Jackson General Hospital
122 Pinnell St, Ripley, WV · Wvumedicine · · NPI 1649277476
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 |
|---|---|---|---|---|
| Levetiracetam therapeutic drug level CPT 80177 | $32.50 | $65.00 | not published | 0 |
| Levofloxacin 250 mg/50 ml in 5 % dextrose intravenous piggyback HCPCS J1956 | $17.25 | $34.50 | $1.50 – $1.50 | 1 |
| Levothyroxine 100 mcg intravenous powder for solution HCPCS J0650 | $280.98 | $561.96 | not published | 0 |
| Liberta rc ipg HCPCS C1820 | $15,153.00 | $30,306.00 | not published | 0 |
| Ligate leg veins open CPT 37761 | $566.00 | $1,132.00 | not published | 0 |
| Ligate leg veins radical 37760 CPT 37760 | $619.00 | $1,238.00 | not published | 0 |
| Ligate oviduct(s) add-on 58611 CPT 58611 | $80.00 | $160.00 | not published | 0 |
| Ligate/strip long leg vein CPT 37722 | $489.50 | $979.00 | not published | 0 |
| Ligate/strip short leg vein CPT 37718 | $422.50 | $845.00 | not published | 0 |
| Ligate/transect fallopian tubes 58600 CPT 58600 | $390.00 | $780.00 | not published | 0 |
| Ligation/biopsy of temporal artery 37609 CPT 37609 | $224.50 | $449.00 | not published | 0 |
| Ligation common iliac vein CPT 37660 | $1,417.00 | $2,834.00 | not published | 0 |
| Ligation/divis of long saph vein 37700 CPT 37700 | $259.00 | $518.00 | not published | 0 |
| Ligation external carotid artery 37600 CPT 37600 | $787.00 | $1,574.00 | not published | 0 |
| Ligation internal/common carotid artery 37605 CPT 37605 | $794.00 | $1,588.00 | not published | 0 |
| Ligation internal jugular vein 37565 CPT 37565 | $766.00 | $1,532.00 | not published | 0 |
| Ligation major artery chest CPT 37616 | $1,219.00 | $2,438.00 | not published | 0 |
| Ligation/major artery/extremity 37618 CPT 37618 | $413.50 | $827.00 | not published | 0 |
| Ligation major artery neck CPT 37615 | $541.50 | $1,083.00 | not published | 0 |
| Ligation of abdomen artery 37617 CPT 37617 | $1,415.00 | $2,830.00 | not published | 0 |
| Ligation of femoral vein CPT 37650 | $494.50 | $989.00 | not published | 0 |
| Ligation of inf vena cava CPT 37619 | $1,863.00 | $3,726.00 | not published | 0 |
| Ligation vericose vein cluster(s) 1 leg CPT 37785 | $265.50 | $531.00 | not published | 0 |
| Lig/band angioaccess av fistula CPT 37607 | $396.00 | $792.00 | not published | 0 |
| Lig&div&compl strpg saph vn CPT 37735 | $625.00 | $1,250.00 | 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 | $16.00 | $32.00 | not published | 0 |
| Lincomycin injection HCPCS J2010 | $23.00 | $46.00 | $16.24 – $16.24 | 1 |
| Linezolid in 5% dextrose in water 600 mg/300 ml intravenous piggyback HCPCS J2020 | $37.35 | $74.70 | $5.45 – $5.45 | 1 |
| Lipase CPT 83690 | $50.50 | $101.00 | not published | 0 |
| Lipoprotein blood quant CPT 83704 | $75.00 | $150.00 | not published | 0 |
| Lipoprotein direct measurement hdl CPT 83718 | $33.50 | $67.00 | not published | 0 |
| Lipoprotein direct measurement ldl CPT 83721 | $104.50 | $209.00 | not published | 0 |
| Lip surgery procedure CPT 40799 | $213.50 | $427.00 | not published | 0 |
| Lithium therapeutic drug level CPT 80178 | $71.00 | $142.00 | not published | 0 |
| Liver abs/cyst dr opn 1-2 stge CPT 47010 | $1,302.00 | $2,604.00 | 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 | $73.50 | $147.00 | not published | 0 |
| Lngth/shrt tendon leg/ankle 1 tendon CPT 27685 | $508.50 | $1,017.00 | not published | 0 |
| Lorazepam 2 mg/ml injection (wrapper) HCPCS J2060 | $6.20 | $12.40 | $1.85 – $1.85 | 1 |
| Low back disk surgery CPT 63030 | $4,702.00 | $9,404.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5271 | $880.50 | $1,761.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5273 | $218.50 | $437.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5275 | $880.50 | $1,761.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5277 | $227.50 | $455.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5272 | $18.50 | $37.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5274 | $46.00 | $92.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5276 | $26.50 | $53.00 | not published | 0 |
| Low cost skin substitute app HCPCS C5278 | $56.50 | $113.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with and without contrast) CPT 72133 | $1,027.50 | $2,055.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (with contrast) CPT 72132 | $906.00 | $1,812.00 | not published | 0 |
| Lower Back (Lumbar Spine) CT scan (without contrast) CPT 72131 | $911.00 | $1,822.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with and without contrast) CPT 72158 | $2,029.50 | $4,059.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (with contrast) CPT 72149 | $1,376.00 | $2,752.00 | not published | 0 |
| Lower Back (Lumbar Spine) MRI (without contrast) CPT 72148 | $1,417.00 | $2,834.00 | not published | 0 |
| Lower Back (Lumbar Spine) X-ray CPT 72100 | $148.00 | $296.00 | not published | 0 |
| Lsh w/t/o ut 250 g or less CPT 58542 | $8,470.00 | $16,940.00 | not published | 0 |
| Lumbar diskogram s&i CPT 72295 | $40.50 | $81.00 | not published | 0 |
| Lung Function Test (Spirometry) CPT 94010 | $178.50 | $357.00 | not published | 0 |
| Lung perfusion imaging CPT 78580 | $413.50 | $827.00 | 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 |
| Lysis penil circumic lesion CPT 54162 | $209.00 | $418.00 | not published | 0 |
| Magnesium CPT 83735 | $52.50 | $105.00 | not published | 0 |
| Magnesium sulfate 2 gram/50 ml (4 %) in water intravenous piggyback HCPCS J3475 | $20.70 | $41.40 | $1.14 – $1.14 | 1 |
| Manipulation chest wall demonstration/evaluation subsequent CPT 94668 | $90.00 | $180.00 | not published | 0 |
| Manipulation chest wall initial demonstration/evaluation CPT 94667 | $94.50 | $189.00 | not published | 0 |
| Manipulat palm cord post inj CPT 26341 | $84.50 | $169.00 | not published | 0 |
| Mapping io sentinel lymph node CPT 38900 | $148.00 | $296.00 | not published | 0 |
| Marker biop eviva buckle ss HCPCS A4648 | $268.50 | $537.00 | not published | 0 |
| Mastectomy partial CPT 19301 | $741.00 | $1,482.00 | not published | 0 |
| Mast mod rad CPT 19307 | $1,262.00 | $2,524.00 | not published | 0 |
| Mastoids complete CPT 70130 | $171.00 | $342.00 | not published | 0 |
| Mast radical CPT 19305 | $1,226.00 | $2,452.00 | not published | 0 |
| Mast simple complete CPT 19303 | $1,076.50 | $2,153.00 | not published | 0 |
| Matrion 1 sq cm HCPCS Q4201 | $566.50 | $1,133.00 | $155.00 – $155.00 | 1 |
| Matrix tissue 15x10cm gentrix extra-gynecological clgn strl-cost per sq cm HCPCS Q4166 | $119.50 | $239.00 | $30.61 – $30.61 | 1 |
| Mayo a1app alpha 1 antitrypsin phenotype CPT 82104 | $62.50 | $125.00 | not published | 0 |
| Mayo aathr protein s free CPT 85306 | $199.00 | $398.00 | 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 | $91.00 | $182.00 | 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 | $62.50 | $125.00 | 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 | $510.50 | $1,021.00 | 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 | $146.50 | $293.00 | not published | 0 |
| Mayo angiotensin 1 converting enzyme (ace) csf CPT 82164 | $9.00 | $18.00 | not published | 0 |
| Mayo antithrombin iii antigen CPT 85301 | $18.50 | $37.00 | not published | 0 |
| Mayo aspergillus fumigatus antibody CPT 86606 | $112.50 | $225.00 | not published | 0 |
| Mayo avwpr vw factor activity CPT 85397 | $145.00 | $290.00 | not published | 0 |
| Mayo babpb infectious agent nucleic acid amplified probe babesia microti CPT 87469 | $201.06 | $402.11 | 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 |
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.