Open periprosthetic breast capsule 19370 at West Virginia University Hospitals
1 Medical Center Dr, Morgantown, WV · Wvumedicine · · NPI 1841271459
$7,851.83
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.
$15,703.66
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.
$2,449.71 with highmark wholecare pennsylvania medicaid vs $27,077.51 with blue cross blue shield traditional — 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 |
|---|---|---|---|
| highmark wholecare pennsylvania medicaid | highmark wholecare pennsylvania medicaid | $2,449.71 | ↓ -69% |
| highmark pa medicare advantage | hmo | $3,768.79 | ↓ -52% |
| peak health medicare advantage | all plans | $3,768.79 | ↓ -52% |
| molina oh medicare advantage | all plans | $3,768.79 | ↓ -52% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $3,768.79 | ↓ -52% |
| highmark wholecare pa medicare advantage | all pla | $3,881.85 | ↓ -51% |
| highmark wv medicare advantage | all plans | $3,919.54 | ↓ -50% |
| upmc for life medicare advantage | all plans | $3,957.23 | ↓ -50% |
| aetna medicare advantage | all plans | $3,957.23 | ↓ -50% |
| pa health & wellness medicare advantage | all plan | $3,957.23 | ↓ -50% |
| buckeye oh medicare advantage | all plans | $3,957.23 | ↓ -50% |
| humana medicare advantage | all plans | $3,957.23 | ↓ -50% |
| valor health medicare advantage | all plans | $3,994.92 | ↓ -49% |
| the health plan wv medicare advantage | all plans | $3,994.92 | ↓ -49% |
| geisinger pa medicare advantage | all plans | $3,994.92 | ↓ -49% |
| wv senior advantage | isnp | $3,994.92 | ↓ -49% |
| unitedhealthcare medicare advantage | all plans | $4,107.98 | ↓ -48% |
| the health plan wv | peia | $4,228.58 | ↓ -46% |
| buckeye commercial | exchange plan | $5,653.18 | ↓ -28% |
| caresource oh exchange | caresource oh exchange | $5,653.18 | ↓ -28% |
| encova | worker's compensation | $5,653.18 | ↓ -28% |
| rockport healthcare group | worker's compensation | $5,841.62 | ↓ -26% |
| coventry health care | worker's compensation | $5,954.69 | ↓ -24% |
| caresource oh medicare advantage | all plans | $6,391.48 | ↓ -19% |
| anthem pathway | anthem pathway | $6,391.48 | ↓ -19% |
| anthem oh medicare advantage | hmo | $6,583.22 | ↓ -16% |
| senior life pa - ma | certain hospitals | $6,711.05 | ↓ -15% |
| alliance coal | alliance coal | $9,987.29 | ↑ +27% |
| blue cross blue shield ppo | blue cross blue shield ppo | $27,077.51 | ↑ +245% |
| blue cross blue shield traditional | blue cross blue shield traditional | $27,077.51 | ↑ +245% |
Visitor-reported prices
Comments
Open periprosthetic breast capsule 19370 at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Camden Clark Medical Center | Parkersburg | $1,937.83 | $3,737.51 – $6,540.64 |