Revision of knee joint at Thomas Hospitals
4605 Maccorkle Ave SW, South Charleston, WV · Wvumedicine · · NPI 1801338850
$15,107.50
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.
$30,215.00
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.
$12,255.24 with united mine workers of america medicare advantage vs $62,022.54 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 | $12,255.24 | ↓ -19% |
| peak health medicare advantage | all plans | $12,255.24 | ↓ -19% |
| highmark wv medicare advantage | all plans | $12,745.45 | ↓ -16% |
| aetna medicare advantage | all plans | $12,868.00 | ↓ -15% |
| humana medicare advantage | all plans | $12,868.00 | ↓ -15% |
| pa health & wellness medicare advantage | all plan | $12,868.00 | ↓ -15% |
| wv senior advantage | isnp | $12,990.55 | ↓ -14% |
| the health plan wv medicare advantage | all plans | $12,990.55 | ↓ -14% |
| unitedhealthcare medicare advantage | all plans | $13,358.21 | ↓ -12% |
| coventry health care | worker's compensation | $19,363.28 | ↑ +28% |
| alliance coal | alliance coal | $21,446.67 | ↑ +42% |
| blue cross blue shield ppo | blue cross blue shield ppo | $62,022.54 | ↑ +311% |
| blue cross blue shield traditional | blue cross blue shield traditional | $62,022.54 | ↑ +311% |
Visitor-reported prices
Comments
Revision of knee joint at other West-virginia hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| Jefferson Medical Center | Ranson | $1,201.00 | not published |
| West Virginia University Hospitals | Morgantown | $21,535.00 | $205.80 – $32,748.28 |
| Grant Memorial Hospital | Petersburg | $1,921.60 | not published |
| Reynolds Memorial Hospital | Glen Dale | $23,559.50 | $205.80 – $21,446.67 |
| Summersville Regional Medical Center | Summersville | $9,600.00 | not published |
| Berkeley Medical Center | Martinsburg | $16,040.00 | $12,356.27 – $21,623.47 |
| Braxton County Memorial Hospital | Gassaway | $1,201.00 | not published |
| Jackson General Hospital | Ripley | $1,215.00 | not published |