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 |
|---|---|---|---|---|
| Observation/inpatient hospital care mod severity 99235 CPT 99235 | $164.00 | $328.00 | not published | 0 |
| Observation per hour HCPCS G0378 | $44.00 | $88.00 | not published | 0 |
| Obtaining screen pap smear HCPCS Q0091 | $28.00 | $56.00 | not published | 0 |
| Ob Ultrasound nuchal meas 1 gest CPT 76813 | $63.00 | $126.00 | not published | 0 |
| Octreotide acetate 100 mcg/ml injection (wrapper) HCPCS J2354 | $10.50 | $21.00 | $1.96 – $1.96 | 1 |
| Ocular function screen CPT 99172 | $49.00 | $98.00 | not published | 0 |
| Ocular instrumnt screen bil CPT 99177 | $42.00 | $84.00 | not published | 0 |
| Ocular reconst transplant CPT 65780 | $559.50 | $1,119.00 | not published | 0 |
| Off/op cnsltj new/est low 30 CPT 99243 | $98.50 | $197.00 | not published | 0 |
| Off/op cnsltj new/est mod 40 CPT 99244 | $150.00 | $300.00 | not published | 0 |
| Off/op consltj new/est hi 55 CPT 99245 | $201.50 | $403.00 | not published | 0 |
| Off/op consltj new/est sf 20 CPT 99242 | $92.50 | $185.00 | not published | 0 |
| Ol dig e/m svc 11-20 min CPT 99422 | $25.50 | $51.00 | not published | 0 |
| Ol dig e/m svc 21+ min CPT 99423 | $40.00 | $80.00 | not published | 0 |
| Ol dig e/m svc 5-10 min CPT 99421 | $12.50 | $25.00 | not published | 0 |
| Omalizumab 150 mg/ml subcutaneous syringe (wrapper) HCPCS J2357 | $74.00 | $148.00 | $65.11 – $65.11 | 1 |
| Ondansetron 8 mg disintegrating tablet HCPCS Q0162 | $0.50 | $1.00 | $0.02 – $0.02 | 1 |
| Ondansetron hcl (pf) 2 mg/ml injection (wrapper) HCPCS J2405 | $0.50 | $1.00 | $0.17 – $0.17 | 1 |
| Open tenotomy tendon flexor foot single or multiple 28230 CPT 28230 | $299.00 | $598.00 | not published | 0 |
| Ophthalmic biometry CPT 92136 | $33.00 | $66.00 | not published | 0 |
| Ophthalmic mitomycin HCPCS J7315 | $566.00 | $1,132.00 | not published | 0 |
| Oph Ultrasound dx ant sgm Ultrasound uni/bi CPT 76513 | $35.50 | $71.00 | not published | 0 |
| Organic acids total quant ea spec CPT 83918 | $279.00 | $558.00 | not published | 0 |
| Oritavancin 1,200 mg intravenous solution HCPCS J2406 | $61.50 | $123.00 | $67.52 – $67.52 | 1 |
| Oritavancin 400 mg intravenous solution HCPCS J2407 | $40.00 | $80.00 | $45.54 – $45.54 | 1 |
| Orphenadrine citrate 30 mg/ml injection solution HCPCS J2360 | $6.50 | $13.00 | $13.00 – $13.00 | 1 |
| Orthovisc inj per dose HCPCS J7324 | $180.00 | $360.00 | $215.56 – $215.56 | 1 |
| Oscillation chest wall mechanical per session CPT 94669 | $200.50 | $401.00 | not published | 0 |
| Osmolality blood CPT 83930 | $40.00 | $80.00 | not published | 0 |
| Osmolality urine CPT 83935 | $207.00 | $414.00 | not published | 0 |
| Osteopath manip tx/5-6 body region 98927 CPT 98927 | $46.00 | $92.00 | not published | 0 |
| Ot evaluation high complexity patient/family CPT 97167 | $175.00 | $350.00 | not published | 0 |
| Ot evaluation low complexity patient/family CPT 97165 | $175.00 | $350.00 | not published | 0 |
| Ot evaluation moderate complexity patient/family CPT 97166 | $175.00 | $350.00 | not published | 0 |
| Ot manual therpy techniques >=1 region each 15 minutes CPT 97140 | $30.00 | $60.00 | not published | 0 |
| Otolaryngo binocular microscopy 92504 CPT 92504 | $9.00 | $18.00 | not published | 0 |
| Ot re-evaluation patient/family CPT 97168 | $89.50 | $179.00 | not published | 0 |
| Ot therapeutic activities direct patient contact each 15 minutes CPT 97530 | $61.00 | $122.00 | not published | 0 |
| Ot therapeutic procedure >=1 area therapeutic exercise each 15 minutes CPT 97110 | $67.50 | $135.00 | not published | 0 |
| Ot therapeutic procedure neuromuscular reeducate each 15 minutes CPT 97112 | $69.00 | $138.00 | not published | 0 |
| Ot training self care/home management direct contact each 15 minutes CPT 97535 | $70.00 | $140.00 | not published | 0 |
| Oxacillin in ns IV syringe 40 mg/ml (neo/ped) - cnr HCPCS J2700 | $1.50 | $3.00 | $1.73 – $1.73 | 1 |
| Paliperidone 117 mg/0.75 ml inj HCPCS J2426 | $21.50 | $43.00 | $23.63 – $23.63 | 1 |
| Palivizumab 50 mg/0.5 ml inj CPT 90378 | $2,731.00 | $5,462.00 | $560.47 – $560.47 | 1 |
| Parathormone (pth) intact CPT 83970 | $113.50 | $227.00 | not published | 0 |
| Parathyrd planar w/spect&ct CPT 78072 | $784.50 | $1,569.00 | not published | 0 |
| Parathyroid planar imaging CPT 78070 | $594.00 | $1,188.00 | not published | 0 |
| Parathyroid planar img w/tomo spect CPT 78071 | $61.00 | $122.00 | not published | 0 |
| Paring/cutting benign hyperkeratotic lesion single CPT 11055 | $192.50 | $385.00 | not published | 0 |
| Partial removal finger bone CPT 26235 | $519.00 | $1,038.00 | not published | 0 |
| Partial removal foot fascia CPT 28060 | $381.50 | $763.00 | not published | 0 |
| Partial removal of eye fluid CPT 67010 | $512.00 | $1,024.00 | not published | 0 |
| Particle matristem matrix 1000mg micron-q4118-cost per mg HCPCS Q4118 | $8.00 | $16.00 | $4.21 – $4.21 | 1 |
| Part removal of metatarsal CPT 28113 | $3,134.00 | $6,268.00 | not published | 0 |
| Pcv21 vaccine im CPT 90684 | $333.50 | $667.00 | not published | 0 |
| Pelvic CT scan (with and without contrast) CPT 72194 | $1,139.00 | $2,278.00 | not published | 0 |
| Pelvic CT scan (with contrast) CPT 72193 | $850.50 | $1,701.00 | not published | 0 |
| Pelvic CT scan (without contrast) CPT 72192 | $725.50 | $1,451.00 | not published | 0 |
| Pelvic MRI (with and without contrast) CPT 72197 | $1,854.00 | $3,708.00 | not published | 0 |
| Pelvic MRI (without contrast) CPT 72195 | $1,166.00 | $2,332.00 | not published | 0 |
| Pelvic Ultrasound (complete) CPT 76856 | $440.50 | $881.00 | not published | 0 |
| Pelvic Ultrasound (limited) CPT 76857 | $273.50 | $547.00 | not published | 0 |
| Peng benzathine/procaine inj HCPCS J0558 | $28.00 | $56.00 | $29.01 – $29.01 | 1 |
| Penicillin g benzathine 1,200,000 unit/2 ml intramuscular syringe HCPCS J0561 | $42.50 | $85.00 | $35.85 – $35.85 | 1 |
| Penile injection CPT 54235 | $77.00 | $154.00 | not published | 0 |
| Peri-proc device eval icd CPT 93287 | $24.00 | $48.00 | not published | 0 |
| Peri-proc device eval pm CPT 93286 | $91.00 | $182.00 | not published | 0 |
| Perq rplcmt g-tube req revsn gstrst trk CPT 43763 | $95.50 | $191.00 | not published | 0 |
| Perq skel fix ulnar styld fx CPT 25651 | $524.00 | $1,048.00 | not published | 0 |
| Pet CT skull-mid thgh initial CPT 78815 | $1,983.00 | $3,966.00 | not published | 0 |
| Pfc sigma fem post aug sz3 8mm HCPCS C1776 | $4,039.00 | $8,078.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 11-20 CPT 98967 | $23.00 | $46.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 21-30 CPT 98968 | $33.00 | $66.00 | not published | 0 |
| Ph1 assmt&mgmt nqhp 5-10 CPT 98966 | $12.00 | $24.00 | not published | 0 |
| Ph body fluid CPT 83986 | $43.00 | $86.00 | not published | 0 |
| Phencyclidine (pcp) CPT 83992 | $77.00 | $154.00 | not published | 0 |
| Phenobarbital therapeutic drug level CPT 80184 | $74.50 | $149.00 | not published | 0 |
| Phenytoin total therapeutic drug level CPT 80185 | $112.50 | $225.00 | not published | 0 |
| Phlebotomy therapeutic CPT 99195 | $99.00 | $198.00 | not published | 0 |
| Phosphorus CPT 84100 | $40.00 | $80.00 | not published | 0 |
| Phosphorus 24 hour urine CPT 84105 | $32.00 | $64.00 | not published | 0 |
| Photopheresis CPT 36522 | $89.50 | $179.00 | not published | 0 |
| Phys blood bank serv reactj CPT 86078 | $45.00 | $90.00 | not published | 0 |
| Physician standby services CPT 99360 | $58.50 | $117.00 | not published | 0 |
| Phytonadione (vitamin k1) 10 mg/ml injection solution HCPCS J3430 | $3.00 | $6.00 | $4.79 – $4.79 | 1 |
| Piflu f-18, dia 1 millicurie HCPCS A9595 | $577.00 | $1,154.00 | $957.58 – $957.58 | 1 |
| Pillow shldr abduc inflat univ HCPCS L3960 | $274.00 | $548.00 | not published | 0 |
| Pinworm exam CPT 87172 | $26.00 | $52.00 | not published | 0 |
| Piperacillin-tazobactam 3.375 gram intravenous solution HCPCS J2543 | $3.00 | $6.00 | $1.95 – $1.95 | 1 |
| Placement localization device(s) breast percutaneous mammographic guidance 1st lesion (both sides) CPT 19281 | $1,519.00 | $3,038.00 | not published | 0 |
| Placement localization device(s) breast percutaneous ultrasound guidance 1st lesion (both sides) CPT 19285 | $767.50 | $1,535.00 | not published | 0 |
| Platelet aggregation each agent teg CPT 85576 | $66.50 | $133.00 | not published | 0 |
| Platelet automated CPT 85049 | $49.00 | $98.00 | not published | 0 |
| Platelets pheresis pathogen-reduced each unit HCPCS P9073 | $1,268.50 | $2,537.00 | not published | 0 |
| Plc pq device breast ea addl lesion Ultrasound guide CPT 19286 | $42.00 | $84.00 | not published | 0 |
| Plethysmography lung volumes/airway resistance CPT 94726 | $303.00 | $606.00 | not published | 0 |
| Pm device progr eval dual CPT 93280 | $41.00 | $82.00 | not published | 0 |
| Pm device progr eval multi CPT 93281 | $45.50 | $91.00 | not published | 0 |
| Pmp22 gene dup/delet CPT 81324 | $995.00 | $1,990.00 | not published | 0 |
| #pnh-flow cytometry interp CPT 88187 | $39.00 | $78.00 | 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.