Observation direct referral from physician office for admission at Thomas Hospitals
4605 Maccorkle Ave SW, South Charleston, WV · Wvumedicine · · NPI 1801338850
$862.50
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.
$1,725.00
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.
$571.27 with united mine workers of america medicare advantage vs $2,891.14 with blue cross blue shield traditional — 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 |
|---|---|---|---|
| united mine workers of america medicare advantage | united mine workers of america medicare advantage | $571.27 | ↓ -34% |
| peak health medicare advantage | all plans | $571.27 | ↓ -34% |
| highmark wv medicare advantage | all plans | $594.12 | ↓ -31% |
| humana medicare advantage | all plans | $599.83 | ↓ -30% |
| pa health & wellness medicare advantage | all plan | $599.83 | ↓ -30% |
| aetna medicare advantage | all plans | $599.83 | ↓ -30% |
| wv senior advantage | isnp | $605.55 | ↓ -30% |
| the health plan wv medicare advantage | all plans | $605.55 | ↓ -30% |
| unitedhealthcare medicare advantage | all plans | $622.68 | ↓ -28% |
| aetna | aetna | $708.61 | ↓ -18% |
| coventry health care | worker's compensation | $902.61 | ↑ +5% |
| alliance coal | alliance coal | $999.72 | ↑ +16% |
| optum | behavioral health | $1,482.00 | ↑ +72% |
| blue cross blue shield ppo | blue cross blue shield ppo | $2,891.14 | ↑ +235% |
| blue cross blue shield traditional | blue cross blue shield traditional | $2,891.14 | ↑ +235% |
Visitor-reported prices
Comments
Observation direct referral from physician office for admission at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jefferson Medical Center | Ranson | $485.50 | not published |
| West Virginia University Hospitals | Morgantown | $304.50 | $90.00 – $2,440.44 |
| Grant Memorial Hospital | Petersburg | $1,166.40 | not published |
| Reynolds Memorial Hospital | Glen Dale | $349.00 | $571.27 – $999.72 |
| Summersville Regional Medical Center | Summersville | $618.50 | not published |
| Berkeley Medical Center | Martinsburg | $463.00 | $575.98 – $1,007.97 |
| Braxton County Memorial Hospital | Gassaway | $570.50 | not published |
| United Hospital Center | Bridgeport | $145.00 | $576.05 – $1,008.09 |