Tonsillectomy (child under 12) at West Virginia University Hospitals
1 Medical Center Dr, Morgantown, WV · Wvumedicine · · NPI 1841271459
$5,152.50
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.
$10,305.00
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 $24,140.04 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 | ↓ -96% |
| highmark health options west va | mgd mcaid | $205.80 | ↓ -96% |
| highmark health options | chip | $205.80 | ↓ -96% |
| wellpoint wv | chip | $205.80 | ↓ -96% |
| the health plan wv | mgd mcaid | $208.74 | ↓ -96% |
| aetna better health wv | chip | $209.72 | ↓ -96% |
| the health plan wv | chip | $209.72 | ↓ -96% |
| aetna | better health mgd medicaid | $209.72 | ↓ -96% |
| aetna better health pa | chip | $694.00 | ↓ -87% |
| uhc community pa chip | unison kids | $714.82 | ↓ -86% |
| upmc for you medicaid | upmc for you medicaid | $728.70 | ↓ -86% |
| pennsylvania health and wellness | mgd medicaid | $763.40 | ↓ -85% |
| upmc for kids | chip | $763.40 | ↓ -85% |
| pennsylvania health & wellness | medicaid | $763.40 | ↓ -85% |
| geisinger pennsylvania | mgd medicaid | $832.80 | ↓ -84% |
| highmark wholecare pennsylvania medicaid | highmark wholecare pennsylvania medicaid | $3,703.77 | ↓ -28% |
| molina oh medicare advantage | all plans | $5,698.11 | ↑ +11% |
| highmark pa medicare advantage | hmo | $5,698.11 | ↑ +11% |
| anthem pathway | anthem pathway | $5,698.11 | ↑ +11% |
| peak health medicare advantage | all plans | $5,698.11 | ↑ +11% |
| caresource oh medicare advantage | all plans | $5,698.11 | ↑ +11% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $5,698.11 | ↑ +11% |
| upmc for life medicare advantage | all plans | $5,698.11 | ↑ +11% |
| anthem oh medicare advantage | hmo | $5,869.05 | ↑ +14% |
| highmark wholecare pa medicare advantage | all pla | $5,869.05 | ↑ +14% |
| highmark wv medicare advantage | all plans | $5,926.03 | ↑ +15% |
| humana medicare advantage | all plans | $5,983.02 | ↑ +16% |
| aetna medicare advantage | all plans | $5,983.02 | ↑ +16% |
| pa health & wellness medicare advantage | all plan | $5,983.02 | ↑ +16% |
| buckeye oh medicare advantage | all plans | $5,983.02 | ↑ +16% |
| senior life pa - ma | certain hospitals | $5,983.02 | ↑ +16% |
| the health plan wv medicare advantage | all plans | $6,040.00 | ↑ +17% |
| wv senior advantage | isnp | $6,040.00 | ↑ +17% |
| valor health medicare advantage | all plans | $6,040.00 | ↑ +17% |
| geisinger pa medicare advantage | all plans | $6,040.00 | ↑ +17% |
| unitedhealthcare medicare advantage | all plans | $6,210.94 | ↑ +21% |
| caresource oh exchange | caresource oh exchange | $6,267.92 | ↑ +22% |
| the health plan wv | peia | $6,393.28 | ↑ +24% |
| buckeye commercial | exchange plan | $8,547.17 | ↑ +66% |
| encova | worker's compensation | $8,547.17 | ↑ +66% |
| rockport healthcare group | worker's compensation | $8,832.07 | ↑ +71% |
| coventry health care | worker's compensation | $9,003.01 | ↑ +75% |
| alliance coal | alliance coal | $9,971.69 | ↑ +94% |
| blue cross blue shield traditional | blue cross blue shield traditional | $24,140.04 | ↑ +369% |
| blue cross blue shield ppo | blue cross blue shield ppo | $24,140.04 | ↑ +369% |
Visitor-reported prices
Comments
Tonsillectomy (child under 12) at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Grant Memorial Hospital | Petersburg | $431.20 | not published |
| Summersville Regional Medical Center | Summersville | $279.50 | not published |
| Berkeley Medical Center | Martinsburg | $2,141.34 | $205.80 – $9,970.45 |
| Braxton County Memorial Hospital | Gassaway | $269.50 | not published |
| Jackson General Hospital | Ripley | $279.50 | not published |
| Potomac Valley Hospital | Keyser | $269.50 | not published |
| Camden Clark Medical Center | Parkersburg | $2,688.50 | $205.80 – $9,888.92 |
| St. Joseph's Hospital | Buckhannon | $290.50 | not published |