Excision breast lesion at Princeton Community Hospital
122 12th St, Princeton, WV · Wvumedicine · · NPI 1558313213
$9,856.50
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.
$19,713.00
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.
$4,002.87 with anthem va medicare advantage vs $23,315.12 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 |
|---|---|---|---|
| anthem va medicare advantage | hmo | $4,002.87 | ↓ -59% |
| peak health medicare advantage | all plans | $4,002.87 | ↓ -59% |
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $4,002.87 | ↓ -59% |
| optima va medicare advantage | all plans | $4,002.87 | ↓ -59% |
| highmark wv medicare advantage | all plans | $4,162.98 | ↓ -58% |
| aetna medicare advantage | all plans | $4,203.01 | ↓ -57% |
| humana medicare advantage | all plans | $4,203.01 | ↓ -57% |
| pa health & wellness medicare advantage | all plan | $4,203.01 | ↓ -57% |
| wv senior advantage | isnp | $4,243.04 | ↓ -57% |
| the health plan wv medicare advantage | all plans | $4,243.04 | ↓ -57% |
| unitedhealthcare medicare advantage | all plans | $4,363.13 | ↓ -56% |
| the health plan wv | peia | $4,483.21 | ↓ -55% |
| occunet | occunet | $5,403.87 | ↓ -45% |
| coventry health care | worker's compensation | $6,324.53 | ↓ -36% |
| alliance coal | alliance coal | $7,005.02 | ↓ -29% |
| blue cross blue shield traditional | blue cross blue shield traditional | $23,315.12 | ↑ +137% |
| blue cross blue shield ppo | blue cross blue shield ppo | $23,315.12 | ↑ +137% |
Visitor-reported prices
Comments
Excision breast lesion at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| West Virginia University Hospitals | Morgantown | $11,543.50 | $2,449.71 – $15,966.48 |
| Grant Memorial Hospital | Petersburg | $830.40 | not published |
| Summersville Regional Medical Center | Summersville | $3,412.50 | not published |
| Braxton County Memorial Hospital | Gassaway | $519.00 | not published |
| Jackson General Hospital | Ripley | $495.50 | not published |
| Potomac Valley Hospital | Keyser | $519.00 | not published |
| Camden Clark Medical Center | Parkersburg | $4,688.50 | $3,737.51 – $6,540.64 |
| St. Joseph's Hospital | Buckhannon | $3,969.00 | not published |