Ex palate/uvula lesion without closure 42104 at Princeton Community Hospital
122 12th St, Princeton, WV · Wvumedicine · · NPI 1558313213
$1,884.67
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.
$3,769.34
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.
$86.50 with molina managed medicaid vs $19,742.48 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 |
|---|---|---|---|
| molina managed medicaid | molina managed medicaid | $86.50 | ↓ -95% |
| aetna better health pa | chip | $95.15 | ↓ -95% |
| highmark health options | chip | $205.80 | ↓ -89% |
| wellpoint west virginia | mgd mcaid | $205.80 | ↓ -89% |
| highmark health options west va | mgd mcaid | $205.80 | ↓ -89% |
| wellpoint wv | chip | $205.80 | ↓ -89% |
| the health plan wv | mgd mcaid | $208.74 | ↓ -89% |
| aetna better health wv | chip | $209.72 | ↓ -89% |
| aetna | better health wv mgd medicaid | $209.72 | ↓ -89% |
| the health plan wv | chip | $209.72 | ↓ -89% |
| aetna | better health va mgd medicaid | $215.60 | ↓ -89% |
| pennsylvania health & wellness | medicaid | $215.60 | ↓ -89% |
| anthem va medicare advantage | hmo | $3,389.50 | ↑ +80% |
| peak health medicare advantage | all plans | $3,389.50 | ↑ +80% |
| optima va medicare advantage | all plans | $3,389.50 | ↑ +80% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $3,389.50 | ↑ +80% |
| highmark wv medicare advantage | all plans | $3,525.08 | ↑ +87% |
| pa health & wellness medicare advantage | all plan | $3,558.98 | ↑ +89% |
| humana medicare advantage | all plans | $3,558.98 | ↑ +89% |
| aetna medicare advantage | all plans | $3,558.98 | ↑ +89% |
| wv senior advantage | isnp | $3,592.87 | ↑ +91% |
| the health plan wv medicare advantage | all plans | $3,592.87 | ↑ +91% |
| unitedhealthcare medicare advantage | all plans | $3,694.56 | ↑ +96% |
| the health plan wv | peia | $3,796.24 | ↑ +101% |
| occunet | occunet | $4,575.82 | ↑ +143% |
| coventry health care | worker's compensation | $5,355.41 | ↑ +184% |
| alliance coal | alliance coal | $5,931.62 | ↑ +215% |
| blue cross blue shield traditional | blue cross blue shield traditional | $19,742.48 | ↑ +948% |
| blue cross blue shield ppo | blue cross blue shield ppo | $19,742.48 | ↑ +948% |
Visitor-reported prices
Comments
Ex palate/uvula lesion without closure 42104 at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| West Virginia University Hospitals | Morgantown | $4,234.50 | $86.50 – $13,519.90 |
| Berkeley Medical Center | Martinsburg | $8,103.00 | $92.56 – $5,584.04 |
| United Hospital Center | Bridgeport | $3,811.00 | $205.80 – $5,981.27 |
| Camden Clark Medical Center | Parkersburg | $3,811.00 | $205.80 – $5,538.40 |
| Thomas Hospitals | South Charleston | $3,827.50 | $205.80 – $16,016.74 |
| Beckley ARH Hospital | Beckley | $231.60 | $99.59 – $115.86 |