Jefferson Medical Center
300 S Preston St, Ranson, WV · Wvumedicine · · NPI 1891722377
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 |
|---|---|---|---|---|
| Kit omnigraft 2.5x2.5cm dermal regeneration matrix - q4105-cost per sq cm HCPCS Q4105 | $119.50 | $239.00 | $41.81 – $41.81 | 1 |
| Knee arthroscopy/surgery CPT 29883 | $891.50 | $1,783.00 | not published | 0 |
| Knee arthroscopy/surgery CPT 29884 | $659.50 | $1,319.00 | not published | 0 |
| Knee MRI (with and without contrast) CPT 73723 | $1,854.00 | $3,708.00 | not published | 0 |
| Knee MRI (with contrast) CPT 73722 | $1,381.50 | $2,763.00 | not published | 0 |
| Knee MRI (without contrast) CPT 73721 | $1,206.50 | $2,413.00 | not published | 0 |
| Knee X-ray CPT 73564 | $173.00 | $346.00 | not published | 0 |
| Kyleena, 19.5 mg HCPCS J7296 | $1,822.00 | $3,644.00 | $2,290.45 – $2,290.45 | 1 |
| Lactate dehydrogenase (ldh) CPT 83615 | $36.50 | $73.00 | not published | 0 |
| Lactated ringers intravenous solution HCPCS J7120 | $7.00 | $14.00 | $4.27 – $4.27 | 1 |
| Lactic acid CPT 83605 | $79.50 | $159.00 | not published | 0 |
| Lactoferrin fecal qualitative CPT 83630 | $90.50 | $181.00 | not published | 0 |
| Lap sleeve gastrectomy CPT 43775 | $1,207.50 | $2,415.00 | not published | 0 |
| Laryngoscopy direct w/wo tracheoscopy dx exc newborn CPT 31525 | $158.00 | $316.00 | not published | 0 |
| Laser surgery eye strands CPT 67031 | $333.50 | $667.00 | not published | 0 |
| Lead capillary CPT 83655 | $66.50 | $133.00 | not published | 0 |
| Leg Vein Ultrasound (DVT study, both legs) CPT 93970 | $666.50 | $1,333.00 | not published | 0 |
| Lens iol ant bicnvx 24.0 multi HCPCS V2632 | $77.00 | $154.00 | not published | 0 |
| Leuprolide 30 mg (4 month) intramuscular syringe kit HCPCS J9217 | $256.50 | $513.00 | $299.15 – $299.15 | 1 |
| Leuprolide 3.75 mg intramuscular syringe kit HCPCS J1950 | $2,607.50 | $5,215.00 | $2,581.59 – $2,581.59 | 1 |
| Levalbuterol non-comp unit HCPCS J7614 | $2.00 | $4.00 | $0.08 – $0.08 | 1 |
| Levetiracetam therapeutic drug level CPT 80177 | $31.00 | $62.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $3.50 | $7.00 | $1.50 – $1.50 | 1 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $216.00 | $432.00 | not published | 0 |
| Liletta, 52 mg HCPCS J7297 | $1,398.00 | $2,796.00 | $1,756.97 – $1,756.97 | 1 |
| Limited visual field xm CPT 92081 | $17.50 | $35.00 | not published | 0 |
| Lincomycin injection HCPCS J2010 | $23.00 | $46.00 | $16.24 – $16.24 | 1 |
| Lipase CPT 83690 | $42.00 | $84.00 | not published | 0 |
| Lipoprotein blood high res frac & quant CPT 83701 | $134.00 | $268.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $50.00 | $100.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $35.00 | $70.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $19.50 | $39.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $56.50 | $113.00 | not published | 0 |
| Liver ds alys 3 bmrk srm alg CPT 81517 | $340.00 | $680.00 | not published | 0 |
| Liver Function Test CPT 80076 | $38.00 | $76.00 | not published | 0 |
| Lmtd oph exam general anes CPT 92019 | $66.00 | $132.00 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $3.00 | $6.00 | $1.85 – $1.85 | 1 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $935.00 | $1,870.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $850.50 | $1,701.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $615.50 | $1,231.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $1,854.50 | $3,709.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,205.50 | $2,411.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $222.50 | $445.00 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $1,870.50 | $3,741.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $191.00 | $382.00 | not published | 0 |
| Lutetium lu 177 dotatat ther HCPCS A9513 | $278.00 | $556.00 | $479.23 – $479.23 | 1 |
| Lymphocyte transformation mitogen CPT 86353 | $350.00 | $700.00 | not published | 0 |
| Magnesium CPT 83735 | $41.00 | $82.00 | not published | 0 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $104.50 | $209.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $110.00 | $220.00 | not published | 0 |
| Manipulat palm cord post inj CPT 26341 | $81.00 | $162.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $153.00 | $306.00 | not published | 0 |
| Matrion 1 sq cm HCPCS Q4201 | $119.50 | $239.00 | $171.96 – $171.96 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $119.50 | $239.00 | $30.61 – $30.61 | 1 |
| M.avium-intra dna amp prob CPT 87561 | $132.00 | $264.00 | not published | 0 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $34.50 | $69.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $47.50 | $95.00 | not published | 0 |
| Mayo activated protein c resistance assay CPT 85307 | $56.00 | $112.00 | not published | 0 |
| Mayo adalimumab (humira) therapeutic drug level CPT 80145 | $455.00 | $910.00 | not published | 0 |
| Mayo alcohol biomarkers definitive assay 1 or 2 phosphatidylethanol confirmation CPT 80321 | $20.00 | $40.00 | not published | 0 |
| Mayo alcohol definitive assay volatile screen CPT 80320 | $56.00 | $112.00 | not published | 0 |
| Mayo alkaline phosphatase isoenzyme CPT 84080 | $1.50 | $3.00 | not published | 0 |
| Mayo alkaloids definitive assay nicotine/cotinine CPT 80323 | $47.50 | $95.00 | not published | 0 |
| Mayo alpha 1 antitrypsin CPT 82103 | $92.50 | $185.00 | not published | 0 |
| Mayo amikacin trough therapeutic drug level CPT 80150 | $125.50 | $251.00 | not published | 0 |
| Mayo amphu methylenedioxyamphetamines definitive assay urine CPT 80359 | $62.00 | $124.00 | not published | 0 |
| Mayo analysis gene calr common variants exon 9 CPT 81219 | $387.00 | $774.00 | not published | 0 |
| Mayo analysis gene jak2 p.val617phe variant CPT 81270 | $650.00 | $1,300.00 | not published | 0 |
| Mayo analysis gene smn1 dosage/deletion CPT 81329 | $300.00 | $600.00 | not published | 0 |
| Mayo analysis microarray cytogenomic copy number/snp variants CPT 81229 | $1,515.00 | $3,030.00 | not published | 0 |
| Mayo androstenedione CPT 82157 | $57.00 | $114.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $9.00 | $18.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $112.50 | $225.00 | not published | 0 |
| Mayo avwpr vw factor activity CPT 85397 | $132.50 | $265.00 | not published | 0 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $133.00 | $266.00 | not published | 0 |
| Mayo barbiturates definitive assay confirmation urine CPT 80345 | $60.00 | $120.00 | not published | 0 |
| Mayo bart bartonella henselae antibody igg CPT 86611 | $37.00 | $74.00 | not published | 0 |
| Mayo bcrfx analysis translocation bcr/abl1 minor breakpoint qualitative/quantitative CPT 81207 | $50.00 | $100.00 | not published | 0 |
| Mayo blastomyces antibody immunodiffusion CPT 86612 | $11.00 | $22.00 | not published | 0 |
| Mayo bordetella pertussis antibody igg CPT 86615 | $72.50 | $145.00 | not published | 0 |
| Mayo brcmg brucella antibody igm CPT 86622 | $21.50 | $43.00 | not published | 0 |
| Mayo cannabinoids natural definitive assay thc confirmation urine CPT 80349 | $115.00 | $230.00 | not published | 0 |
| Mayo carnitine total and free quantitative each specimen plasma CPT 82379 | $18.50 | $37.00 | not published | 0 |
| Mayo cd20b mononuclear cell antigen nos quantitative each CPT 86356 | $115.00 | $230.00 | not published | 0 |
| Mayo cdcom hla class ii typing low resolution one locus each CPT 81376 | $29.00 | $58.00 | not published | 0 |
| Mayo ceruloplasmin CPT 82390 | $80.00 | $160.00 | not published | 0 |
| Mayo chemiluminescent parathyroid related peptide CPT 82397 | $87.50 | $175.00 | not published | 0 |
| Mayo chikv chikungunya antibodies igg CPT 86790 | $74.00 | $148.00 | not published | 0 |
| Mayo chrcb tissue culture non-neoplastic disorders lymphocyte CPT 88230 | $428.00 | $856.00 | not published | 0 |
| Mayo chromium CPT 82495 | $54.00 | $108.00 | not published | 0 |
| Mayo cocaine definitive assay confirmation urine CPT 80353 | $100.00 | $200.00 | not published | 0 |
| Mayo coccidioides antibody CPT 86635 | $60.00 | $120.00 | not published | 0 |
| Mayo cocou cortisone urine CPT 82542 | $550.50 | $1,101.00 | not published | 0 |
| Mayo cortisol free CPT 82530 | $50.00 | $100.00 | not published | 0 |
| Mayo covid-19 antibody nucleocapsid total CPT 86769 | $65.00 | $130.00 | not published | 0 |
| Mayo coxiella brunetii (q fever) igg antibody CPT 86638 | $29.50 | $59.00 | not published | 0 |
| Mayo cyanide CPT 82600 | $14.00 | $28.00 | not published | 0 |
| Mayo cytopathology in situ hybridization urinary tract 3-5 probes each specimen manual CPT 88120 | $200.00 | $400.00 | not published | 0 |
| Mayo dhea (dehydroepiandrosterone) CPT 82626 | $14.50 | $29.00 | not published | 0 |
| Mayo dihydrotestosterone CPT 82642 | $26.00 | $52.00 | 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.