.52 | ↓ -63% |
| caresource oh exchange | caresource oh exchange | $7,472.45 | ↓ -63% |
| the health plan wv | peia | $7,621.90 | ↓ -62% |
| buckeye commercial | exchange plan | $10,189.71 | ↓ -49% |
| encova | worker's compensation | $10,189.71 | ↓ -49% |
| rockport healthcare group | worker's compensation | $10,529.37 | ↓ -47% |
| coventry health care | worker's compensation | $10,733.16 | ↓ -46% |
| alliance coal | alliance coal | $11,888.00 | ↓ -41% |
| blue cross blue shield traditional | blue cross blue shield traditional | $28,779.14 | ↑ +44% |
| blue cross blue shield ppo | blue cross blue shield ppo | $28,779.14 | ↑ +44% |
Visitor-reported prices
Comments
Nasal/sinus endo w/ethmoidectomy part 31254 at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Berkeley Medical Center | Martinsburg | $5,694.00 | $6,792.27 – $11,886.47 |
| Camden Clark Medical Center | Parkersburg | $2,187.83 | $6,736.74 – $11,789.30 |
| Princeton Community Hospital | Princeton | $4,719.50 | $205.80 – $42,024.72 |
| Thomas Hospitals | South Charleston | $3,670.75 | $205.80 – $34,093.97 |
| Beckley ARH Hospital | Beckley | $1,032.60 | $184.01 – $199.85 |