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 |
|---|---|---|---|---|
| Destroy vulva lesion simple 56501 CPT 56501 | $212.00 | $265.00 | not published | 0 |
| Destruct ben lesion 15/> 17111 CPT 17111 | $247.20 | $309.00 | not published | 0 |
| Destruct cut vasl lesions 10-50cm 17107 CPT 17107 | $546.40 | $683.00 | not published | 0 |
| Destruct cut vasl lesions <10cm 17106 CPT 17106 | $424.80 | $531.00 | not published | 0 |
| Destruct cut vasl lesions >50cm 17108 CPT 17108 | $812.00 | $1,015.00 | not published | 0 |
| Destruction 2-14 lesions 17003 CPT 17003 | $3.20 | $4.00 | not published | 0 |
| Destruction anal lesion(s) CPT 46910 | $232.00 | $290.00 | not published | 0 |
| Destruction anal lesion(s) smpl chem 46900 CPT 46900 | $234.40 | $293.00 | not published | 0 |
| Destruction benign lesions < 14 lesions CPT 17110 | $308.00 | $385.00 | not published | 0 |
| Destruction by injection tx of nerve 64630 CPT 64630 | $335.20 | $419.00 | not published | 0 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral additional (both sides) CPT 64636 | $93.60 | $117.00 | not published | 0 |
| Destruction by neurolytic agent w/imaging guidance lumbar/sacral (both sides) CPT 64635 | $311.20 | $389.00 | not published | 0 |
| Destruction penis lesion(s) chem 54050 CPT 54050 | $168.80 | $211.00 | not published | 0 |
| Destruction penis lesion(s) exten 54065 CPT 54065 | $268.00 | $335.00 | not published | 0 |
| Destruction premal lesions 15/> 17004 CPT 17004 | $146.40 | $183.00 | not published | 0 |
| Destruction vag lesions complex 57065 CPT 57065 | $300.80 | $376.00 | not published | 0 |
| Destruction vag lesions simple 57061 CPT 57061 | $185.60 | $232.00 | not published | 0 |
| Destruct penis les/smp/electrodesi 54055 CPT 54055 | $152.80 | $191.00 | not published | 0 |
| Detect agent nos dna dir CPT 87797 | $316.80 | $396.00 | not published | 0 |
| Determine refractive state CPT 92015 | $28.80 | $36.00 | not published | 0 |
| Developmental screen/score/document 96110 CPT 96110 | $21.60 | $27.00 | not published | 0 |
| Device ablt adv novasure HCPCS C1886 | $644.91 | $806.14 | not published | 0 |
| Device intraute mirena HCPCS J7298 | $2,915.20 | $3,644.00 | $2,290.45 – $2,290.45 | 1 |
| Dexa bone density study >=1 sites appendicular skeleton (peripheral) CPT 77081 | $132.00 | $165.00 | not published | 0 |
| Dexamethasone 4 mg tablet HCPCS J8540 | $168.80 | $211.00 | $0.13 – $0.13 | 1 |
| Dexamethasone in ns IV syringe 0.1 mg/ml (neonate) - cnr HCPCS J1100 | $6.48 | $8.10 | $0.20 – $0.20 | 1 |
| Dexamethasone intra implant HCPCS J7312 | $471.20 | $589.00 | $339.26 – $339.26 | 1 |
| Dextrose 5 % in water (d5w) intravenous solution (non-pvc) HCPCS J7060 | $24.00 | $30.00 | not published | 0 |
| Dhea-s (dehydroepiand sulfate) CPT 82627 | $68.00 | $85.00 | not published | 0 |
| Diabetes (HbA1c) Test CPT 83036 | $20.00 | $25.00 | not published | 0 |
| Diag laparo separate proc 49320 CPT 49320 | $3,964.63 | $4,955.79 | not published | 0 |
| Diagnostic anoscopy CPT 46601 | $156.00 | $195.00 | not published | 0 |
| Diagnostic anoscopy spx 46600 CPT 46600 | $204.00 | $255.00 | not published | 0 |
| Diagnostic digital breast tomosynthesis bil CPT 77062 | $64.80 | $81.00 | not published | 0 |
| Diagnostic digital breast tomosynthesis unil CPT 77061 | $64.80 | $81.00 | not published | 0 |
| Diagnostic laryngoscopy 31575 CPT 31575 | $108.80 | $136.00 | not published | 0 |
| Diagnostic Mammogram (both breasts) CPT 77066 | $240.00 | $300.00 | not published | 0 |
| Diagnostic Mammogram (one breast) CPT 77065 | $188.00 | $235.00 | not published | 0 |
| Dialysis circuit perm vascular embolization 36909 CPT 36909 | $335.20 | $419.00 | not published | 0 |
| Diazepam 5 mg/ml injection solution (wrapper) HCPCS J3360 | $34.18 | $42.72 | $9.03 – $9.03 | 1 |
| Dicyclomine injection HCPCS J0500 | $17.64 | $22.05 | $22.05 – $22.05 | 1 |
| Diffusing capacity CPT 94729 | $96.00 | $120.00 | not published | 0 |
| Digoxin 250 mcg/ml (0.25 mg/ml) injection solution HCPCS J1160 | $3.40 | $4.25 | $4.25 – $4.25 | 1 |
| Digoxin total therapeutic drug level CPT 80162 | $25.60 | $32.00 | not published | 0 |
| Dihydroergotamine 0.05 mg/ml IV syringe - cnr HCPCS J1110 | $104.00 | $130.00 | $69.86 – $69.86 | 1 |
| Dilate biliary duct/ampulla CPT 47542 | $220.00 | $275.00 | not published | 0 |
| Dilate esophagus 1/mult pass CPT 43450 | $132.00 | $165.00 | not published | 0 |
| Dilate tear duct opening CPT 68801 | $122.40 | $153.00 | not published | 0 |
| Dilate urethra stricture CPT 53600 | $383.20 | $479.00 | not published | 0 |
| Dilate urethra stricture CPT 53601 | $88.00 | $110.00 | not published | 0 |
| Dilate urethra stricture CPT 53605 | $104.00 | $130.00 | not published | 0 |
| Dilate urethra stricture CPT 53621 | $383.20 | $479.00 | not published | 0 |
| Dilation/female urethra/initial 53660 CPT 53660 | $68.00 | $85.00 | not published | 0 |
| Dilation of anal sphincter CPT 45905 | $301.60 | $377.00 | not published | 0 |
| Dilation of rectal stricture 45910 CPT 45910 | $338.40 | $423.00 | not published | 0 |
| Dilation of urethra CPT 53661 | $65.60 | $82.00 | not published | 0 |
| Dilation/urethral strict/male/ini 53620 CPT 53620 | $1,068.80 | $1,336.00 | not published | 0 |
| Diltiazem 5 mg/ml intravenous solution HCPCS J1163 | $3.79 | $4.74 | not published | 0 |
| Dimethyl sulfoxide 50% 50 ml HCPCS J1212 | $1,608.80 | $2,011.00 | $1,123.35 – $1,123.35 | 1 |
| Diphenhydramine 12.5 mg/5 ml oral elixir HCPCS Q0163 | $1.60 | $2.00 | $2.00 – $2.00 | 1 |
| Diphenhydramine 50 mg/ml injection (wrapper) HCPCS J1200 | $2.40 | $3.00 | $0.50 – $0.50 | 1 |
| Disability dlco CPT 94727 | $516.00 | $645.00 | not published | 0 |
| Disaccharidases CPT 82657 | $664.00 | $830.00 | not published | 0 |
| Dist revas ligation hemo CPT 36838 | $1,995.20 | $2,494.00 | not published | 0 |
| Dna antibody native/double stranded CPT 86225 | $288.00 | $360.00 | not published | 0 |
| Dobutamine 250 mg/20 ml (12.5 mg/ml) intravenous solution HCPCS J1250 | $66.00 | $82.50 | not published | 0 |
| Docetaxel 20 mg/ml intravenous solution (wrapper) HCPCS J9171 | $75.17 | $93.96 | $1.65 – $1.65 | 1 |
| Dopamine 40 mg/ml intravenous solution (wrapper) HCPCS J1265 | $25.80 | $32.25 | not published | 0 |
| Doppler echo complete CPT 93320 | $31.20 | $39.00 | not published | 0 |
| Doppler upper/lower extremity arteries complete bilateral CPT 93923 | $331.20 | $414.00 | not published | 0 |
| Doppler upper/lower extremity arteries limited bilateral CPT 93922 | $204.00 | $255.00 | not published | 0 |
| Dostarlimab-gxly 50 mg/ml intravenous solution HCPCS J9272 | $27,751.49 | $34,689.36 | not published | 0 |
| Double transfer toe-hand CPT 26554 | $6,308.00 | $7,885.00 | not published | 0 |
| Doxorubicin 2 mg/ml intravenous solution (wrapper) HCPCS J9000 | $35.76 | $44.70 | $5.41 – $5.41 | 1 |
| Dpyd gene common variants CPT 81232 | $1,280.00 | $1,600.00 | not published | 0 |
| Drainage absc/cyst/hmtma/vestibule mouth smpl CPT 40800 | $1,160.80 | $1,451.00 | not published | 0 |
| Drainage ext aud canal abscess 69020 CPT 69020 | $230.40 | $288.00 | not published | 0 |
| Drainage external ear simple 69000 CPT 69000 | $206.40 | $258.00 | not published | 0 |
| Drainage lymph node lesion 38300 CPT 38300 | $383.20 | $479.00 | not published | 0 |
| Drainage mouth roof lesion CPT 42000 | $174.40 | $218.00 | not published | 0 |
| Drainage of arm bursa 23931 CPT 23931 | $279.20 | $349.00 | not published | 0 |
| Drainage of eye CPT 65800 | $129.60 | $162.00 | not published | 0 |
| Drainage of eye CPT 65815 | $717.60 | $897.00 | not published | 0 |
| Drainage of forearm bursa CPT 25031 | $643.20 | $804.00 | not published | 0 |
| Drainage of mouth lesion CPT 41005 | $363.20 | $454.00 | not published | 0 |
| Drainage of mouth lesion CPT 41017 | $563.20 | $704.00 | not published | 0 |
| Drainage of nose lesion int 30000 CPT 30000 | $194.40 | $243.00 | not published | 0 |
| Drainage of pelvis lesion 26990 CPT 26990 | $1,172.00 | $1,465.00 | not published | 0 |
| Drainage of rectal abscess CPT 45005 | $1,946.40 | $2,433.00 | not published | 0 |
| Drain blood from under nail 11740 CPT 11740 | $281.60 | $352.00 | not published | 0 |
| Drain cath image guided peri/retroperitoneal transvag/transrectal CPT 49407 | $337.60 | $422.00 | not published | 0 |
| Drain cath image guided visceral pq CPT 49405 | $311.20 | $389.00 | not published | 0 |
| Drain cerebro spinal fluid 62272 CPT 62272 | $1,595.20 | $1,994.00 | not published | 0 |
| Drain finger abscess;simple 26010 CPT 26010 | $308.00 | $385.00 | not published | 0 |
| Drain lower leg lesion 27603 CPT 27603 | $664.00 | $830.00 | not published | 0 |
| Drain neck/chest lesion 21501 CPT 21501 | $581.60 | $727.00 | not published | 0 |
| Drain ovary abscess open CPT 58820 | $548.00 | $685.00 | not published | 0 |
| Drain shoulder lesion CPT 23030 | $440.00 | $550.00 | not published | 0 |
| Drain thigh/knee lesion 27301 CPT 27301 | $874.40 | $1,093.00 | not published | 0 |
| Dress/debride pt-tck burn/5-10% bs 16025 CPT 16025 | $184.80 | $231.00 | not published | 0 |
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.