Grant Memorial Hospital
117 Hospital Dr, Petersburg, WV · Wvumedicine · · NPI 1013603919
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| 17-hydroxypregnenolone CPT 84143 | $88.80 | $111.00 | not published | 0 |
| 1st hosp/birthing center care per day nml nb 99460 CPT 99460 | $161.60 | $202.00 | not published | 0 |
| 1st psyc collab care mgmt CPT 99492 | $150.40 | $188.00 | not published | 0 |
| 1st/sbsq psyc collab care CPT 99494 | $112.00 | $140.00 | not published | 0 |
| 2nd order venous cath CPT 36012 | $293.60 | $367.00 | not published | 0 |
| 3d recon without postprocess indpndt CPT 76376 | $515.20 | $644.00 | not published | 0 |
| 5' nucleotidase - sendout CPT 83915 | $47.20 | $59.00 | not published | 0 |
| 88334 ap bill cytologic exam each additional site CPT 88334 | $61.60 | $77.00 | not published | 0 |
| 99381 initial comp preventive med less than 1 year new CPT 99381 | $184.80 | $231.00 | not published | 0 |
| 99382 initial comp preventive med 1 to 4 years new CPT 99382 | $124.00 | $155.00 | not published | 0 |
| 99383 initial comp preventive med 5 to 11 years new CPT 99383 | $170.40 | $213.00 | not published | 0 |
| 99391 periodic comp preventive med less than 1 year est CPT 99391 | $131.20 | $164.00 | not published | 0 |
| 99392 periodic comp preventive med 1 to 4 years est CPT 99392 | $146.40 | $183.00 | not published | 0 |
| 99393 periodic comp preventive med 5 to 11 years est CPT 99393 | $145.60 | $182.00 | not published | 0 |
| 99394 periodic comp preventive med 12 to 17 years est CPT 99394 | $160.80 | $201.00 | not published | 0 |
| 99397 periodic comp preventive med 65+ years est CPT 99397 | $177.60 | $222.00 | not published | 0 |
| #a/b/c/c/h pnl-candida albicans ab CPT 86628 | $132.80 | $166.00 | not published | 0 |
| Abd exp/postop hem/throm/infec 35840 CPT 35840 | $2,123.20 | $2,654.00 | not published | 0 |
| Abd/low ext cath 1st CPT 36245 | $395.20 | $494.00 | not published | 0 |
| Abd/low ext cath 2nd CPT 36246 | $428.00 | $535.00 | not published | 0 |
| Abd/low ext cath 3rd CPT 36247 | $493.60 | $617.00 | not published | 0 |
| Abdominal CT scan (with and without contrast) CPT 74170 | $766.40 | $958.00 | not published | 0 |
| Abdominal CT scan (with contrast) CPT 74160 | $766.40 | $958.00 | not published | 0 |
| Abdominal CT scan (without contrast) CPT 74150 | $472.00 | $590.00 | not published | 0 |
| Abdominal MRI (with and without contrast) CPT 74183 | $1,588.80 | $1,986.00 | not published | 0 |
| Abdominal MRI (with contrast) CPT 74182 | $2,206.40 | $2,758.00 | not published | 0 |
| Abdominal MRI (without contrast) CPT 74181 | $969.60 | $1,212.00 | not published | 0 |
| Abdominal paracentesis w/image guidance CPT 49083 | $1,651.20 | $2,064.00 | not published | 0 |
| Abdominal Ultrasound (complete) CPT 76700 | $260.00 | $325.00 | not published | 0 |
| Abdominal Ultrasound (limited) CPT 76705 | $257.60 | $322.00 | not published | 0 |
| Abdominoplasty 15830 CPT 15830 | $1,948.00 | $2,435.00 | not published | 0 |
| Abd paracentesis/w/o image guide 49082 CPT 49082 | $1,389.60 | $1,737.00 | not published | 0 |
| Ablate bone tumor(s) perq CPT 20982 | $604.00 | $755.00 | not published | 0 |
| Ablation cryo thigh/knee CPT 27599 | $1,996.80 | $2,496.00 | not published | 0 |
| Ablation of upper extremity nerves rf CPT 64999 | $4,185.60 | $5,232.00 | not published | 0 |
| Abobotulinumtoxina HCPCS J0586 | $20.80 | $26.00 | $14.54 – $14.54 | 1 |
| Abscess drain retroperitoneal surg code CPT 49406 | $311.20 | $389.00 | not published | 0 |
| Acetaminophen 10 mg/ml soln 100 ml glass cont HCPCS J0131 | $28.80 | $36.00 | $0.08 – $0.08 | 1 |
| Acetaminophen level CPT 80143 | $24.80 | $31.00 | not published | 0 |
| Acetazolamide 500 mg solution for injection HCPCS J1120 | $24.80 | $31.00 | $31.00 – $31.00 | 1 |
| Acetone qualitative CPT 82009 | $4.00 | $5.00 | not published | 0 |
| Acetylcholine receptor modulating antibody CPT 86043 | $80.00 | $100.00 | not published | 0 |
| Acetylcysteine 200 mg/ml (20 %) intravenous solution HCPCS J0132 | $72.63 | $90.79 | not published | 0 |
| Acetylcysteine non-comp unit HCPCS J7608 | $27.79 | $34.74 | $11.27 – $11.27 | 1 |
| Acne surgery 10040 CPT 10040 | $77.60 | $97.00 | not published | 0 |
| Aco annual medicare visit (awv), initial g0438aco HCPCS G0438 | $304.00 | $380.00 | not published | 0 |
| Aco annual medicare visit (awv), subsq g0439aco HCPCS G0439 | $239.20 | $299.00 | not published | 0 |
| Aco ccm; at least 20 min 99490aco CPT 99490 | $156.00 | $195.00 | not published | 0 |
| Aco ccm; ea addl 20 min 99439aco CPT 99439 | $56.00 | $70.00 | not published | 0 |
| Aco cmplx chron care addl 20 min 99489aco CPT 99489 | $80.00 | $100.00 | not published | 0 |
| Aco cmplx chron care without pt visit, 60 min 99487aco CPT 99487 | $291.20 | $364.00 | not published | 0 |
| Aco cont gluc mnt phys/qhp eqp 95250aco CPT 95250 | $244.80 | $306.00 | not published | 0 |
| Aco depression screen annual medicare g0444aco HCPCS G0444 | $36.00 | $45.00 | not published | 0 |
| Acromp/acromionectomy prtl CPT 23130 | $1,056.00 | $1,320.00 | not published | 0 |
| Acute hepatitis panel CPT 80074 | $60.00 | $75.00 | not published | 0 |
| Acyclovir 5 mg/ml in ns IV syringe (neo/ped) - cnr HCPCS J0133 | $5.97 | $7.46 | not published | 0 |
| #acylcarnitineprfl CPT 82017 | $28.00 | $35.00 | not published | 0 |
| Adenosine 3 mg/250 ml bag for osm HCPCS J0153 | $26.42 | $33.02 | $0.99 – $0.99 | 1 |
| Adh-sendout CPT 84588 | $172.00 | $215.00 | not published | 0 |
| Adj tis trans/see area/10.1-30sqcm 14041 CPT 14041 | $1,168.00 | $1,460.00 | not published | 0 |
| Admelog u-100 insulin lispro 100 unit/ml subcutaneous solution HCPCS J1815 | $42.94 | $53.67 | $0.92 – $0.92 | 1 |
| Admin ecg contrast agent CPT 93352 | $59.20 | $74.00 | not published | 0 |
| Administration chemotherapy IV infusion each additional hour CPT 96415 | $372.00 | $465.00 | not published | 0 |
| Administration chemotherapy IV infusion each addl sequential infusion diff substance/drug >1 hr CPT 96417 | $248.00 | $310.00 | not published | 0 |
| Administration chemotherapy IV infusion up to 1 hour single/initial substance/drug CPT 96413 | $652.80 | $816.00 | not published | 0 |
| Administration chemotherapy IV push single/initial substance/drug CPT 96409 | $407.20 | $509.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic hormonal CPT 96402 | $130.40 | $163.00 | not published | 0 |
| Administration chemotherapy subcutaneous/im anti neoplastic non hormonal CPT 96401 | $248.00 | $310.00 | not published | 0 |
| Administration immunization 1 vaccine CPT 90471 | $60.80 | $76.00 | not published | 0 |
| Administration immunization each additional vaccine CPT 90472 | $39.20 | $49.00 | not published | 0 |
| Administration immunization intranasal/oral route 1 vaccine CPT 90473 | $59.20 | $74.00 | not published | 0 |
| Administration immunization intranasal/oral route each additional vaccine CPT 90474 | $18.40 | $23.00 | not published | 0 |
| Administration rsv monoclonal ab seasonal dose im w/counseling CPT 96380 | $62.40 | $78.00 | not published | 0 |
| Administration vaccine hepatitis b HCPCS G0010 | $40.80 | $51.00 | not published | 0 |
| Administration vaccine influenza virus HCPCS G0008 | $40.80 | $51.00 | not published | 0 |
| Administration vaccine pneumococcal HCPCS G0009 | $60.80 | $76.00 | not published | 0 |
| Ado-trastuzumab emtansine 100 mg intravenous solution HCPCS J9354 | $15,093.74 | $18,867.18 | not published | 0 |
| Adrenalin epinephrine inject HCPCS J0171 | $271.80 | $339.75 | not published | 0 |
| Advance care planning each additional 30 min 99498 CPT 99498 | $115.20 | $144.00 | not published | 0 |
| _afb id by dna probe rflx ast CPT 87149 | $232.00 | $290.00 | not published | 0 |
| Aflibercept injection HCPCS J0178 | $1,355.20 | $1,694.00 | $1,422.76 – $1,422.76 | 1 |
| After cataract laser surgery CPT 66821 | $473.60 | $592.00 | not published | 0 |
| Air conduction bilat CPT 92552 | $193.60 | $242.00 | not published | 0 |
| Albumin body fluid quantitative each specimen CPT 82042 | $20.00 | $25.00 | not published | 0 |
| Albumin (human), 25%, 50ml HCPCS P9047 | $98.40 | $123.00 | $87.58 – $87.58 | 1 |
| Albumin (microalbumin) 24 hour urine quantitative CPT 82043 | $19.20 | $24.00 | not published | 0 |
| Albumin serum plasma or whole blood CPT 82040 | $11.20 | $14.00 | not published | 0 |
| Albuterol ipratrop non-comp HCPCS J7620 | $1.60 | $2.00 | $0.28 – $0.28 | 1 |
| Alcohol (ethanol) any specimen except urine/breath CPT 82077 | $44.80 | $56.00 | not published | 0 |
| Alcohol/subs interv 15-30mn HCPCS G0396 | $57.60 | $72.00 | not published | 0 |
| Alkaline phosphatase CPT 84075 | $28.80 | $36.00 | not published | 0 |
| Allergen alpha lactalbumin ige CPT 86008 | $74.40 | $93.00 | not published | 0 |
| Allergen egg white ige CPT 86003 | $220.80 | $276.00 | not published | 0 |
| Allergen specific ige qual multi scrn ea CPT 86005 | $26.40 | $33.00 | not published | 0 |
| Allergy injections; 2 or more 95117 CPT 95117 | $50.40 | $63.00 | not published | 0 |
| Allergy injection; single 95115 CPT 95115 | $38.40 | $48.00 | not published | 0 |
| Allergy Skin Testing CPT 95004 | $6.40 | $8.00 | not published | 0 |
| Allograft amnioexcel plus 17mm disk HCPCS Q4137 | $191.20 | $239.00 | $187.57 – $187.57 | 1 |
| Allograft amniotic activebarrier 200 2x2cm-q4100-cost per sheet HCPCS Q4100 | $0.01 | $0.01 | not published | 0 |
| Allograft graftjacket 2x12cm-q4107-cost per sq cm HCPCS Q4107 | $191.20 | $239.00 | $225.18 – $225.18 | 1 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.