Does Princeton Community Hospital Assn Inc have an emergency room?

Yes. Medicare (CMS) data lists emergency services at Princeton Community Hospital Assn Inc. In a medical emergency, call 911.

Where is Princeton Community Hospital Assn Inc?

122 12th Street, Princeton, WV 24740, in Mercer County, West Virginia.

What is the phone number of Princeton Community Hospital Assn Inc?

(304) 487-7000, as listed by Medicare (CMS).

What is the Medicare star rating of Princeton Community Hospital Assn Inc?

2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Princeton Community Hospital Assn Inc

Quick answers

Does Princeton Community Hospital Assn Inc have an emergency room?: Yes. Medicare (CMS) data lists emergency services at Princeton Community Hospital Assn Inc. In a medical emergency, call 911.
Where is Princeton Community Hospital Assn Inc?: 122 12th Street, Princeton, WV 24740, in Mercer County, West Virginia.
What is the phone number of Princeton Community Hospital Assn Inc?: (304) 487-7000, as listed by Medicare (CMS).
What is the Medicare star rating of Princeton Community Hospital Assn Inc?: 2 out of 5 stars in the CMS overall hospital quality rating (CMS data updated 2026-07-22).

Specialties and care areas^[4][5]

Procedures^[5]

Hip and knee replacement
Robotic-assisted surgery

Programs and centers^[4][5]

Women's Center
Behavioral Health Center
Cancer program

Emergency care (hospital website)^[4][7]

Emergency room	Yes
Open 24/7	Yes

Visiting and practical information

Visiting	General units and ICU/CCU: two visitors at a time, 7 am to 9 pm; one overnight visitor. Women's Center has its own hours^[9]
Parking	Two main lots (Main and North). Free valet parking for patients at the North Lot^[8]
Interpreters and languages	Free language services including qualified interpreters for people whose primary language is not English^[6]

Recognition^[5]

DNV accreditation
DNV Center of Excellence for Hip and Knee Replacement
American College of Surgeons Commission on Cancer accredited cancer program
College of American Pathologists laboratory accreditation

Doctors and clinicians (469)

469 doctors and other clinicians list Princeton Community Hospital Assn Inc as a hospital where they work, in Medicare's official clinician data (updated 2026-10-02). It is not a complete staff list.

Main specialties

And 445 more: the button below opens the full list.

Other emergency rooms nearby

Hospitals that list emergency services, by straight-line distance (not driving distance).

Carilion Giles Community Hospital20 mi · Pearisburg, VA · Critical Access Hospital
Summers County Arh Hospital24 mi · Hinton, WV · Critical Access Hospital
Carilion Tazewell Community Hospital27 mi · Tazewell, VA · Acute Care Hospital
Welch Community Hospital27 mi · Welch, WV · Acute Care Hospital
Lewisgale Hospital Pulaski28 mi · Pulaski, VA · Acute Care Hospital

Other hospitals nearby

Encompass Health Rehab Hospital of Princeton0.0 mi · Princeton, WV · Inpatient Rehabilitation Hospital

Nursing homes, hospice, home health and dialysis nearby

Medicare-certified providers within 25 miles, by straight-line distance. Hospice and home health care is given at home: their address is the office.

Nursing homes

Princeton Health Care Center0.8 mi · Princeton, WV · 3 of 5 stars
Glenwood Healthcare Center2.9 mi · Princeton, WV · 4 of 5 stars
Bluestone Health and Rehabilitation9.3 mi · Bluefield, WV · 1 of 5 stars

All nursing homes in the state →

Hospice providers

Hospice Compassus - Southern West Virginia2.8 mi · Princeton, WV · 5 of 5 stars
Amedisys Hospice of Bluefield6.4 mi · Bluefield, WV

All hospice providers in the state →

Home health agencies

PCH Home Health2.8 mi · Princeton, WV

All home health agencies in the state →

Dialysis facilities

Fresenius Medical Care Mercer County2.8 mi · Princeton, WV · 1 of 5 stars
FMC Dialysis Services Two Virginias6.4 mi · Bluefield, WV · 1 of 5 stars
DaVita Giles County Dialysis20 mi · Pearisburg, VA · 4 of 5 stars

All dialysis facilities in the state →

Community care nearby

Health centers, clinics, urgent care and pharmacies closest to this hospital, by straight-line distance, from official HRSA, Medicare and NPI Registry data. In a medical emergency, call 911.

Community health centers

Tug River Heatlh --Princeton0.1 mi · Princeton, WV · Community health center
AccessHealth Princeton1.0 mi · Princeton, WV · Community health center
Bluestone 11.7 mi · Princeton, WV · Community health center

Clinics and urgent care

Jana Peters2.8 mi · Princeton, WV · Rural health clinic
Summit Women's Health2.8 mi · Princeton, WV · Rural health clinic
Urgent Care, Inc - West Virginia2.8 mi · Princeton, WV · Urgent care center

Pharmacies

Bluestone Health Center Pharmacy2.8 mi · Princeton, WV · Community/retail pharmacy
Community Health Systems, Inc.2.8 mi · Princeton, WV · Clinic pharmacy
Four Seasons Pharmacy Inc2.8 mi · Princeton, WV · Community/retail pharmacy

Assisted living nearby

Licensed homes from the official state licence list, by straight-line distance.

Havens at Princeton2.8 mi · Princeton, WV
Ridge Care, LLC5.9 mi · Princeton, WV
Rockin Chair Residential Care Inc11 mi · Lerona, WV

About the Medicare star rating

CMS (the federal Medicare agency) gives many hospitals an overall rating from 1 to 5 stars, based on measures of mortality, safety, readmissions, patient experience and timely care. It is one piece of information: ask your doctor what matters for your care. See the full Medicare profile →

Medicare quality data

What Princeton Community Hospital Assn Inc reported to Medicare (CMS), the federal agency that publishes these results for hospitals nationwide. These are averages for many patients, not a prediction for any one person: ask your doctor what matters for your care. In a medical emergency, call 911.

What patients said (patient survey)

What this means: Patients who stayed overnight answered a national survey (HCAHPS) about their stay. More stars mean patients reported a better experience than at other hospitals. The percentages show how often patients gave the best answer, next to the national average.

Summary star rating (all survey topics)	3 of 5 stars
Overall rating of the hospital	2 of 5 stars
Would recommend the hospital	2 of 5 stars
Nurses communicated well	4 of 5 stars
Doctors communicated well	4 of 5 stars
Staff explained medicines	3 of 5 stars
Information about recovery at home	3 of 5 stars
Room and bathroom kept clean	3 of 5 stars
Quiet at night	2 of 5 stars
Rated the hospital 9 or 10 out of 10	63%National average: 72%
Would definitely recommend the hospital	59%National average: 71%
Nurses “always” communicated well	81%National average: 80%
Doctors “always” communicated well	82%National average: 80%
Staff “always” explained medicines before giving them	66%National average: 62%
Were given information about recovery at home	87%National average: 86%
Room and bathroom “always” clean	67%National average: 74%
Area around the room “always” quiet at night	49%National average: 60%
Completed surveys	395Response rate: 18%

Source: Patient survey (HCAHPS) - Hospital — CMS, released July 22, 2026; patients discharged October 2024 to September 2025.

Infections caught in the hospital

What this means: CMS compares the number of infections patients caught in this hospital with the number expected for a hospital like it. The number shown is that ratio: below 1 means fewer infections than expected, above 1 means more. “Better” or “worse” is shown only when the difference is clear in the data.

Central line bloodstream infections (CLABSI)	0.938No different from the national benchmark
Catheter-associated urinary tract infections (CAUTI)	0.632No different from the national benchmark
Surgical site infections after colon surgery	0.551No different from the national benchmark
Surgical site infections after abdominal hysterectomy	Not reported to Medicare
MRSA bloodstream infections	0.479No different from the national benchmark
Clostridioides difficile (C. diff) intestinal infections	0.553No different from the national benchmark

Source: Healthcare Associated Infections - Hospital — CMS, released July 22, 2026; data from October 2024 to September 2025.

Complications and deaths

What this means: Death rates are the share of patients who died within 30 days of going into the hospital for that condition, adjusted for how sick they were. PSI-90 combines several serious complications (a lower number is better). “No different from the national rate” is the most common result and means the hospital is in line with hospitals nationwide.

Deaths within 30 days: heart attack patients	12.1%
Deaths within 30 days: heart failure patients	11.5%
Deaths within 30 days: pneumonia patients	18%
Deaths within 30 days: COPD patients	9.6%
Deaths within 30 days: stroke patients	9.8%
Deaths within 30 days: coronary bypass surgery (CABG)	Not reported to Medicare
Serious complications (patient safety indicator PSI-90)	1.11No different from the national rate
Complications after hip or knee replacement	6.1%

Source: Complications and Deaths - Hospital — CMS, released September 10, 2026; data from July 2022 to June 2025.

Return visits to the hospital (readmissions)

What this means: The share of patients who had to be admitted to a hospital again within 30 days after going home, adjusted for how sick they were. A lower percentage is better.

Returned to any hospital within 30 days (all patients)	Not reported to Medicare
Readmitted within 30 days: heart attack	13.7%
Readmitted within 30 days: heart failure	24.3%
Readmitted within 30 days: pneumonia	21.1%
Readmitted within 30 days: COPD	19.5%
Readmitted within 30 days: coronary bypass surgery	Not reported to Medicare
Readmitted within 30 days: hip or knee replacement	6.4%

Source: Unplanned Hospital Visits - Hospital — CMS, released September 10, 2026; data from July 2023 to June 2025.

Emergency room times and sepsis care

What this means: ER time is the middle (median) time from arriving at the emergency room to leaving it; busier ERs usually have longer times, so the ER volume is shown too. Leaving before being seen: a lower percentage is better. Sepsis is a life-threatening reaction to an infection; a higher percentage means more patients got every recommended early step.

Emergency room volume (patients per year)	High (40,000–59,999)
Average (median) time patients spent in the emergency room before leaving (OP-18b)	172 minutesNational average: 162 minutes
Patients who left the emergency room before being seen (OP-22)	2%National average: 2%
Sepsis patients who got all the recommended early care (SEP-1)	90%National average: 65%

Source: Timely and Effective Care - Hospital — CMS, released July 22, 2026; data from January 2024 to December 2024.

See every measure on Medicare Care Compare →

ER wait times and Medicare ratings nearby

How this hospital compares with others in the area, ranked only by official Medicare (CMS) numbers.

ER wait times in West Virginia Best hospitals in West Virginia

Prices

Every US hospital must publish its standard charges in a file that follows a federal (CMS) format. Below are 75 common services exactly as Princeton Community Hospital Assn Inc lists them in its file. This is not a quote: what you pay depends on your insurance and plan, the doctors involved and the care you actually receive. Prices change: ask the hospital for an estimate before you schedule care (if you are uninsured or paying yourself, you have the right to a written “good faith estimate”). In a medical emergency, call 911.

What the prices mean

Hospital charge: The hospital’s list price (“gross charge”) before any discount or insurance. Few people pay this amount.
Cash price: The price the hospital offers if you pay yourself, without insurance (“discounted cash price”).
Insurance rates: The lowest and highest amounts the hospital has agreed with any insurance plan for the service (“de-identified minimum and maximum”), and some of the rates it lists by insurer and plan. Your share depends on your deductible, copay and coinsurance.
Hospital and doctor fees: A service can have a hospital (facility) fee and a separate doctor (professional) fee; the total for your care can include both, plus other services.

How to use hospital prices: estimates, financial assistance and your rights →

Office and emergency visits

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$126	$63	$54.25 – $420.07
New patient office visit (about 30–44 minutes): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $64.70 Aetna — Better Health WV Mgd Medicaid: $62.94 Aetna Better Health PA — CHIP: $59.68 Aetna Better Health WV — CHIP: $62.94 Aetna Medicare Advantage — All Plans: $75.73 Anthem VA Medicare Advantage — HMO: $72.12 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $420.07 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $420.07 Coventry Health Care — Worker's Compensation: $113.95 Highmark Health Options — CHIP: $61.76
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW LOW 30 MIN	$177	$88.50	$54.25 – $420.07
New patient office visit (about 30–44 minutes): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $64.70 Aetna — Better Health WV Mgd Medicaid: $62.94 Aetna Better Health PA — CHIP: $59.68 Aetna Better Health WV — CHIP: $62.94 Aetna Medicare Advantage — All Plans: $75.73 Anthem VA Medicare Advantage — HMO: $72.12 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $420.07 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $420.07 Coventry Health Care — Worker's Compensation: $113.95 Highmark Health Options — CHIP: $61.76
New patient office visit (about 30–44 minutes) CPT 99203 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-44 MINUTES	$126	$63	$72.12 – $420.07
New patient office visit (about 30–44 minutes): 10 of 32 insurance plan rates Aetna Medicare Advantage — All Plans: $75.73 Anthem VA Medicare Advantage — HMO: $72.12 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $420.07 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $420.07 Coventry Health Care — Worker's Compensation: $113.95 Highmark WV Medicare Advantage — All Plans: $75 Humana Medicare Advantage — All Plans: $75.73 Occunet — Occunet: $97.36 Optima VA Medicare Advantage — All Plans: $72.12 PA Health & Wellness Medicare Advantage — All Plan: $75.73
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$126	$63	$90.37 – $684.22
New patient office visit (about 45–59 minutes): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $105.41 Aetna — Better Health WV Mgd Medicaid: $102.54 Aetna Better Health PA — CHIP: $99.41 Aetna Better Health WV — CHIP: $102.54 Aetna Medicare Advantage — All Plans: $123.34 Anthem VA Medicare Advantage — HMO: $117.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $684.22 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $684.22 Coventry Health Care — Worker's Compensation: $185.60 Highmark Health Options — CHIP: $100.62
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW MOD 45 MIN	$286	$143	$90.37 – $684.22
New patient office visit (about 45–59 minutes): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $105.41 Aetna — Better Health WV Mgd Medicaid: $102.54 Aetna Better Health PA — CHIP: $99.41 Aetna Better Health WV — CHIP: $102.54 Aetna Medicare Advantage — All Plans: $123.34 Anthem VA Medicare Advantage — HMO: $117.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $684.22 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $684.22 Coventry Health Care — Worker's Compensation: $185.60 Highmark Health Options — CHIP: $100.62
New patient office visit (about 45–59 minutes) CPT 99204 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: NEW PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 45-59 MINUTES	$310	$155	$117.47 – $684.22
New patient office visit (about 45–59 minutes): 10 of 32 insurance plan rates Aetna Medicare Advantage — All Plans: $123.34 Anthem VA Medicare Advantage — HMO: $117.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $684.22 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $684.22 Coventry Health Care — Worker's Compensation: $185.60 Highmark WV Medicare Advantage — All Plans: $122.17 Humana Medicare Advantage — All Plans: $123.34 Occunet — Occunet: $158.58 Optima VA Medicare Advantage — All Plans: $117.47 PA Health & Wellness Medicare Advantage — All Plan: $123.34
New patient office visit (about 60–74 minutes) CPT 99205 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P NEW HI 60 MIN	$370	$185	$117.54 – $940.09
New patient office visit (about 60–74 minutes): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $143.43 Aetna — Better Health WV Mgd Medicaid: $139.52 Aetna Better Health PA — CHIP: $129.29 Aetna Better Health WV — CHIP: $139.52 Aetna Medicare Advantage — All Plans: $169.47 Anthem VA Medicare Advantage — HMO: $161.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $940.09 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $940.09 Coventry Health Care — Worker's Compensation: $255.01 Highmark Health Options — CHIP: $136.91
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$126	$63	$40 – $333.75
Established patient office visit (about 20–29 minutes): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $51.77 Aetna — Better Health WV Mgd Medicaid: $50.35 Aetna Better Health PA — CHIP: $44 Aetna Better Health WV — CHIP: $50.35 Aetna Medicare Advantage — All Plans: $60.16 Anthem VA Medicare Advantage — HMO: $57.30 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $333.75 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $333.75 Coventry Health Care — Worker's Compensation: $90.53 Highmark Health Options — CHIP: $49.41
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P EST LOW 20 MIN	$141	$70.50	$40 – $333.75
Established patient office visit (about 20–29 minutes): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $51.77 Aetna — Better Health WV Mgd Medicaid: $50.35 Aetna Better Health PA — CHIP: $44 Aetna Better Health WV — CHIP: $50.35 Aetna Medicare Advantage — All Plans: $60.16 Anthem VA Medicare Advantage — HMO: $57.30 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $333.75 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $333.75 Coventry Health Care — Worker's Compensation: $90.53 Highmark Health Options — CHIP: $49.41
Established patient office visit (about 20–29 minutes) CPT 99213 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 20-29 MINUTES	$126	$63	$57.30 – $333.75
Established patient office visit (about 20–29 minutes): 10 of 32 insurance plan rates Aetna Medicare Advantage — All Plans: $60.16 Anthem VA Medicare Advantage — HMO: $57.30 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $333.75 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $333.75 Coventry Health Care — Worker's Compensation: $90.53 Highmark WV Medicare Advantage — All Plans: $59.59 Humana Medicare Advantage — All Plans: $60.16 Occunet — Occunet: $77.36 Optima VA Medicare Advantage — All Plans: $57.30 PA Health & Wellness Medicare Advantage — All Plan: $60.16
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$126	$63	$54.42 – $491.95
Established patient office visit (about 30–39 minutes): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $76.57 Aetna — Better Health WV Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $59.86 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $88.68 Anthem VA Medicare Advantage — HMO: $84.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $491.95 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $491.95 Coventry Health Care — Worker's Compensation: $133.45 Highmark Health Options — CHIP: $73.09
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFFICE O/P EST MOD 30 MIN	$208	$104	$54.42 – $491.95
Established patient office visit (about 30–39 minutes): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $76.57 Aetna — Better Health WV Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $59.86 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $88.68 Anthem VA Medicare Advantage — HMO: $84.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $491.95 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $491.95 Coventry Health Care — Worker's Compensation: $133.45 Highmark Health Options — CHIP: $73.09
Established patient office visit (about 30–39 minutes) CPT 99214 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: ESTABLISHED PATIENT OFFICE OR OTHER OUTPATIENT VISIT; 30-39 MINUTES	$126	$63	$84.46 – $491.95
Established patient office visit (about 30–39 minutes): 10 of 32 insurance plan rates Aetna Medicare Advantage — All Plans: $88.68 Anthem VA Medicare Advantage — HMO: $84.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $491.95 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $491.95 Coventry Health Care — Worker's Compensation: $133.45 Highmark WV Medicare Advantage — All Plans: $87.84 Humana Medicare Advantage — All Plans: $88.68 Occunet — Occunet: $114.02 Optima VA Medicare Advantage — All Plans: $84.46 PA Health & Wellness Medicare Advantage — All Plan: $88.68
Office consultation with a specialist (moderate) CPT 99243 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: OFF/OP CNSLTJ NEW/EST LOW 30	$197	$98.50	$66.14 – $69.29
Office consultation with a specialist (moderate): 10 of 26 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $69.29 Aetna — Better Health WV Mgd Medicaid: $67.40 Aetna Better Health WV — CHIP: $67.40 Highmark Health Options — CHIP: $66.14 Highmark Health Options West VA — Mgd MCaid: $66.14 Pennsylvania Health & Wellness — Medicaid: $69.29 The Health Plan WV — CHIP: $67.40 The Health Plan WV — Mgd MCaid: $67.08 Wellpoint West Virginia — Mgd MCaid: $66.14 Wellpoint WV — CHIP: $66.14
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 18-39	$129	$64.50	$70.52 – $311.30
Preventive checkup, new patient, age 18–39: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $73.88 Aetna — Better Health WV Mgd Medicaid: $71.86 Aetna Better Health PA — CHIP: $311.30 Aetna Better Health WV — CHIP: $71.86 Highmark Health Options — CHIP: $70.52 Highmark Health Options West VA — Mgd MCaid: $70.52 Molina Managed Medicaid — Molina Managed Medicaid: $129 Pennsylvania Health & Wellness — Medicaid: $73.88 The Health Plan WV — CHIP: $71.86 The Health Plan WV — Mgd MCaid: $71.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PREV VISIT NEW AGE 18-39	$200	$100	$70.52 – $311.30
Preventive checkup, new patient, age 18–39: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $73.88 Aetna — Better Health WV Mgd Medicaid: $71.86 Aetna Better Health PA — CHIP: $311.30 Aetna Better Health WV — CHIP: $71.86 Highmark Health Options — CHIP: $70.52 Highmark Health Options West VA — Mgd MCaid: $70.52 Molina Managed Medicaid — Molina Managed Medicaid: $200 Pennsylvania Health & Wellness — Medicaid: $73.88 The Health Plan WV — CHIP: $71.86 The Health Plan WV — Mgd MCaid: $71.53
Preventive checkup, new patient, age 18–39 CPT 99385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (18-39 YEARS)	$126	$63	$70.52 – $311.30
Preventive checkup, new patient, age 18–39: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $73.88 Aetna — Better Health WV Mgd Medicaid: $71.86 Aetna Better Health PA — CHIP: $311.30 Aetna Better Health WV — CHIP: $71.86 Highmark Health Options — CHIP: $70.52 Highmark Health Options West VA — Mgd MCaid: $70.52 Molina Managed Medicaid — Molina Managed Medicaid: $126 Pennsylvania Health & Wellness — Medicaid: $73.88 The Health Plan WV — CHIP: $71.86 The Health Plan WV — Mgd MCaid: $71.53
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PREV VISIT NEW AGE 40-64	$173	$86.50	$85.19 – $311.30
Preventive checkup, new patient, age 40–64: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $89.24 Aetna — Better Health WV Mgd Medicaid: $86.81 Aetna Better Health PA — CHIP: $311.30 Aetna Better Health WV — CHIP: $86.81 Highmark Health Options — CHIP: $85.19 Highmark Health Options West VA — Mgd MCaid: $85.19 Molina Managed Medicaid — Molina Managed Medicaid: $173 Pennsylvania Health & Wellness — Medicaid: $89.24 The Health Plan WV — CHIP: $86.81 The Health Plan WV — Mgd MCaid: $86.40
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PREV VISIT NEW AGE 40-64	$242	$121	$85.19 – $311.30
Preventive checkup, new patient, age 40–64: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $89.24 Aetna — Better Health WV Mgd Medicaid: $86.81 Aetna Better Health PA — CHIP: $311.30 Aetna Better Health WV — CHIP: $86.81 Highmark Health Options — CHIP: $85.19 Highmark Health Options West VA — Mgd MCaid: $85.19 Molina Managed Medicaid — Molina Managed Medicaid: $242 Pennsylvania Health & Wellness — Medicaid: $89.24 The Health Plan WV — CHIP: $86.81 The Health Plan WV — Mgd MCaid: $86.40
Preventive checkup, new patient, age 40–64 CPT 99386 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: INITIAL NEW PATIENT PREVENTIVE MEDICINE EVALUATION (40-64 YEARS)	$169	$84.50	$85.19 – $311.30
Preventive checkup, new patient, age 40–64: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $89.24 Aetna — Better Health WV Mgd Medicaid: $86.81 Aetna Better Health PA — CHIP: $311.30 Aetna Better Health WV — CHIP: $86.81 Highmark Health Options — CHIP: $85.19 Highmark Health Options West VA — Mgd MCaid: $85.19 Molina Managed Medicaid — Molina Managed Medicaid: $169 Pennsylvania Health & Wellness — Medicaid: $89.24 The Health Plan WV — CHIP: $86.81 The Health Plan WV — Mgd MCaid: $86.40
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT LOW MDM	$1,343	$671.50	$62.32 – $1,625.53
Emergency room visit (moderate): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $107.53 Aetna — Better Health WV Mgd Medicaid: $104.59 Aetna Better Health PA — CHIP: $62.32 Aetna Better Health WV — CHIP: $104.59 Aetna Medicare Advantage — All Plans: $293.03 Alliance Coal — Alliance Coal: $488.39 Anthem VA Medicare Advantage — HMO: $279.08 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,625.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,625.53 Coventry Health Care — Worker's Compensation: $440.95
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,167	$583.50	$62.32 – $1,625.53
Emergency room visit (moderate): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $107.53 Aetna — Better Health WV Mgd Medicaid: $104.59 Aetna Better Health PA — CHIP: $62.32 Aetna Better Health WV — CHIP: $104.59 Aetna Medicare Advantage — All Plans: $293.03 Alliance Coal — Alliance Coal: $488.39 Anthem VA Medicare Advantage — HMO: $279.08 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,625.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,625.53 Coventry Health Care — Worker's Compensation: $440.95
Emergency room visit (moderate) CPT 99283 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF MODERATE SEVERITY	$1,167	$583.50	$279.08 – $1,625.53
Emergency room visit (moderate): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $293.03 Alliance Coal — Alliance Coal: $488.39 Anthem VA Medicare Advantage — HMO: $279.08 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,625.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,625.53 Coventry Health Care — Worker's Compensation: $440.95 Highmark WV Medicare Advantage — All Plans: $290.24 Humana Medicare Advantage — All Plans: $293.03 Occunet — Occunet: $376.76 Optima VA Medicare Advantage — All Plans: $279.08
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT MOD MDM	$2,182	$1,091	$104.86 – $2,484.66
Emergency room visit (moderately high): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $210.98 Aetna — Better Health WV Mgd Medicaid: $205.23 Aetna Better Health PA — CHIP: $104.86 Aetna Better Health WV — CHIP: $205.23 Aetna Medicare Advantage — All Plans: $447.91 Alliance Coal — Alliance Coal: $746.51 Anthem VA Medicare Advantage — HMO: $426.58 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,484.66 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,484.66 Coventry Health Care — Worker's Compensation: $674
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$1,897	$948.50	$104.86 – $2,484.66
Emergency room visit (moderately high): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $210.98 Aetna — Better Health WV Mgd Medicaid: $205.23 Aetna Better Health PA — CHIP: $104.86 Aetna Better Health WV — CHIP: $205.23 Aetna Medicare Advantage — All Plans: $447.91 Alliance Coal — Alliance Coal: $746.52 Anthem VA Medicare Advantage — HMO: $426.58 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,484.66 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,484.66 Coventry Health Care — Worker's Compensation: $674
Emergency room visit (moderately high) CPT 99284 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR PROBLEM OF HIGH SEVERITY	$1,897	$948.50	$426.58 – $2,484.66
Emergency room visit (moderately high): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $447.91 Alliance Coal — Alliance Coal: $746.52 Anthem VA Medicare Advantage — HMO: $426.58 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,484.66 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,484.66 Coventry Health Care — Worker's Compensation: $674 Highmark WV Medicare Advantage — All Plans: $443.64 Humana Medicare Advantage — All Plans: $447.91 Occunet — Occunet: $575.88 Optima VA Medicare Advantage — All Plans: $426.58
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPT VISIT HI MDM	$3,242	$1,621	$152.61 – $3,546.19
Emergency room visit (high): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $638.33 Aetna — Better Health WV Mgd Medicaid: $620.92 Aetna Better Health PA — CHIP: $152.61 Aetna Better Health WV — CHIP: $620.92 Aetna Medicare Advantage — All Plans: $639.27 Alliance Coal — Alliance Coal: $1,065.45 Anthem VA Medicare Advantage — HMO: $608.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,546.19 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,546.19 Coventry Health Care — Worker's Compensation: $961.95
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$2,819	$1,409.50	$152.61 – $3,546.19
Emergency room visit (high): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $638.33 Aetna — Better Health WV Mgd Medicaid: $620.92 Aetna Better Health PA — CHIP: $152.61 Aetna Better Health WV — CHIP: $620.92 Aetna Medicare Advantage — All Plans: $639.27 Alliance Coal — Alliance Coal: $1,065.45 Anthem VA Medicare Advantage — HMO: $608.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,546.19 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,546.19 Coventry Health Care — Worker's Compensation: $961.95
Emergency room visit (high) CPT 99285 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 25 In the file: EMERGENCY DEPARTMENT VISIT FOR LIFE THREATENING OR FUNCTIONING SEVERITY	$2,819	$1,409.50	$608.83 – $3,546.19
Emergency room visit (high): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $639.27 Alliance Coal — Alliance Coal: $1,065.45 Anthem VA Medicare Advantage — HMO: $608.83 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,546.19 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,546.19 Coventry Health Care — Worker's Compensation: $961.95 Highmark WV Medicare Advantage — All Plans: $633.18 Humana Medicare Advantage — All Plans: $639.27 Occunet — Occunet: $821.92 Optima VA Medicare Advantage — All Plans: $608.83

Lab tests

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: METABOLIC PANEL TOTAL CA	$173	$86.50	$7.99 – $49.28
Basic metabolic panel (blood test): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $8.37 Aetna — Better Health WV Mgd Medicaid: $8.14 Aetna Better Health PA — CHIP: $10.30 Aetna Better Health WV — CHIP: $8.14 Aetna Medicare Advantage — All Plans: $8.88 Alliance Coal — Alliance Coal: $10.58 Anthem VA Medicare Advantage — HMO: $8.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $49.28 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $49.28 Coventry Health Care — Worker's Compensation: $13.37
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$6.44	$3.22	$6.44 – $49.28
Basic metabolic panel (blood test): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $8.37 Aetna — Better Health WV Mgd Medicaid: $8.14 Aetna Better Health PA — CHIP: $10.30 Aetna Better Health WV — CHIP: $8.14 Aetna Medicare Advantage — All Plans: $8.88 Alliance Coal — Alliance Coal: $10.57 Anthem VA Medicare Advantage — HMO: $8.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $49.28 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $49.28 Coventry Health Care — Worker's Compensation: $13.37
Basic metabolic panel (blood test) CPT 80048 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: BLOOD TEST; BASIC GROUP OF BLOOD CHEMICALS (CALCIUM; TOTAL)	$88	$44	$8.46 – $49.28
Basic metabolic panel (blood test): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $8.88 Alliance Coal — Alliance Coal: $10.58 Anthem VA Medicare Advantage — HMO: $8.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $49.28 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $49.28 Coventry Health Care — Worker's Compensation: $13.37 Highmark WV Medicare Advantage — All Plans: $8.80 Humana Medicare Advantage — All Plans: $8.88 Occunet — Occunet: $11.42 Optima VA Medicare Advantage — All Plans: $8.46
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$110	$55	$9.98 – $61.51
Comprehensive metabolic panel (blood test): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $10.45 Aetna — Better Health WV Mgd Medicaid: $10.17 Aetna Better Health PA — CHIP: $12.86 Aetna Better Health WV — CHIP: $10.17 Aetna Medicare Advantage — All Plans: $11.09 Alliance Coal — Alliance Coal: $13.20 Anthem VA Medicare Advantage — HMO: $10.56 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $61.51 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $61.51 Coventry Health Care — Worker's Compensation: $16.68
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPREHEN METABOLIC PANEL	$222	$111	$9.98 – $61.51
Comprehensive metabolic panel (blood test): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $10.45 Aetna — Better Health WV Mgd Medicaid: $10.17 Aetna Better Health PA — CHIP: $12.86 Aetna Better Health WV — CHIP: $10.17 Aetna Medicare Advantage — All Plans: $11.09 Alliance Coal — Alliance Coal: $13.20 Anthem VA Medicare Advantage — HMO: $10.56 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $61.51 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $61.51 Coventry Health Care — Worker's Compensation: $16.68
Comprehensive metabolic panel (blood test) CPT 80053 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 91 In the file: BLOOD TEST; COMPREHENSIVE GROUP OF BLOOD CHEMICALS	$110	$55	$10.56 – $61.51
Comprehensive metabolic panel (blood test): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $11.09 Alliance Coal — Alliance Coal: $13.20 Anthem VA Medicare Advantage — HMO: $10.56 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $61.51 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $61.51 Coventry Health Care — Worker's Compensation: $16.68 Highmark WV Medicare Advantage — All Plans: $10.98 Humana Medicare Advantage — All Plans: $11.09 Occunet — Occunet: $14.26 Optima VA Medicare Advantage — All Plans: $10.56
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$139	$69.50	$12.65 – $77.99
Cholesterol panel (lipid panel): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $13.26 Aetna — Better Health WV Mgd Medicaid: $12.89 Aetna Better Health PA — CHIP: $15.40 Aetna Better Health WV — CHIP: $12.89 Aetna Medicare Advantage — All Plans: $14.06 Alliance Coal — Alliance Coal: $16.74 Anthem VA Medicare Advantage — HMO: $13.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $77.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $77.99 Coventry Health Care — Worker's Compensation: $21.16
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$139	$69.50	$13.39 – $77.99
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $14.06 Alliance Coal — Alliance Coal: $16.74 Anthem VA Medicare Advantage — HMO: $13.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $77.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $77.99 Coventry Health Care — Worker's Compensation: $21.16 Highmark WV Medicare Advantage — All Plans: $13.93 Humana Medicare Advantage — All Plans: $14.06 Occunet — Occunet: $18.08 Optima VA Medicare Advantage — All Plans: $13.39
Cholesterol panel (lipid panel) CPT 80061 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: BLOOD TEST; LIPIDS (CHOLESTEROL AND TRIGLYCERIDES)	$139	$69.50	$13.39 – $77.99
Cholesterol panel (lipid panel): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $14.06 Alliance Coal — Alliance Coal: $16.74 Anthem VA Medicare Advantage — HMO: $13.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $77.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $77.99 Coventry Health Care — Worker's Compensation: $21.16 Highmark WV Medicare Advantage — All Plans: $13.93 Humana Medicare Advantage — All Plans: $14.06 Occunet — Occunet: $18.08 Optima VA Medicare Advantage — All Plans: $13.39
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$89	$44.50	$8.20 – $50.56
Kidney function panel: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $8.59 Aetna — Better Health WV Mgd Medicaid: $8.36 Aetna Better Health PA — CHIP: $10.56 Aetna Better Health WV — CHIP: $8.36 Aetna Medicare Advantage — All Plans: $9.11 Alliance Coal — Alliance Coal: $10.85 Anthem VA Medicare Advantage — HMO: $8.68 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $50.56 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $50.56 Coventry Health Care — Worker's Compensation: $13.71
Kidney function panel CPT 80069 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PN In the file: KIDNEY FUNCTION BLOOD TEST PANEL	$89	$44.50	$8.68 – $50.56
Kidney function panel: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $9.11 Alliance Coal — Alliance Coal: $10.85 Anthem VA Medicare Advantage — HMO: $8.68 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $50.56 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $50.56 Coventry Health Care — Worker's Compensation: $13.71 Highmark WV Medicare Advantage — All Plans: $9.03 Humana Medicare Advantage — All Plans: $9.11 Occunet — Occunet: $11.72 Optima VA Medicare Advantage — All Plans: $8.68
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: LIVER FUNCTION BLOOD TEST PANEL	$84	$42	$7.72 – $47.59
Liver function panel: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $8.09 Aetna — Better Health WV Mgd Medicaid: $7.86 Aetna Better Health PA — CHIP: $9.93 Aetna Better Health WV — CHIP: $7.86 Aetna Medicare Advantage — All Plans: $8.58 Alliance Coal — Alliance Coal: $10.21 Anthem VA Medicare Advantage — HMO: $8.17 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $47.59 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $47.59 Coventry Health Care — Worker's Compensation: $12.91
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: LIVER FUNCTION BLOOD TEST PANEL	$84	$42	$8.17 – $47.59
Liver function panel: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $8.58 Alliance Coal — Alliance Coal: $10.21 Anthem VA Medicare Advantage — HMO: $8.17 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $47.59 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $47.59 Coventry Health Care — Worker's Compensation: $12.91 Highmark WV Medicare Advantage — All Plans: $8.50 Humana Medicare Advantage — All Plans: $8.58 Occunet — Occunet: $11.03 Optima VA Medicare Advantage — All Plans: $8.17
Liver function panel CPT 80076 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: LIVER FUNCTION BLOOD TEST PANEL	$84	$42	$8.17 – $47.59
Liver function panel: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $8.58 Alliance Coal — Alliance Coal: $10.21 Anthem VA Medicare Advantage — HMO: $8.17 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $47.59 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $47.59 Coventry Health Care — Worker's Compensation: $12.91 Highmark WV Medicare Advantage — All Plans: $8.50 Humana Medicare Advantage — All Plans: $8.58 Occunet — Occunet: $11.03 Optima VA Medicare Advantage — All Plans: $8.17
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/SCOPE	$54	$27	$2.99 – $18.46
Urine test (automated, with microscope): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $3.14 Aetna — Better Health WV Mgd Medicaid: $3.05 Aetna Better Health PA — CHIP: $3.30 Aetna Better Health WV — CHIP: $3.05 Aetna Medicare Advantage — All Plans: $3.33 Alliance Coal — Alliance Coal: $3.96 Anthem VA Medicare Advantage — HMO: $3.17 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.46 Coventry Health Care — Worker's Compensation: $5.01
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$10.46	$5.23	$2.99 – $18.46
Urine test (automated, with microscope): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $3.14 Aetna — Better Health WV Mgd Medicaid: $3.05 Aetna Better Health PA — CHIP: $3.30 Aetna Better Health WV — CHIP: $3.05 Aetna Medicare Advantage — All Plans: $3.33 Alliance Coal — Alliance Coal: $3.96 Anthem VA Medicare Advantage — HMO: $3.17 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.46 Coventry Health Care — Worker's Compensation: $5.01
Urine test (automated, with microscope) CPT 81001 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: MANUAL URINALYSIS TEST WITH EXAMINATION USING MICROSCOPE; AUTOMATED	$31	$15.50	$3.17 – $18.46
Urine test (automated, with microscope): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3.33 Alliance Coal — Alliance Coal: $3.96 Anthem VA Medicare Advantage — HMO: $3.17 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $18.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $18.46 Coventry Health Care — Worker's Compensation: $5.01 Highmark WV Medicare Advantage — All Plans: $3.30 Humana Medicare Advantage — All Plans: $3.33 Occunet — Occunet: $4.28 Optima VA Medicare Advantage — All Plans: $3.17
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS; MANUAL TEST	$25	$12.50	$3.29 – $20.27
Urine test (manual, without microscope): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $3.44 Aetna — Better Health WV Mgd Medicaid: $3.35 Aetna Better Health PA — CHIP: $3.93 Aetna Better Health WV — CHIP: $3.35 Aetna Medicare Advantage — All Plans: $3.65 Alliance Coal — Alliance Coal: $4.35 Anthem VA Medicare Advantage — HMO: $3.48 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $20.27 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $20.27 Coventry Health Care — Worker's Compensation: $5.50
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: URINALYSIS; MANUAL TEST	$25	$12.50	$3.48 – $20.27
Urine test (manual, without microscope): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3.65 Alliance Coal — Alliance Coal: $4.35 Anthem VA Medicare Advantage — HMO: $3.48 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $20.27 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $20.27 Coventry Health Care — Worker's Compensation: $5.50 Highmark WV Medicare Advantage — All Plans: $3.62 Humana Medicare Advantage — All Plans: $3.65 Occunet — Occunet: $4.70 Optima VA Medicare Advantage — All Plans: $3.48
Urine test (manual, without microscope) CPT 81002 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_PN In the file: URINALYSIS; MANUAL TEST	$25	$12.50	$3.48 – $20.27
Urine test (manual, without microscope): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3.65 Alliance Coal — Alliance Coal: $4.35 Anthem VA Medicare Advantage — HMO: $3.48 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $20.27 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $20.27 Coventry Health Care — Worker's Compensation: $5.50 Highmark WV Medicare Advantage — All Plans: $3.62 Humana Medicare Advantage — All Plans: $3.65 Occunet — Occunet: $4.70 Optima VA Medicare Advantage — All Plans: $3.48
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: URINALYSIS AUTO W/O SCOPE	$25	$12.50	$2.13 – $13.11
Urine test (automated, without microscope): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $2.23 Aetna — Better Health WV Mgd Medicaid: $2.17 Aetna Better Health PA — CHIP: $3.41 Aetna Better Health WV — CHIP: $2.17 Aetna Medicare Advantage — All Plans: $2.36 Alliance Coal — Alliance Coal: $2.81 Anthem VA Medicare Advantage — HMO: $2.25 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.11 Coventry Health Care — Worker's Compensation: $3.56
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AUTOMATED URINALYSIS TEST	$24	$12	$2.13 – $13.11
Urine test (automated, without microscope): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $2.23 Aetna — Better Health WV Mgd Medicaid: $2.17 Aetna Better Health PA — CHIP: $3.41 Aetna Better Health WV — CHIP: $2.17 Aetna Medicare Advantage — All Plans: $2.36 Alliance Coal — Alliance Coal: $2.81 Anthem VA Medicare Advantage — HMO: $2.25 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.11 Coventry Health Care — Worker's Compensation: $3.56
Urine test (automated, without microscope) CPT 81003 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: AUTOMATED URINALYSIS TEST	$24	$12	$2.25 – $13.11
Urine test (automated, without microscope): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $2.36 Alliance Coal — Alliance Coal: $2.81 Anthem VA Medicare Advantage — HMO: $2.25 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $13.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $13.11 Coventry Health Care — Worker's Compensation: $3.56 Highmark WV Medicare Advantage — All Plans: $2.34 Humana Medicare Advantage — All Plans: $2.36 Occunet — Occunet: $3.04 Optima VA Medicare Advantage — All Plans: $2.25
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY OF PSA TOTAL	$190	$95	$17.38 – $107.11
PSA (prostate specific antigen) blood test: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $18.21 Aetna — Better Health WV Mgd Medicaid: $17.71 Aetna Better Health PA — CHIP: $26.80 Aetna Better Health WV — CHIP: $17.71 Aetna Medicare Advantage — All Plans: $19.31 Alliance Coal — Alliance Coal: $22.99 Anthem VA Medicare Advantage — HMO: $18.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $107.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $107.11 Coventry Health Care — Worker's Compensation: $29.06
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$186	$93	$17.38 – $107.11
PSA (prostate specific antigen) blood test: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $18.21 Aetna — Better Health WV Mgd Medicaid: $17.71 Aetna Better Health PA — CHIP: $26.80 Aetna Better Health WV — CHIP: $17.71 Aetna Medicare Advantage — All Plans: $19.31 Alliance Coal — Alliance Coal: $22.99 Anthem VA Medicare Advantage — HMO: $18.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $107.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $107.11 Coventry Health Care — Worker's Compensation: $29.06
PSA (prostate specific antigen) blood test CPT 84153 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: PSA (PROSTATE SPECIFIC ANTIGEN) MEASUREMENT; TOTAL	$186	$93	$18.39 – $107.11
PSA (prostate specific antigen) blood test: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $19.31 Alliance Coal — Alliance Coal: $22.99 Anthem VA Medicare Advantage — HMO: $18.39 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $107.11 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $107.11 Coventry Health Care — Worker's Compensation: $29.06 Highmark WV Medicare Advantage — All Plans: $19.13 Humana Medicare Advantage — All Plans: $19.31 Occunet — Occunet: $24.83 Optima VA Medicare Advantage — All Plans: $18.39
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ASSAY THYROID STIM HORMONE	$47	$23.50	$15.88 – $97.85
Thyroid stimulating hormone (TSH) test: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $16.63 Aetna — Better Health WV Mgd Medicaid: $16.18 Aetna Better Health PA — CHIP: $25.53 Aetna Better Health WV — CHIP: $16.18 Aetna Medicare Advantage — All Plans: $17.64 Alliance Coal — Alliance Coal: $21 Anthem VA Medicare Advantage — HMO: $16.80 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $97.85 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $97.85 Coventry Health Care — Worker's Compensation: $26.54
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$9.60	$4.80	$9.60 – $97.85
Thyroid stimulating hormone (TSH) test: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $16.63 Aetna — Better Health WV Mgd Medicaid: $16.18 Aetna Better Health PA — CHIP: $25.53 Aetna Better Health WV — CHIP: $16.18 Aetna Medicare Advantage — All Plans: $17.64 Alliance Coal — Alliance Coal: $21 Anthem VA Medicare Advantage — HMO: $16.80 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $97.85 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $97.85 Coventry Health Care — Worker's Compensation: $26.54
Thyroid stimulating hormone (TSH) test CPT 84443 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier EP In the file: BLOOD TEST; THYROID STIMULATING HORMONE (TSH)	$170	$85	$16.80 – $97.85
Thyroid stimulating hormone (TSH) test: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $17.64 Alliance Coal — Alliance Coal: $21 Anthem VA Medicare Advantage — HMO: $16.80 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $97.85 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $97.85 Coventry Health Care — Worker's Compensation: $26.54 Highmark WV Medicare Advantage — All Plans: $17.47 Humana Medicare Advantage — All Plans: $17.64 Occunet — Occunet: $22.68 Optima VA Medicare Advantage — All Plans: $16.80
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC W/AUTO DIFF WBC	$83	$41.50	$6 – $45.26
Complete blood count (CBC) with differential: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $7.69 Aetna — Better Health WV Mgd Medicaid: $7.48 Aetna Better Health PA — CHIP: $6.60 Aetna Better Health WV — CHIP: $7.48 Aetna Medicare Advantage — All Plans: $8.16 Alliance Coal — Alliance Coal: $9.71 Anthem VA Medicare Advantage — HMO: $7.77 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $45.26 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $45.26 Coventry Health Care — Worker's Compensation: $12.28
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$4.18	$2.09	$4.18 – $45.26
Complete blood count (CBC) with differential: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $7.69 Aetna — Better Health WV Mgd Medicaid: $7.48 Aetna Better Health PA — CHIP: $6.60 Aetna Better Health WV — CHIP: $7.48 Aetna Medicare Advantage — All Plans: $8.16 Alliance Coal — Alliance Coal: $9.71 Anthem VA Medicare Advantage — HMO: $7.77 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $45.26 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $45.26 Coventry Health Care — Worker's Compensation: $12.28
Complete blood count (CBC) with differential CPT 85025 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST AND AUTOMATED DIFFERENTIAL WHITE BLOOD CELL COUNT	$80	$40	$7.77 – $45.26
Complete blood count (CBC) with differential: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $8.16 Alliance Coal — Alliance Coal: $9.71 Anthem VA Medicare Advantage — HMO: $7.77 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $45.26 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $45.26 Coventry Health Care — Worker's Compensation: $12.28 Highmark WV Medicare Advantage — All Plans: $8.08 Humana Medicare Advantage — All Plans: $8.16 Occunet — Occunet: $10.49 Optima VA Medicare Advantage — All Plans: $7.77
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE CBC AUTOMATED	$70	$35	$6.11 – $37.69
Complete blood count (CBC), automated: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $6.40 Aetna — Better Health WV Mgd Medicaid: $6.23 Aetna Better Health PA — CHIP: $8.27 Aetna Better Health WV — CHIP: $6.23 Aetna Medicare Advantage — All Plans: $6.79 Alliance Coal — Alliance Coal: $8.09 Anthem VA Medicare Advantage — HMO: $6.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $37.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $37.69 Coventry Health Care — Worker's Compensation: $10.22
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$68	$34	$6.11 – $37.69
Complete blood count (CBC), automated: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $6.40 Aetna — Better Health WV Mgd Medicaid: $6.23 Aetna Better Health PA — CHIP: $8.27 Aetna Better Health WV — CHIP: $6.23 Aetna Medicare Advantage — All Plans: $6.79 Alliance Coal — Alliance Coal: $8.09 Anthem VA Medicare Advantage — HMO: $6.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $37.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $37.69 Coventry Health Care — Worker's Compensation: $10.22
Complete blood count (CBC), automated CPT 85027 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: COMPLETE BLOOD CELL COUNT (RED CELLS; WHITE BLOOD CELL; PLATELETS); AUTOMATED TEST	$68	$34	$6.47 – $37.69
Complete blood count (CBC), automated: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $6.79 Alliance Coal — Alliance Coal: $8.09 Anthem VA Medicare Advantage — HMO: $6.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $37.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $37.69 Coventry Health Care — Worker's Compensation: $10.22 Highmark WV Medicare Advantage — All Plans: $6.73 Humana Medicare Advantage — All Plans: $6.79 Occunet — Occunet: $8.73 Optima VA Medicare Advantage — All Plans: $6.47
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PROTHROMBIN TIME	$43	$21.50	$4 – $24.99
Blood clotting time test (prothrombin time, PT): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $4.25 Aetna — Better Health WV Mgd Medicaid: $4.13 Aetna Better Health PA — CHIP: $4.40 Aetna Better Health WV — CHIP: $4.13 Aetna Medicare Advantage — All Plans: $4.50 Alliance Coal — Alliance Coal: $5.36 Anthem VA Medicare Advantage — HMO: $4.29 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24.99 Coventry Health Care — Worker's Compensation: $6.78
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BLOOD TEST; CLOTTING TIME	$84	$42	$4 – $24.99
Blood clotting time test (prothrombin time, PT): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $4.25 Aetna — Better Health WV Mgd Medicaid: $4.13 Aetna Better Health PA — CHIP: $4.40 Aetna Better Health WV — CHIP: $4.13 Aetna Medicare Advantage — All Plans: $4.50 Alliance Coal — Alliance Coal: $5.36 Anthem VA Medicare Advantage — HMO: $4.29 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24.99 Coventry Health Care — Worker's Compensation: $6.78
Blood clotting time test (prothrombin time, PT) CPT 85610 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: BLOOD TEST; CLOTTING TIME	$42	$21	$4.29 – $24.99
Blood clotting time test (prothrombin time, PT): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $4.50 Alliance Coal — Alliance Coal: $5.36 Anthem VA Medicare Advantage — HMO: $4.29 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $24.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $24.99 Coventry Health Care — Worker's Compensation: $6.78 Highmark WV Medicare Advantage — All Plans: $4.46 Humana Medicare Advantage — All Plans: $4.50 Occunet — Occunet: $5.79 Optima VA Medicare Advantage — All Plans: $4.29
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THROMBOPLASTIN TIME PARTIAL	$74	$37	$5.68 – $35.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $5.95 Aetna — Better Health WV Mgd Medicaid: $5.79 Aetna Better Health PA — CHIP: $8.25 Aetna Better Health WV — CHIP: $5.79 Aetna Medicare Advantage — All Plans: $6.31 Alliance Coal — Alliance Coal: $7.51 Anthem VA Medicare Advantage — HMO: $6.01 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35.01 Coventry Health Care — Worker's Compensation: $9.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$63	$31.50	$5.68 – $35.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $5.95 Aetna — Better Health WV Mgd Medicaid: $5.79 Aetna Better Health PA — CHIP: $8.25 Aetna Better Health WV — CHIP: $5.79 Aetna Medicare Advantage — All Plans: $6.31 Alliance Coal — Alliance Coal: $7.51 Anthem VA Medicare Advantage — HMO: $6.01 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35.01 Coventry Health Care — Worker's Compensation: $9.50
Blood clotting test (partial thromboplastin time, PTT) CPT 85730 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: COAGULATION ASSESSMENT BLOOD TEST; PLASMA OR WHOLE BLOOD	$63	$31.50	$6.01 – $35.01
Blood clotting test (partial thromboplastin time, PTT): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $6.31 Alliance Coal — Alliance Coal: $7.51 Anthem VA Medicare Advantage — HMO: $6.01 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35.01 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35.01 Coventry Health Care — Worker's Compensation: $9.50 Highmark WV Medicare Advantage — All Plans: $6.25 Humana Medicare Advantage — All Plans: $6.31 Occunet — Occunet: $8.11 Optima VA Medicare Advantage — All Plans: $6.01

Imaging (X-ray, CT, MRI, ultrasound, mammogram)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT HEAD/BRAIN W/O DYE	$1,351	$675.50	$30.11 – $622.48
CT scan of the head or brain, without contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $31.55 Aetna — Better Health WV Mgd Medicaid: $30.69 Aetna Better Health PA — CHIP: $85.25 Aetna Better Health WV — CHIP: $30.69 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$1,324	$662	$30.11 – $622.48
CT scan of the head or brain, without contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $31.55 Aetna — Better Health WV Mgd Medicaid: $30.69 Aetna Better Health PA — CHIP: $85.25 Aetna Better Health WV — CHIP: $30.69 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
CT scan of the head or brain, without contrast CPT 70450 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN HEAD OR BRAIN WITHOUT CONTRAST	$1,324	$662	$106.87 – $622.48
CT scan of the head or brain, without contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85 Highmark WV Medicare Advantage — All Plans: $111.14 Humana Medicare Advantage — All Plans: $112.21 Occunet — Occunet: $144.27 Optima VA Medicare Advantage — All Plans: $106.87
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI BRAIN STEM W/O & W/DYE	$5,625	$2,812.50	$81.59 – $2,077.40
MRI of the brain, before and after contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $85.47 Aetna — Better Health WV Mgd Medicaid: $83.14 Aetna Better Health PA — CHIP: $295.90 Aetna Better Health WV — CHIP: $83.14 Aetna Medicare Advantage — All Plans: $374.49 Alliance Coal — Alliance Coal: $624.16 Anthem VA Medicare Advantage — HMO: $356.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,077.40 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,077.40 Coventry Health Care — Worker's Compensation: $563.52
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$5,514	$2,757	$81.59 – $2,077.40
MRI of the brain, before and after contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $85.47 Aetna — Better Health WV Mgd Medicaid: $83.14 Aetna Better Health PA — CHIP: $295.90 Aetna Better Health WV — CHIP: $83.14 Aetna Medicare Advantage — All Plans: $374.49 Alliance Coal — Alliance Coal: $624.16 Anthem VA Medicare Advantage — HMO: $356.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,077.40 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,077.40 Coventry Health Care — Worker's Compensation: $563.52
MRI of the brain, before and after contrast CPT 70553 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: MRI SCAN OF BRAIN BEFORE AND AFTER CONTRAST	$5,514	$2,757	$356.66 – $2,077.40
MRI of the brain, before and after contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $374.49 Alliance Coal — Alliance Coal: $624.16 Anthem VA Medicare Advantage — HMO: $356.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,077.40 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,077.40 Coventry Health Care — Worker's Compensation: $563.52 Highmark WV Medicare Advantage — All Plans: $370.93 Humana Medicare Advantage — All Plans: $374.49 Occunet — Occunet: $481.49 Optima VA Medicare Advantage — All Plans: $356.66
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF CHEST; 2 VIEWS	$387	$193.50	$7.72 – $518.16
Chest X-ray, 2 views: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $8.09 Aetna — Better Health WV Mgd Medicaid: $7.86 Aetna Better Health PA — CHIP: $16.34 Aetna Better Health WV — CHIP: $7.86 Aetna Medicare Advantage — All Plans: $93.41 Alliance Coal — Alliance Coal: $155.68 Anthem VA Medicare Advantage — HMO: $88.96 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $518.16 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $518.16 Coventry Health Care — Worker's Compensation: $140.56
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_PN_TC In the file: X-RAY OF CHEST; 2 VIEWS	$387	$193.50	$33.23 – $193.55
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $34.89 Alliance Coal — Alliance Coal: $58.15 Anthem VA Medicare Advantage — HMO: $33.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $193.55 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $193.55 Coventry Health Care — Worker's Compensation: $52.50 Highmark WV Medicare Advantage — All Plans: $34.56 Humana Medicare Advantage — All Plans: $34.89 Occunet — Occunet: $44.86 Optima VA Medicare Advantage — All Plans: $33.23
Chest X-ray, 2 views CPT 71046 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_TC In the file: X-RAY OF CHEST; 2 VIEWS	$387	$193.50	$88.96 – $518.16
Chest X-ray, 2 views: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $93.41 Alliance Coal — Alliance Coal: $155.68 Anthem VA Medicare Advantage — HMO: $88.96 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $518.16 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $518.16 Coventry Health Care — Worker's Compensation: $140.56 Highmark WV Medicare Advantage — All Plans: $92.52 Humana Medicare Advantage — All Plans: $93.41 Occunet — Occunet: $120.10 Optima VA Medicare Advantage — All Plans: $88.96
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$645	$322.50	$9.26 – $622.48
X-ray of the lower spine, at least 4 views: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $9.70 Aetna — Better Health WV Mgd Medicaid: $9.44 Aetna Better Health PA — CHIP: $24.75 Aetna Better Health WV — CHIP: $9.44 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$645	$322.50	$106.87 – $622.48
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85 Highmark WV Medicare Advantage — All Plans: $111.14 Humana Medicare Advantage — All Plans: $112.21 Occunet — Occunet: $144.27 Optima VA Medicare Advantage — All Plans: $106.87
X-ray of the lower spine, at least 4 views CPT 72110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER_PN_TC In the file: X-RAY OF LOWER AND SACRAL SPINE; MINIMUM OF 4 VIEWS	$645	$322.50	$39.91 – $232.46
X-ray of the lower spine, at least 4 views: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $41.91 Alliance Coal — Alliance Coal: $69.84 Anthem VA Medicare Advantage — HMO: $39.91 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $232.46 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $232.46 Coventry Health Care — Worker's Compensation: $63.06 Highmark WV Medicare Advantage — All Plans: $41.51 Humana Medicare Advantage — All Plans: $41.91 Occunet — Occunet: $53.88 Optima VA Medicare Advantage — All Plans: $39.91
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI LUMBAR SPINE W/O DYE	$3,449	$1,724.50	$52.50 – $1,420.79
MRI of the lower back (lumbar spine), without contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $55 Aetna — Better Health WV Mgd Medicaid: $53.50 Aetna Better Health PA — CHIP: $205.92 Aetna Better Health WV — CHIP: $53.50 Aetna Medicare Advantage — All Plans: $256.13 Alliance Coal — Alliance Coal: $426.88 Anthem VA Medicare Advantage — HMO: $243.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,420.79 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,420.79 Coventry Health Care — Worker's Compensation: $385.41
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$3,381	$1,690.50	$52.50 – $1,420.79
MRI of the lower back (lumbar spine), without contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $55 Aetna — Better Health WV Mgd Medicaid: $53.50 Aetna Better Health PA — CHIP: $205.92 Aetna Better Health WV — CHIP: $53.50 Aetna Medicare Advantage — All Plans: $256.13 Alliance Coal — Alliance Coal: $426.88 Anthem VA Medicare Advantage — HMO: $243.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,420.79 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,420.79 Coventry Health Care — Worker's Compensation: $385.41
MRI of the lower back (lumbar spine), without contrast CPT 72148 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier PO In the file: MRI SCAN OF LOWER SPINAL CANAL WITHOUT CONTRAST	$3,381	$1,690.50	$243.93 – $1,420.79
MRI of the lower back (lumbar spine), without contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $256.13 Alliance Coal — Alliance Coal: $426.88 Anthem VA Medicare Advantage — HMO: $243.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,420.79 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,420.79 Coventry Health Care — Worker's Compensation: $385.41 Highmark WV Medicare Advantage — All Plans: $253.69 Humana Medicare Advantage — All Plans: $256.13 Occunet — Occunet: $329.31 Optima VA Medicare Advantage — All Plans: $243.93
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT PELVIS W/DYE	$224	$112	$40.92 – $1,044.47
CT scan of the pelvis, with contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $42.87 Aetna — Better Health WV Mgd Medicaid: $41.70 Aetna Better Health PA — CHIP: $95.15 Aetna Better Health WV — CHIP: $41.70 Aetna Medicare Advantage — All Plans: $188.29 Alliance Coal — Alliance Coal: $313.81 Anthem VA Medicare Advantage — HMO: $179.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,044.47 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,044.47 Coventry Health Care — Worker's Compensation: $283.33
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF PELVIS WITH CONTRAST	$219	$109.50	$40.92 – $1,044.47
CT scan of the pelvis, with contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $42.87 Aetna — Better Health WV Mgd Medicaid: $41.70 Aetna Better Health PA — CHIP: $95.15 Aetna Better Health WV — CHIP: $41.70 Aetna Medicare Advantage — All Plans: $188.29 Alliance Coal — Alliance Coal: $313.81 Anthem VA Medicare Advantage — HMO: $179.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,044.47 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,044.47 Coventry Health Care — Worker's Compensation: $283.33
CT scan of the pelvis, with contrast CPT 72193 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER In the file: CT SCAN OF PELVIS WITH CONTRAST	$219	$109.50	$179.32 – $1,044.47
CT scan of the pelvis, with contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $188.29 Alliance Coal — Alliance Coal: $313.81 Anthem VA Medicare Advantage — HMO: $179.32 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,044.47 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,044.47 Coventry Health Care — Worker's Compensation: $283.33 Highmark WV Medicare Advantage — All Plans: $186.49 Humana Medicare Advantage — All Plans: $188.29 Occunet — Occunet: $242.08 Optima VA Medicare Advantage — All Plans: $179.32
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: MRI JNT OF LWR EXTRE W/O DYE	$3,449	$1,724.50	$47.87 – $1,420.79
MRI of a leg joint (such as the knee), without contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $50.15 Aetna — Better Health WV Mgd Medicaid: $48.78 Aetna Better Health PA — CHIP: $295.90 Aetna Better Health WV — CHIP: $48.78 Aetna Medicare Advantage — All Plans: $256.13 Alliance Coal — Alliance Coal: $426.88 Anthem VA Medicare Advantage — HMO: $243.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,420.79 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,420.79 Coventry Health Care — Worker's Compensation: $385.41
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$3,381	$1,690.50	$243.93 – $1,420.79
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $256.13 Alliance Coal — Alliance Coal: $426.88 Anthem VA Medicare Advantage — HMO: $243.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,420.79 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,420.79 Coventry Health Care — Worker's Compensation: $385.41 Highmark WV Medicare Advantage — All Plans: $253.69 Humana Medicare Advantage — All Plans: $256.13 Occunet — Occunet: $329.31 Optima VA Medicare Advantage — All Plans: $243.93
MRI of a leg joint (such as the knee), without contrast CPT 73721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_PO In the file: MRI SCAN OF LEG JOINT WITHOUT CONTRAST	$3,381	$1,690.50	$243.93 – $1,420.79
MRI of a leg joint (such as the knee), without contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $256.13 Alliance Coal — Alliance Coal: $426.88 Anthem VA Medicare Advantage — HMO: $243.93 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,420.79 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,420.79 Coventry Health Care — Worker's Compensation: $385.41 Highmark WV Medicare Advantage — All Plans: $253.69 Humana Medicare Advantage — All Plans: $256.13 Occunet — Occunet: $329.31 Optima VA Medicare Advantage — All Plans: $243.93
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT ABD & PELVIS W/CONTRAST	$4,141	$2,070.50	$64.86 – $2,077.40
CT scan of the abdomen and pelvis, with contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $67.95 Aetna — Better Health WV Mgd Medicaid: $66.09 Aetna Better Health PA — CHIP: $212 Aetna Better Health WV — CHIP: $66.09 Aetna Medicare Advantage — All Plans: $374.49 Alliance Coal — Alliance Coal: $624.16 Anthem VA Medicare Advantage — HMO: $356.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,077.40 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,077.40 Coventry Health Care — Worker's Compensation: $563.52
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$4,059	$2,029.50	$64.86 – $2,077.40
CT scan of the abdomen and pelvis, with contrast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $67.95 Aetna — Better Health WV Mgd Medicaid: $66.09 Aetna Better Health PA — CHIP: $212 Aetna Better Health WV — CHIP: $66.09 Aetna Medicare Advantage — All Plans: $374.49 Alliance Coal — Alliance Coal: $624.16 Anthem VA Medicare Advantage — HMO: $356.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,077.40 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,077.40 Coventry Health Care — Worker's Compensation: $563.52
CT scan of the abdomen and pelvis, with contrast CPT 74177 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59 In the file: CT SCAN OF ABDOMEN AND PELVIS WITH CONTRAST	$4,059	$2,029.50	$356.66 – $2,077.40
CT scan of the abdomen and pelvis, with contrast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $374.49 Alliance Coal — Alliance Coal: $624.16 Anthem VA Medicare Advantage — HMO: $356.66 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,077.40 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,077.40 Coventry Health Care — Worker's Compensation: $563.52 Highmark WV Medicare Advantage — All Plans: $370.93 Humana Medicare Advantage — All Plans: $374.49 Occunet — Occunet: $481.49 Optima VA Medicare Advantage — All Plans: $356.66
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: US EXAM ABDOM COMPLETE	$1,139	$569.50	$28.57 – $622.48
Ultrasound of the abdomen, complete: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $29.93 Aetna — Better Health WV Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $63.25 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,116	$558	$28.57 – $622.48
Ultrasound of the abdomen, complete: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $29.93 Aetna — Better Health WV Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $63.25 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
Ultrasound of the abdomen, complete CPT 76700 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_TC In the file: COMPLETE ULTRASOUND SCAN OF ABDOMEN	$1,116	$558	$106.87 – $622.48
Ultrasound of the abdomen, complete: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85 Highmark WV Medicare Advantage — All Plans: $111.14 Humana Medicare Advantage — All Plans: $112.21 Occunet — Occunet: $144.27 Optima VA Medicare Advantage — All Plans: $106.87
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: OB US >= 14 WKS SNGL FETUS	$1,139	$569.50	$35.26 – $622.48
Pregnancy ultrasound (after the first trimester): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $36.94 Aetna — Better Health WV Mgd Medicaid: $35.93 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $35.93 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$1,116	$558	$35.26 – $622.48
Pregnancy ultrasound (after the first trimester): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $36.94 Aetna — Better Health WV Mgd Medicaid: $35.93 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $35.93 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
Pregnancy ultrasound (after the first trimester) CPT 76805 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF PREGNANT UTERUS (14 WEEKS OR MORE); SINGLE OR FIRST FETUS	$1,116	$558	$106.87 – $622.48
Pregnancy ultrasound (after the first trimester): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85 Highmark WV Medicare Advantage — All Plans: $111.14 Humana Medicare Advantage — All Plans: $112.21 Occunet — Occunet: $144.27 Optima VA Medicare Advantage — All Plans: $106.87
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: TRANSVAGINAL US NON-OB	$1,139	$569.50	$24.44 – $622.48
Transvaginal ultrasound: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $25.61 Aetna — Better Health WV Mgd Medicaid: $24.91 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $24.91 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$1,116	$558	$24.44 – $622.48
Transvaginal ultrasound: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $25.61 Aetna — Better Health WV Mgd Medicaid: $24.91 Aetna Better Health PA — CHIP: $51.15 Aetna Better Health WV — CHIP: $24.91 Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85
Transvaginal ultrasound CPT 76830 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: ULTRASOUND SCAN OF UTERUS; OVARIES; TUBES; CERVIX AND PELVIC AREA THROUGH VAGINA	$1,116	$558	$106.87 – $622.48
Transvaginal ultrasound: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $112.21 Alliance Coal — Alliance Coal: $187.02 Anthem VA Medicare Advantage — HMO: $106.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $622.48 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $622.48 Coventry Health Care — Worker's Compensation: $168.85 Highmark WV Medicare Advantage — All Plans: $111.14 Humana Medicare Advantage — All Plans: $112.21 Occunet — Occunet: $144.27 Optima VA Medicare Advantage — All Plans: $106.87
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD UNI	$464	$232	$28.57 – $216.68
Diagnostic mammogram, one breast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $29.93 Aetna — Better Health WV Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $78.11 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $39.06 Alliance Coal — Alliance Coal: $65.10 Anthem VA Medicare Advantage — HMO: $37.20 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $216.68 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $216.68 Coventry Health Care — Worker's Compensation: $58.78
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$454	$227	$28.57 – $216.68
Diagnostic mammogram, one breast: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $29.93 Aetna — Better Health WV Mgd Medicaid: $29.11 Aetna Better Health PA — CHIP: $78.11 Aetna Better Health WV — CHIP: $29.11 Aetna Medicare Advantage — All Plans: $39.06 Alliance Coal — Alliance Coal: $65.10 Anthem VA Medicare Advantage — HMO: $37.20 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $216.68 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $216.68 Coventry Health Care — Worker's Compensation: $58.78
Diagnostic mammogram, one breast CPT 77065 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT_TC In the file: DIAGNOSTIC MAMMOGRAPHY OF 1 BREAST	$454	$227	$37.20 – $216.68
Diagnostic mammogram, one breast: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $39.06 Alliance Coal — Alliance Coal: $65.10 Anthem VA Medicare Advantage — HMO: $37.20 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $216.68 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $216.68 Coventry Health Care — Worker's Compensation: $58.78 Highmark WV Medicare Advantage — All Plans: $38.69 Humana Medicare Advantage — All Plans: $39.06 Occunet — Occunet: $50.22 Optima VA Medicare Advantage — All Plans: $37.20
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DX MAMMO INCL CAD BI	$597	$298.50	$35 – $266.53
Diagnostic mammogram, both breasts: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $36.66 Aetna — Better Health WV Mgd Medicaid: $35.66 Aetna Better Health PA — CHIP: $99.91 Aetna Better Health WV — CHIP: $35.66 Aetna Medicare Advantage — All Plans: $48.05 Alliance Coal — Alliance Coal: $80.08 Anthem VA Medicare Advantage — HMO: $45.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $266.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $266.53 Coventry Health Care — Worker's Compensation: $72.30
Diagnostic mammogram, both breasts CPT 77066 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier TC In the file: DIAGNOSTIC MAMMOGRAPHY OF BOTH BREASTS	$585	$292.50	$45.76 – $266.53
Diagnostic mammogram, both breasts: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $48.05 Alliance Coal — Alliance Coal: $80.08 Anthem VA Medicare Advantage — HMO: $45.76 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $266.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $266.53 Coventry Health Care — Worker's Compensation: $72.30 Highmark WV Medicare Advantage — All Plans: $47.59 Humana Medicare Advantage — All Plans: $48.05 Occunet — Occunet: $61.78 Optima VA Medicare Advantage — All Plans: $45.76
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SCREENING MAMMOGRAPHY	$494	$247	$27.03 – $200.72
Screening mammogram, both breasts: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $28.31 Aetna — Better Health WV Mgd Medicaid: $27.54 Aetna Better Health PA — CHIP: $82.52 Aetna Better Health WV — CHIP: $27.54 Aetna Medicare Advantage — All Plans: $36.18 Alliance Coal — Alliance Coal: $60.30 Anthem VA Medicare Advantage — HMO: $34.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $200.72 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $200.72 Coventry Health Care — Worker's Compensation: $54.45
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_LT_PO_TC In the file: SCREENING MAMMOGRAPHY	$484	$242	$34.46 – $200.72
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $36.18 Alliance Coal — Alliance Coal: $60.30 Anthem VA Medicare Advantage — HMO: $34.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $200.72 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $200.72 Coventry Health Care — Worker's Compensation: $54.45 Highmark WV Medicare Advantage — All Plans: $35.84 Humana Medicare Advantage — All Plans: $36.18 Occunet — Occunet: $46.52 Optima VA Medicare Advantage — All Plans: $34.46
Screening mammogram, both breasts CPT 77067 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52_LT_TC In the file: SCREENING MAMMOGRAPHY	$484	$242	$34.46 – $200.72
Screening mammogram, both breasts: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $36.18 Alliance Coal — Alliance Coal: $60.30 Anthem VA Medicare Advantage — HMO: $34.46 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $200.72 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $200.72 Coventry Health Care — Worker's Compensation: $54.45 Highmark WV Medicare Advantage — All Plans: $35.84 Humana Medicare Advantage — All Plans: $36.18 Occunet — Occunet: $46.52 Optima VA Medicare Advantage — All Plans: $34.46

Heart tests and sleep study

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Electrocardiogram (ECG/EKG) with reading CPT 93000 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: ELECTROCARDIOGRAM COMPLETE	$43	$21.50	$10.55 – $21.14
Electrocardiogram (ECG/EKG) with reading: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $11.06 Aetna — Better Health WV Mgd Medicaid: $10.75 Aetna Better Health PA — CHIP: $21.14 Aetna Better Health WV — CHIP: $10.75 Highmark Health Options — CHIP: $10.55 Highmark Health Options West VA — Mgd MCaid: $10.55 Molina Managed Medicaid — Molina Managed Medicaid: $19.22 Pennsylvania Health & Wellness — Medicaid: $11.06 The Health Plan WV — CHIP: $10.75 The Health Plan WV — Mgd MCaid: $10.70
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: POLYSOM 6/> YRS 4/> PARAM	$5,113	$2,556.50	$86.98 – $5,113.53
Sleep study (overnight, in a sleep lab): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $91.12 Aetna — Better Health WV Mgd Medicaid: $88.64 Aetna Better Health PA — CHIP: $297.35 Aetna Better Health WV — CHIP: $88.64 Aetna Medicare Advantage — All Plans: $921.82 Alliance Coal — Alliance Coal: $1,536.36 Anthem VA Medicare Advantage — HMO: $877.92 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,113.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,113.53 Coventry Health Care — Worker's Compensation: $1,387.11
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$6,507	$3,253.50	$86.98 – $5,113.53
Sleep study (overnight, in a sleep lab): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $91.12 Aetna — Better Health WV Mgd Medicaid: $88.64 Aetna Better Health PA — CHIP: $297.35 Aetna Better Health WV — CHIP: $88.64 Aetna Medicare Advantage — All Plans: $921.82 Alliance Coal — Alliance Coal: $1,536.36 Anthem VA Medicare Advantage — HMO: $877.92 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,113.53 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,113.53 Coventry Health Care — Worker's Compensation: $1,387.11
Sleep study (overnight, in a sleep lab) CPT 95810 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 52 In the file: SLEEP STUDY IN SLEEP LAB (6 YEARS OR OLDER)	$6,507	$3,253.50	$438.96 – $2,556.77
Sleep study (overnight, in a sleep lab): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $460.91 Alliance Coal — Alliance Coal: $768.18 Anthem VA Medicare Advantage — HMO: $438.96 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,556.77 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,556.77 Coventry Health Care — Worker's Compensation: $693.56 Highmark WV Medicare Advantage — All Plans: $456.52 Humana Medicare Advantage — All Plans: $460.91 Occunet — Occunet: $592.60 Optima VA Medicare Advantage — All Plans: $438.96

Physical therapy and mental health

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: THERAPEUTIC EXERCISES	$245	$122.50	$21.36 – $159.65
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $22.37 Aetna — Better Health WV Mgd Medicaid: $21.76 Aetna Better Health WV — CHIP: $21.76 Aetna Medicare Advantage — All Plans: $28.78 Alliance Coal — Alliance Coal: $37 Anthem VA Medicare Advantage — HMO: $27.41 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $159.65 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $159.65 Coventry Health Care — Worker's Compensation: $43.31 Highmark Health Options — CHIP: $21.36
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$240	$120	$27.41 – $159.65
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $28.78 Alliance Coal — Alliance Coal: $37 Anthem VA Medicare Advantage — HMO: $27.41 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $159.65 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $159.65 Coventry Health Care — Worker's Compensation: $43.31 Highmark WV Medicare Advantage — All Plans: $28.51 Humana Medicare Advantage — All Plans: $28.78 Occunet — Occunet: $37 Optima VA Medicare Advantage — All Plans: $27.41
Physical therapy: therapeutic exercise (each 15 minutes) CPT 97110 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP_KX In the file: THERAPY PROCEDURE USING EXERCISE TO DEVELOP STRENGTH; ENDURANCE; RANGE OF MOTION; AND FLEXIBILITY; EACH 15 MINUTES	$240	$120	$27.41 – $159.65
Physical therapy: therapeutic exercise (each 15 minutes): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $28.78 Alliance Coal — Alliance Coal: $37 Anthem VA Medicare Advantage — HMO: $27.41 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $159.65 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $159.65 Coventry Health Care — Worker's Compensation: $43.31 Highmark WV Medicare Advantage — All Plans: $28.51 Humana Medicare Advantage — All Plans: $28.78 Occunet — Occunet: $37 Optima VA Medicare Advantage — All Plans: $27.41
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL LOW COMPLEX 20 MIN	$564	$282	$63.61 – $535.69
Physical therapy evaluation (low complexity): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $76.57 Aetna — Better Health WV Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $69.97 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$564	$282	$91.97 – $535.69
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31 Highmark WV Medicare Advantage — All Plans: $95.65 Humana Medicare Advantage — All Plans: $96.57 Occunet — Occunet: $124.16 Optima VA Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (low complexity) CPT 97161 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier ER_GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 20 MINUTES	$564	$282	$91.97 – $535.69
Physical therapy evaluation (low complexity): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31 Highmark WV Medicare Advantage — All Plans: $95.65 Humana Medicare Advantage — All Plans: $96.57 Occunet — Occunet: $124.16 Optima VA Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL MOD COMPLEX 30 MIN	$564	$282	$63.61 – $535.69
Physical therapy evaluation (moderate complexity): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $76.57 Aetna — Better Health WV Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $69.97 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31
Physical therapy evaluation (moderate complexity) CPT 97162 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 30 MINUTES	$564	$282	$91.97 – $535.69
Physical therapy evaluation (moderate complexity): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31 Highmark WV Medicare Advantage — All Plans: $95.65 Humana Medicare Advantage — All Plans: $96.57 Occunet — Occunet: $124.16 Optima VA Medicare Advantage — All Plans: $91.97
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: PT EVAL HIGH COMPLEX 45 MIN	$564	$282	$63.61 – $535.69
Physical therapy evaluation (high complexity): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $76.57 Aetna — Better Health WV Mgd Medicaid: $74.48 Aetna Better Health PA — CHIP: $69.97 Aetna Better Health WV — CHIP: $74.48 Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31
Physical therapy evaluation (high complexity) CPT 97163 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier GP In the file: EVALUATION FOR PHYSICAL THERAPY; TYPICALLY 45 MINUTES	$564	$282	$91.97 – $535.69
Physical therapy evaluation (high complexity): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $96.57 Alliance Coal — Alliance Coal: $124.16 Anthem VA Medicare Advantage — HMO: $91.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $535.69 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $535.69 Coventry Health Care — Worker's Compensation: $145.31 Highmark WV Medicare Advantage — All Plans: $95.65 Humana Medicare Advantage — All Plans: $96.57 Occunet — Occunet: $124.16 Optima VA Medicare Advantage — All Plans: $91.97
Psychotherapy, 30 minutes CPT 90832 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 30 MINUTES	$187	$93.50	$54.31 – $1,056.99
Psychotherapy, 30 minutes: 10 of 42 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $56.89 Aetna — Better Health WV Mgd Medicaid: $55.34 Aetna Better Health WV — CHIP: $55.34 Aetna Medicare Advantage — All Plans: $190.54 Alliance Coal — Alliance Coal: $317.57 Anthem VA Medicare Advantage — HMO: $181.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,056.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,056.99 Coventry Health Care — Worker's Compensation: $286.72 Highmark Health Options — CHIP: $54.31
Psychotherapy, 45 minutes CPT 90834 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 45 MINUTES	$171	$85.50	$71.80 – $1,056.99
Psychotherapy, 45 minutes: 10 of 42 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $75.22 Aetna — Better Health WV Mgd Medicaid: $73.17 Aetna Better Health WV — CHIP: $73.17 Aetna Medicare Advantage — All Plans: $190.54 Alliance Coal — Alliance Coal: $317.57 Anthem VA Medicare Advantage — HMO: $181.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,056.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,056.99 Coventry Health Care — Worker's Compensation: $286.72 Highmark Health Options — CHIP: $71.80
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYTX W PT 60 MINUTES	$245	$122.50	$106.29 – $1,056.99
Psychotherapy, 60 minutes: 10 of 42 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $111.35 Aetna — Better Health WV Mgd Medicaid: $108.32 Aetna Better Health WV — CHIP: $108.32 Aetna Medicare Advantage — All Plans: $190.54 Alliance Coal — Alliance Coal: $317.57 Anthem VA Medicare Advantage — HMO: $181.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,056.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,056.99 Coventry Health Care — Worker's Compensation: $286.72 Highmark Health Options — CHIP: $106.29
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: PSYCHOTHERAPY; 1 HOUR	$330	$165	$106.29 – $1,056.99
Psychotherapy, 60 minutes: 10 of 42 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $111.35 Aetna — Better Health WV Mgd Medicaid: $108.32 Aetna Better Health WV — CHIP: $108.32 Aetna Medicare Advantage — All Plans: $190.54 Alliance Coal — Alliance Coal: $317.57 Anthem VA Medicare Advantage — HMO: $181.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,056.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,056.99 Coventry Health Care — Worker's Compensation: $286.72 Highmark Health Options — CHIP: $106.29
Psychotherapy, 60 minutes CPT 90837 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier PO In the file: PSYCHOTHERAPY; 1 HOUR	$190	$95	$181.47 – $1,056.99
Psychotherapy, 60 minutes: 10 of 32 insurance plan rates Aetna Medicare Advantage — All Plans: $190.54 Alliance Coal — Alliance Coal: $317.57 Anthem VA Medicare Advantage — HMO: $181.47 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $1,056.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,056.99 Coventry Health Care — Worker's Compensation: $286.72 Highmark WV Medicare Advantage — All Plans: $188.73 Humana Medicare Advantage — All Plans: $190.54 Occunet — Occunet: $244.98 Optima VA Medicare Advantage — All Plans: $181.47
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee In the file: GROUP PSYCHOTHERAPY	$109	$54.50	$19.30 – $604.94
Group psychotherapy: 10 of 42 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $20.22 Aetna — Better Health WV Mgd Medicaid: $19.67 Aetna Better Health WV — CHIP: $19.67 Aetna Medicare Advantage — All Plans: $109.05 Alliance Coal — Alliance Coal: $181.76 Anthem VA Medicare Advantage — HMO: $103.86 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $604.94 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $604.94 Coventry Health Care — Worker's Compensation: $164.10 Highmark Health Options — CHIP: $19.30
Group psychotherapy CPT 90853 · Outpatient (no overnight stay) · Doctor (professional) fee · modifier PO In the file: GROUP PSYCHOTHERAPY	$318	$159	$103.86 – $604.94
Group psychotherapy: 10 of 32 insurance plan rates Aetna Medicare Advantage — All Plans: $109.05 Alliance Coal — Alliance Coal: $181.76 Anthem VA Medicare Advantage — HMO: $103.86 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $604.94 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $604.94 Coventry Health Care — Worker's Compensation: $164.10 Highmark WV Medicare Advantage — All Plans: $108.01 Humana Medicare Advantage — All Plans: $109.05 Occunet — Occunet: $140.21 Optima VA Medicare Advantage — All Plans: $103.86

Procedures and surgery

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$6,652	$3,326	$4,002.87 – $23,315.12
Removal of breast growth (open surgery): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $4,203.01 Alliance Coal — Alliance Coal: $7,005.02 Anthem VA Medicare Advantage — HMO: $4,002.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $23,315.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $23,315.12 Coventry Health Care — Worker's Compensation: $6,324.53 Highmark WV Medicare Advantage — All Plans: $4,162.98 Humana Medicare Advantage — All Plans: $4,203.01 Occunet — Occunet: $5,403.87 Optima VA Medicare Advantage — All Plans: $4,002.87
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$7,022	$3,511	$4,002.87 – $23,315.12
Removal of breast growth (open surgery): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $4,203.01 Alliance Coal — Alliance Coal: $7,005.02 Anthem VA Medicare Advantage — HMO: $4,002.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $23,315.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $23,315.12 Coventry Health Care — Worker's Compensation: $6,324.53 Highmark WV Medicare Advantage — All Plans: $4,162.98 Humana Medicare Advantage — All Plans: $4,203.01 Occunet — Occunet: $5,403.87 Optima VA Medicare Advantage — All Plans: $4,002.87
Removal of breast growth (open surgery) CPT 19120 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF GROWTH AND TISSUE OF BREAST; DUCT; OR NIPPLE	$3,374	$1,687	$4,002.87 – $23,315.12
Removal of breast growth (open surgery): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $4,203.01 Alliance Coal — Alliance Coal: $7,005.02 Anthem VA Medicare Advantage — HMO: $4,002.87 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $23,315.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $23,315.12 Coventry Health Care — Worker's Compensation: $6,324.53 Highmark WV Medicare Advantage — All Plans: $4,162.98 Humana Medicare Advantage — All Plans: $4,203.01 Occunet — Occunet: $5,403.87 Optima VA Medicare Advantage — All Plans: $4,002.87
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$16,284	$8,142	$853.60 – $76,450.03
Total hip replacement: 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $1,028.29 Aetna — Better Health WV Mgd Medicaid: $1,000.25 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $1,000.25 Aetna Medicare Advantage — All Plans: $13,781.64 Alliance Coal — Alliance Coal: $22,969.40 Anthem VA Medicare Advantage — HMO: $13,125.37 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76,450.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76,450.03 Coventry Health Care — Worker's Compensation: $20,738.08
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$7,626	$3,813	$13,125.37 – $76,450.03
Total hip replacement: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $13,781.64 Alliance Coal — Alliance Coal: $22,969.40 Anthem VA Medicare Advantage — HMO: $13,125.37 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76,450.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76,450.03 Coventry Health Care — Worker's Compensation: $20,738.08 Highmark WV Medicare Advantage — All Plans: $13,650.38 Humana Medicare Advantage — All Plans: $13,781.64 Occunet — Occunet: $17,719.25 Optima VA Medicare Advantage — All Plans: $13,125.37
Total hip replacement CPT 27130 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 73_RT In the file: REPLACEMENT OF THIGH BONE AND HIP JOINT WITH PROSTHESIS	$15,097	$7,548.50	$6,562.68 – $38,224.99
Total hip replacement: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $6,890.81 Alliance Coal — Alliance Coal: $11,484.69 Anthem VA Medicare Advantage — HMO: $6,562.68 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $38,224.99 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $38,224.99 Coventry Health Care — Worker's Compensation: $10,369.03 Highmark WV Medicare Advantage — All Plans: $6,825.19 Humana Medicare Advantage — All Plans: $6,890.81 Occunet — Occunet: $8,859.62 Optima VA Medicare Advantage — All Plans: $6,562.68
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$13,484	$6,742	$205.80 – $76,450.03
Total knee replacement: 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $13,781.64 Alliance Coal — Alliance Coal: $22,969.40 Anthem VA Medicare Advantage — HMO: $13,125.37 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76,450.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76,450.03 Coventry Health Care — Worker's Compensation: $20,738.08
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$28,101	$14,050.50	$13,125.37 – $76,450.03
Total knee replacement: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $13,781.64 Alliance Coal — Alliance Coal: $22,969.40 Anthem VA Medicare Advantage — HMO: $13,125.37 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76,450.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76,450.03 Coventry Health Care — Worker's Compensation: $20,738.08 Highmark WV Medicare Advantage — All Plans: $13,650.38 Humana Medicare Advantage — All Plans: $13,781.64 Occunet — Occunet: $17,719.25 Optima VA Medicare Advantage — All Plans: $13,125.37
Total knee replacement CPT 27447 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50_62 In the file: REPLACEMENT OF KNEE JOINT; BOTH SIDES OF KNEE	$35,564	$17,782	$13,125.37 – $76,450.03
Total knee replacement: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $13,781.64 Alliance Coal — Alliance Coal: $22,969.40 Anthem VA Medicare Advantage — HMO: $13,125.37 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $76,450.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $76,450.03 Coventry Health Care — Worker's Compensation: $20,738.08 Highmark WV Medicare Advantage — All Plans: $13,650.38 Humana Medicare Advantage — All Plans: $13,781.64 Occunet — Occunet: $17,719.25 Optima VA Medicare Advantage — All Plans: $13,125.37
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$4,418	$2,209	$152 – $885.34
Shoulder arthroscopy: shaving of shoulder bone: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $159.60 Alliance Coal — Alliance Coal: $266 Anthem VA Medicare Advantage — HMO: $152 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $885.34 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $885.34 Coventry Health Care — Worker's Compensation: $240.16 Highmark WV Medicare Advantage — All Plans: $158.08 Humana Medicare Advantage — All Plans: $159.60 Occunet — Occunet: $205.20 Optima VA Medicare Advantage — All Plans: $152
Shoulder arthroscopy: shaving of shoulder bone CPT 29826 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: SHAVING OF PART OF SHOULDER BONE AND REPAIR OF LIGAMENT USING AN ENDOSCOPE	$5,228.66	$2,614.33	$152 – $885.34
Shoulder arthroscopy: shaving of shoulder bone: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $159.60 Alliance Coal — Alliance Coal: $266 Anthem VA Medicare Advantage — HMO: $152 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $885.34 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $885.34 Coventry Health Care — Worker's Compensation: $240.16 Highmark WV Medicare Advantage — All Plans: $158.08 Humana Medicare Advantage — All Plans: $159.60 Occunet — Occunet: $205.20 Optima VA Medicare Advantage — All Plans: $152
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$9,833.66	$4,916.83	$3,345.06 – $19,483.64
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3,512.31 Alliance Coal — Alliance Coal: $5,853.85 Anthem VA Medicare Advantage — HMO: $3,345.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $19,483.64 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $19,483.64 Coventry Health Care — Worker's Compensation: $5,285.19 Highmark WV Medicare Advantage — All Plans: $3,478.86 Humana Medicare Advantage — All Plans: $3,512.31 Occunet — Occunet: $4,515.83 Optima VA Medicare Advantage — All Plans: $3,345.06
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$10,114	$5,057	$3,345.06 – $19,483.64
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3,512.31 Alliance Coal — Alliance Coal: $5,853.85 Anthem VA Medicare Advantage — HMO: $3,345.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $19,483.64 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $19,483.64 Coventry Health Care — Worker's Compensation: $5,285.19 Highmark WV Medicare Advantage — All Plans: $3,478.86 Humana Medicare Advantage — All Plans: $3,512.31 Occunet — Occunet: $4,515.83 Optima VA Medicare Advantage — All Plans: $3,345.06
Knee arthroscopy: removal of torn cartilage (meniscus) CPT 29881 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REMOVAL OF KNEE CARTILAGE USING AN ENDOSCOPE	$11,885	$5,942.50	$3,345.06 – $19,483.64
Knee arthroscopy: removal of torn cartilage (meniscus): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3,512.31 Alliance Coal — Alliance Coal: $5,853.85 Anthem VA Medicare Advantage — HMO: $3,345.06 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $19,483.64 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $19,483.64 Coventry Health Care — Worker's Compensation: $5,285.19 Highmark WV Medicare Advantage — All Plans: $3,478.86 Humana Medicare Advantage — All Plans: $3,512.31 Occunet — Occunet: $4,515.83 Optima VA Medicare Advantage — All Plans: $3,345.06
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$7,174	$3,587	$205.80 – $35,250.60
Removal of tonsils and adenoids (under age 12): 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $763.40 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $6,354.62 Alliance Coal — Alliance Coal: $10,591.04 Anthem VA Medicare Advantage — HMO: $6,052.02 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35,250.60 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35,250.60 Coventry Health Care — Worker's Compensation: $9,562.19
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$13,102	$6,551	$6,052.02 – $35,250.60
Removal of tonsils and adenoids (under age 12): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $6,354.62 Alliance Coal — Alliance Coal: $10,591.04 Anthem VA Medicare Advantage — HMO: $6,052.02 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35,250.60 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35,250.60 Coventry Health Care — Worker's Compensation: $9,562.19 Highmark WV Medicare Advantage — All Plans: $6,294.10 Humana Medicare Advantage — All Plans: $6,354.62 Occunet — Occunet: $8,170.23 Optima VA Medicare Advantage — All Plans: $6,052.02
Removal of tonsils and adenoids (under age 12) CPT 42820 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 51 In the file: REMOVAL OF TONSILS AND ADENOID GLANDS (YOUNGER THAN 12 YEARS)	$6,640.67	$3,320.34	$6,052.02 – $35,250.60
Removal of tonsils and adenoids (under age 12): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $6,354.62 Alliance Coal — Alliance Coal: $10,591.04 Anthem VA Medicare Advantage — HMO: $6,052.02 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35,250.60 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35,250.60 Coventry Health Care — Worker's Compensation: $9,562.19 Highmark WV Medicare Advantage — All Plans: $6,294.10 Humana Medicare Advantage — All Plans: $6,354.62 Occunet — Occunet: $8,170.23 Optima VA Medicare Advantage — All Plans: $6,052.02
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: EGD DIAGNOSTIC BRUSH WASH	$2,203	$1,101.50	$105 – $5,400.74
Upper GI endoscopy (diagnostic): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $110 Aetna — Better Health WV Mgd Medicaid: $107 Aetna Better Health PA — CHIP: $137.74 Aetna Better Health WV — CHIP: $107 Aetna Medicare Advantage — All Plans: $973.59 Alliance Coal — Alliance Coal: $1,622.65 Anthem VA Medicare Advantage — HMO: $927.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,400.74 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,400.74 Coventry Health Care — Worker's Compensation: $1,465.02
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,159	$1,079.50	$105 – $5,400.74
Upper GI endoscopy (diagnostic): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $110 Aetna — Better Health WV Mgd Medicaid: $107 Aetna Better Health PA — CHIP: $137.74 Aetna Better Health WV — CHIP: $107 Aetna Medicare Advantage — All Plans: $973.59 Alliance Coal — Alliance Coal: $1,622.65 Anthem VA Medicare Advantage — HMO: $927.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,400.74 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,400.74 Coventry Health Care — Worker's Compensation: $1,465.02
Upper GI endoscopy (diagnostic) CPT 43235 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: DIAGNOSTIC EXAM OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$2,694	$1,347	$927.23 – $5,400.74
Upper GI endoscopy (diagnostic): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $973.59 Alliance Coal — Alliance Coal: $1,622.65 Anthem VA Medicare Advantage — HMO: $927.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,400.74 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,400.74 Coventry Health Care — Worker's Compensation: $1,465.02 Highmark WV Medicare Advantage — All Plans: $964.32 Humana Medicare Advantage — All Plans: $973.59 Occunet — Occunet: $1,251.76 Optima VA Medicare Advantage — All Plans: $927.23
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$4,280	$2,140	$148.58 – $5,400.74
Upper GI endoscopy with biopsy: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $163.44 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $973.59 Alliance Coal — Alliance Coal: $1,622.65 Anthem VA Medicare Advantage — HMO: $927.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,400.74 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,400.74 Coventry Health Care — Worker's Compensation: $1,465.02
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XS In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,304.66	$652.33	$927.23 – $5,400.74
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $973.59 Alliance Coal — Alliance Coal: $1,622.65 Anthem VA Medicare Advantage — HMO: $927.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,400.74 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,400.74 Coventry Health Care — Worker's Compensation: $1,465.02 Highmark WV Medicare Advantage — All Plans: $964.32 Humana Medicare Advantage — All Plans: $973.59 Occunet — Occunet: $1,251.76 Optima VA Medicare Advantage — All Plans: $927.23
Upper GI endoscopy with biopsy CPT 43239 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: BIOPSY OF ESOPHAGUS; STOMACH; AND/OR UPPER SMALL BOWEL USING A FLEXIBLE ENDOSCOPE	$1,223.33	$611.67	$927.23 – $5,400.74
Upper GI endoscopy with biopsy: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $973.59 Alliance Coal — Alliance Coal: $1,622.65 Anthem VA Medicare Advantage — HMO: $927.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,400.74 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,400.74 Coventry Health Care — Worker's Compensation: $1,465.02 Highmark WV Medicare Advantage — All Plans: $964.32 Humana Medicare Advantage — All Plans: $973.59 Occunet — Occunet: $1,251.76 Optima VA Medicare Advantage — All Plans: $927.23
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$5,622	$2,811	$105 – $5,537.62
Colonoscopy (diagnostic): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $110 Aetna — Better Health WV Mgd Medicaid: $107 Aetna Better Health PA — CHIP: $198.55 Aetna Better Health WV — CHIP: $107 Aetna Medicare Advantage — All Plans: $998.27 Alliance Coal — Alliance Coal: $1,663.78 Anthem VA Medicare Advantage — HMO: $950.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,537.62 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,537.62 Coventry Health Care — Worker's Compensation: $1,502.15
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 73 In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$7,452	$3,726	$475.36 – $2,768.78
Colonoscopy (diagnostic): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $499.13 Alliance Coal — Alliance Coal: $831.88 Anthem VA Medicare Advantage — HMO: $475.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $2,768.78 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $2,768.78 Coventry Health Care — Worker's Compensation: $751.07 Highmark WV Medicare Advantage — All Plans: $494.37 Humana Medicare Advantage — All Plans: $499.13 Occunet — Occunet: $641.74 Optima VA Medicare Advantage — All Plans: $475.36
Colonoscopy (diagnostic) CPT 45378 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74_PT In the file: DIAGNOSTIC EXAM OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$8,184	$4,092	$950.73 – $5,537.62
Colonoscopy (diagnostic): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $998.27 Alliance Coal — Alliance Coal: $1,663.78 Anthem VA Medicare Advantage — HMO: $950.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,537.62 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,537.62 Coventry Health Care — Worker's Compensation: $1,502.15 Highmark WV Medicare Advantage — All Plans: $988.76 Humana Medicare Advantage — All Plans: $998.27 Occunet — Occunet: $1,283.49 Optima VA Medicare Advantage — All Plans: $950.73
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$2,284	$1,142	$205.80 – $7,125.58
Colonoscopy with biopsy: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $247.96 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,284.53 Alliance Coal — Alliance Coal: $2,140.88 Anthem VA Medicare Advantage — HMO: $1,223.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,125.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,125.58 Coventry Health Care — Worker's Compensation: $1,932.91
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_74 In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$5,012	$2,506	$1,223.36 – $7,125.58
Colonoscopy with biopsy: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $1,284.53 Alliance Coal — Alliance Coal: $2,140.88 Anthem VA Medicare Advantage — HMO: $1,223.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,125.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,125.58 Coventry Health Care — Worker's Compensation: $1,932.91 Highmark WV Medicare Advantage — All Plans: $1,272.29 Humana Medicare Advantage — All Plans: $1,284.53 Occunet — Occunet: $1,651.54 Optima VA Medicare Advantage — All Plans: $1,223.36
Colonoscopy with biopsy CPT 45380 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_XS In the file: BIOPSY OF LARGE BOWEL USING A FLEXIBLE ENDOSCOPE	$1,304.66	$652.33	$1,223.36 – $7,125.58
Colonoscopy with biopsy: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $1,284.53 Alliance Coal — Alliance Coal: $2,140.88 Anthem VA Medicare Advantage — HMO: $1,223.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,125.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,125.58 Coventry Health Care — Worker's Compensation: $1,932.91 Highmark WV Medicare Advantage — All Plans: $1,272.29 Humana Medicare Advantage — All Plans: $1,284.53 Occunet — Occunet: $1,651.54 Optima VA Medicare Advantage — All Plans: $1,223.36
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$3,304	$1,652	$205.80 – $7,125.58
Colonoscopy with removal of polyps (snare): 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $294.89 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $1,284.53 Alliance Coal — Alliance Coal: $2,140.88 Anthem VA Medicare Advantage — HMO: $1,223.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,125.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,125.58 Coventry Health Care — Worker's Compensation: $1,932.91
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 33_XU In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$4,280	$2,140	$1,223.36 – $7,125.58
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $1,284.53 Alliance Coal — Alliance Coal: $2,140.88 Anthem VA Medicare Advantage — HMO: $1,223.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,125.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,125.58 Coventry Health Care — Worker's Compensation: $1,932.91 Highmark WV Medicare Advantage — All Plans: $1,272.29 Humana Medicare Advantage — All Plans: $1,284.53 Occunet — Occunet: $1,651.54 Optima VA Medicare Advantage — All Plans: $1,223.36
Colonoscopy with removal of polyps (snare) CPT 45385 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: REMOVAL OF POLYPS OR GROWTHS OF LARGE BOWEL USING AN ENDOSCOPE WITH MECHANICAL SNARE	$5,212	$2,606	$1,223.36 – $7,125.58
Colonoscopy with removal of polyps (snare): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $1,284.53 Alliance Coal — Alliance Coal: $2,140.88 Anthem VA Medicare Advantage — HMO: $1,223.36 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,125.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,125.58 Coventry Health Care — Worker's Compensation: $1,932.91 Highmark WV Medicare Advantage — All Plans: $1,272.29 Humana Medicare Advantage — All Plans: $1,284.53 Occunet — Occunet: $1,651.54 Optima VA Medicare Advantage — All Plans: $1,223.36
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$4,402	$2,201	$138.72 – $5,537.62
Screening colonoscopy (not high risk): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $145.32 Aetna — Better Health WV Mgd Medicaid: $141.36 Aetna Better Health WV — CHIP: $141.36 Aetna Medicare Advantage — All Plans: $998.27 Alliance Coal — Alliance Coal: $1,663.78 Anthem VA Medicare Advantage — HMO: $950.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,537.62 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,537.62 Coventry Health Care — Worker's Compensation: $1,502.15 Highmark Health Options — CHIP: $138.72
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$2,816	$1,408	$950.73 – $5,537.62
Screening colonoscopy (not high risk): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $998.27 Alliance Coal — Alliance Coal: $1,663.78 Anthem VA Medicare Advantage — HMO: $950.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,537.62 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,537.62 Coventry Health Care — Worker's Compensation: $1,502.15 Highmark WV Medicare Advantage — All Plans: $988.76 Humana Medicare Advantage — All Plans: $998.27 Occunet — Occunet: $1,283.49 Optima VA Medicare Advantage — All Plans: $950.73
Screening colonoscopy (not high risk) HCPCS G0121 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier KX_PT In the file: COLORECTAL CANCER SCREENING; COLONOSCOPY ON INDIVIDUAL NOT MEETING CRITERIA FOR HIGH RISK	$4,280	$2,140	$950.73 – $5,537.62
Screening colonoscopy (not high risk): 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $998.27 Alliance Coal — Alliance Coal: $1,663.78 Anthem VA Medicare Advantage — HMO: $950.73 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,537.62 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,537.62 Coventry Health Care — Worker's Compensation: $1,502.15 Highmark WV Medicare Advantage — All Plans: $988.76 Humana Medicare Advantage — All Plans: $998.27 Occunet — Occunet: $1,283.49 Optima VA Medicare Advantage — All Plans: $950.73
Gallbladder removal by laparoscope CPT 47562 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: REMOVAL OF GALLBLADDER USING AN ENDOSCOPE	$15,105	$7,552.50	$205.80 – $35,999.12
Gallbladder removal by laparoscope: 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $6,489.56 Alliance Coal — Alliance Coal: $10,815.93 Anthem VA Medicare Advantage — HMO: $6,180.53 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $35,999.12 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $35,999.12 Coventry Health Care — Worker's Compensation: $9,765.24
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier RT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$9,150	$4,575	$3,660.35 – $21,320.07
Groin (inguinal) hernia repair, age 5 or older: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3,843.37 Alliance Coal — Alliance Coal: $6,405.61 Anthem VA Medicare Advantage — HMO: $3,660.35 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $21,320.07 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $21,320.07 Coventry Health Care — Worker's Compensation: $5,783.35 Highmark WV Medicare Advantage — All Plans: $3,806.76 Humana Medicare Advantage — All Plans: $3,843.37 Occunet — Occunet: $4,941.47 Optima VA Medicare Advantage — All Plans: $3,660.35
Groin (inguinal) hernia repair, age 5 or older CPT 49505 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier LT In the file: REPAIR OF GROIN HERNIA (5 YEARS OR OLDER)	$11,582	$5,791	$3,660.35 – $21,320.07
Groin (inguinal) hernia repair, age 5 or older: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3,843.37 Alliance Coal — Alliance Coal: $6,405.61 Anthem VA Medicare Advantage — HMO: $3,660.35 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $21,320.07 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $21,320.07 Coventry Health Care — Worker's Compensation: $5,783.35 Highmark WV Medicare Advantage — All Plans: $3,806.76 Humana Medicare Advantage — All Plans: $3,843.37 Occunet — Occunet: $4,941.47 Optima VA Medicare Advantage — All Plans: $3,660.35
Prostate biopsy CPT 55700 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF PROSTATE GLAND	$4,742	$2,371	$89.50 – $215.60
Prostate biopsy: 10 of 28 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $98.45 Aetna Better Health WV — CHIP: $209.72 Highmark Health Options — CHIP: $205.80 Highmark Health Options West VA — Mgd MCaid: $205.80 Molina Managed Medicaid — Molina Managed Medicaid: $89.50 Pennsylvania Health & Wellness — Medicaid: $215.60 The Health Plan WV — CHIP: $209.72 The Health Plan WV — Mgd MCaid: $208.74
Prostate removal by laparoscope (radical prostatectomy) CPT 55866 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: SURGICAL REMOVAL OF PROSTATE AND SURROUNDING LYMPH NODES USING AN ENDOSCOPE	$45,512.67	$22,756.34	$906.15 – $63,297.03
Prostate removal by laparoscope (radical prostatectomy): 10 of 43 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $949.30 Aetna — Better Health WV Mgd Medicaid: $923.41 Aetna Better Health WV — CHIP: $923.41 Aetna Medicare Advantage — All Plans: $11,410.55 Alliance Coal — Alliance Coal: $19,017.58 Anthem VA Medicare Advantage — HMO: $10,867.19 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $63,297.03 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $63,297.03 Coventry Health Care — Worker's Compensation: $17,170.16 Highmark Health Options — CHIP: $906.15
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$22,028	$11,014	$205.80 – $19,275.93
Hysteroscopy with biopsy of the uterus lining: 10 of 44 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $853.60 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $3,474.87 Alliance Coal — Alliance Coal: $5,791.45 Anthem VA Medicare Advantage — HMO: $3,309.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $19,275.93 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $19,275.93 Coventry Health Care — Worker's Compensation: $5,228.85
Hysteroscopy with biopsy of the uterus lining CPT 58558 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 74 In the file: BIOPSY OF LINING OF UTERUS AND/OR REMOVAL OF POLYP USING AN ENDOSCOPE	$10,062	$5,031	$3,309.40 – $19,275.93
Hysteroscopy with biopsy of the uterus lining: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $3,474.87 Alliance Coal — Alliance Coal: $5,791.45 Anthem VA Medicare Advantage — HMO: $3,309.40 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $19,275.93 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $19,275.93 Coventry Health Care — Worker's Compensation: $5,228.85 Highmark WV Medicare Advantage — All Plans: $3,441.78 Humana Medicare Advantage — All Plans: $3,474.87 Occunet — Occunet: $4,467.69 Optima VA Medicare Advantage — All Plans: $3,309.40
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX INTERLAMINAR LMBR/SAC	$2,949	$1,474.50	$74.37 – $4,203.26
Spinal injection, lower back (epidural), with imaging guidance: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $77.91 Aetna — Better Health WV Mgd Medicaid: $75.79 Aetna Better Health PA — CHIP: $89.45 Aetna Better Health WV — CHIP: $75.79 Aetna Medicare Advantage — All Plans: $757.72 Alliance Coal — Alliance Coal: $1,262.87 Anthem VA Medicare Advantage — HMO: $721.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,203.26 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,203.26 Coventry Health Care — Worker's Compensation: $1,140.19
Spinal injection, lower back (epidural), with imaging guidance CPT 62323 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier XU In the file: INJECTION OF SUBSTANCE INTO LOWER SPINE CANAL USING IMAGING GUIDANCE	$2,891	$1,445.50	$721.64 – $4,203.26
Spinal injection, lower back (epidural), with imaging guidance: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $757.72 Alliance Coal — Alliance Coal: $1,262.87 Anthem VA Medicare Advantage — HMO: $721.64 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $4,203.26 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $4,203.26 Coventry Health Care — Worker's Compensation: $1,140.19 Highmark WV Medicare Advantage — All Plans: $750.51 Humana Medicare Advantage — All Plans: $757.72 Occunet — Occunet: $974.21 Optima VA Medicare Advantage — All Plans: $721.64
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: NJX AA&/STRD TFRM EPI L/S 1	$3,322	$1,661	$95.04 – $5,266.78
Nerve root injection, lower back, with imaging guidance: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $104.54 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $949.44 Alliance Coal — Alliance Coal: $1,582.40 Anthem VA Medicare Advantage — HMO: $904.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,266.78 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,266.78 Coventry Health Care — Worker's Compensation: $1,428.68
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$6,918	$3,459	$1,356.34 – $7,900.14
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $1,424.16 Alliance Coal — Alliance Coal: $2,373.59 Anthem VA Medicare Advantage — HMO: $1,356.34 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $7,900.14 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $7,900.14 Coventry Health Care — Worker's Compensation: $2,143.02 Highmark WV Medicare Advantage — All Plans: $1,410.59 Humana Medicare Advantage — All Plans: $1,424.16 Occunet — Occunet: $1,831.06 Optima VA Medicare Advantage — All Plans: $1,356.34
Nerve root injection, lower back, with imaging guidance CPT 64483 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 59_RT In the file: INJECTION OF ANESTHETIC AND/OR STEROID DRUG INTO SACRAL SPINE NERVE ROOT USING IMAGING GUIDANCE; SINGLE LEVEL	$3,459	$1,729.50	$904.23 – $5,266.78
Nerve root injection, lower back, with imaging guidance: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $949.44 Alliance Coal — Alliance Coal: $1,582.40 Anthem VA Medicare Advantage — HMO: $904.23 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $5,266.78 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $5,266.78 Coventry Health Care — Worker's Compensation: $1,428.68 Highmark WV Medicare Advantage — All Plans: $940.40 Humana Medicare Advantage — All Plans: $949.44 Occunet — Occunet: $1,220.71 Optima VA Medicare Advantage — All Plans: $904.23
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 50 In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$7,630	$3,815	$1,996.33 – $11,627.82
Carpal tunnel release: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $2,096.15 Alliance Coal — Alliance Coal: $3,493.58 Anthem VA Medicare Advantage — HMO: $1,996.33 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $11,627.82 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $11,627.82 Coventry Health Care — Worker's Compensation: $3,154.20 Highmark WV Medicare Advantage — All Plans: $2,076.18 Humana Medicare Advantage — All Plans: $2,096.15 Occunet — Occunet: $2,695.05 Optima VA Medicare Advantage — All Plans: $1,996.33
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 51_LT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$4,363	$2,181.50	$1,996.33 – $11,627.82
Carpal tunnel release: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $2,096.15 Alliance Coal — Alliance Coal: $3,493.58 Anthem VA Medicare Advantage — HMO: $1,996.33 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $11,627.82 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $11,627.82 Coventry Health Care — Worker's Compensation: $3,154.20 Highmark WV Medicare Advantage — All Plans: $2,076.18 Humana Medicare Advantage — All Plans: $2,096.15 Occunet — Occunet: $2,695.05 Optima VA Medicare Advantage — All Plans: $1,996.33
Carpal tunnel release CPT 64721 · Outpatient (no overnight stay) · Hospital (facility) fee · modifier 51_RT In the file: RELEASE AND/OR RELOCATION OF HAND NERVE	$6,080.33	$3,040.17	$1,996.33 – $11,627.82
Carpal tunnel release: 10 of 33 insurance plan rates Aetna Medicare Advantage — All Plans: $2,096.15 Alliance Coal — Alliance Coal: $3,493.58 Anthem VA Medicare Advantage — HMO: $1,996.33 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $11,627.82 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $11,627.82 Coventry Health Care — Worker's Compensation: $3,154.20 Highmark WV Medicare Advantage — All Plans: $2,076.18 Humana Medicare Advantage — All Plans: $2,096.15 Occunet — Occunet: $2,695.05 Optima VA Medicare Advantage — All Plans: $1,996.33
Laser treatment of clouding after cataract surgery CPT 66821 · Outpatient (no overnight stay) · Hospital (facility) fee In the file: AFTER CATARACT LASER SURGERY	$1,611	$805.50	$205.80 – $3,275.06
Laser treatment of clouding after cataract surgery: 10 of 45 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $215.60 Aetna — Better Health WV Mgd Medicaid: $209.72 Aetna Better Health PA — CHIP: $238.16 Aetna Better Health WV — CHIP: $209.72 Aetna Medicare Advantage — All Plans: $590.39 Alliance Coal — Alliance Coal: $983.99 Anthem VA Medicare Advantage — HMO: $562.28 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $3,275.06 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $3,275.06 Coventry Health Care — Worker's Compensation: $888.40

Hospital stays (whole stay, MS-DRG)

Service	Hospital charge	Cash price	Insurance rates (lowest – highest)
Heart valve or major heart-chest surgery with heart catheterization, with major complications MS-DRG 216 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC	Not listed in the file	Not listed in the file	$1,482 – $178,547.07
Heart valve or major heart-chest surgery with heart catheterization, with major complications: 10 of 46 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $178,547.07 Aetna — Better Health WV Mgd Medicaid: $59,455.30 Aetna Better Health PA — CHIP: $77,196.07 Aetna Better Health WV — CHIP: $49,214.72 Aetna Medicare Advantage — All Plans: $76,979.23 Alliance Coal — Alliance Coal: $12,172 Anthem VA Medicare Advantage — HMO: $73,313.55 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $175,996.85 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $175,996.85 Coventry Health Care — Worker's Compensation: $115,835.41
Spinal fusion (not neck), without major complications MS-DRG 460 · Inpatient (hospital stay) · Hospital (facility) fee In the file: Spinal fusion except cervical without major comorbid conditions or complications	Not listed in the file	Not listed in the file	$1,482 – $12,172
Spinal fusion (not neck), without major complications: 10 of 19 insurance plan rates Alliance Coal — Alliance Coal: $12,172 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $1,617 Occunet — Occunet: $1,650 Optum — Behavioral Health: $1,482 4 Most Zelis Stratose — 4 Most Zelis Stratose: 95% (a percentage in the contract, not a dollar amount) Aetna — Better Health: 60% (a percentage in the contract, not a dollar amount) Aetna Rental — First Health: 95% (a percentage in the contract, not a dollar amount) American Correctional Healthcare, Inc. — FBOP: 100% (a percentage in the contract, not a dollar amount) AMPS — Direct Agreements: 95% (a percentage in the contract, not a dollar amount) BRMS — Direct Agreements: 94% (a percentage in the contract, not a dollar amount)
Hip or knee replacement (major joint of the leg), without major complications MS-DRG 470 · Inpatient (hospital stay) · Hospital (facility) fee In the file: MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT COMORBITY	Not listed in the file	Not listed in the file	$1,482 – $31,290.76
Hip or knee replacement (major joint of the leg), without major complications: 10 of 46 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $31,290.76 Aetna — Better Health WV Mgd Medicaid: $10,419.67 Aetna Better Health PA — CHIP: $15,220.95 Aetna Better Health WV — CHIP: $9,703.79 Aetna Medicare Advantage — All Plans: $15,178.20 Alliance Coal — Alliance Coal: $12,172 Anthem VA Medicare Advantage — HMO: $14,455.43 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $30,949.58 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $30,949.58 Coventry Health Care — Worker's Compensation: $22,839.58
Neck (cervical) spinal fusion, without complications MS-DRG 473 · Inpatient (hospital stay) · Hospital (facility) fee In the file: CERVICAL SPINAL FUSION WITHOUT CC/MCC	Not listed in the file	Not listed in the file	$1,482 – $44,849.78
Neck (cervical) spinal fusion, without complications: 10 of 46 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $44,849.78 Aetna — Better Health WV Mgd Medicaid: $14,934.76 Aetna Better Health PA — CHIP: $19,264.30 Aetna Better Health WV — CHIP: $12,281.55 Aetna Medicare Advantage — All Plans: $19,210.19 Alliance Coal — Alliance Coal: $12,172 Anthem VA Medicare Advantage — HMO: $18,295.42 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $39,828.98 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $39,828.98 Coventry Health Care — Worker's Compensation: $28,906.76
Uterus and ovary surgery (not for cancer), without complications MS-DRG 743 · Inpatient (hospital stay) · Hospital (facility) fee In the file: UTERINE & ADNEXA PROC FOR NON-MALIGNANCY WITHOUT COMPLICATION/COMORBITY	Not listed in the file	Not listed in the file	$1,482 – $22,403.80
Uterus and ovary surgery (not for cancer), without complications: 10 of 46 insurance plan rates Aetna — Better Health VA Mgd Medicaid: $19,683.63 Aetna — Better Health WV Mgd Medicaid: $6,554.55 Aetna Better Health PA — CHIP: $9,790.36 Aetna Better Health WV — CHIP: $6,241.64 Aetna Medicare Advantage — All Plans: $9,762.87 Alliance Coal — Alliance Coal: $12,172 Anthem VA Medicare Advantage — HMO: $9,297.97 Blue Cross Blue Shield PPO — Blue Cross Blue Shield PPO: $22,403.80 Blue Cross Blue Shield Traditional — Blue Cross Blue Shield Traditional: $22,403.80 Coventry Health Care — Worker's Compensation: $14,690.79

Source: Princeton Community Hospital Assn Inc’s standard charges file (wvumedicine.org, CSV, CMS template 3.0.0; it can be a very large file), last updated by the hospital on July 10, 2026; retrieved November 1, 2026. The hospital’s price transparency page →

Found through the hospital’s cms-hpt.txt file, as required by the federal hospital price transparency rule (CMS). We show a selection of common services; the file has every item and service.

Hospital information

Hospital type	Acute Care Hospital
Address	122 12th Street, Princeton, WV 24740
County	Mercer County
State	West Virginia
Phone	(304) 487‑7000
Emergency services	Yes
Ownership	Government - Local
Medicare overall rating	2 of 5 stars
Birthing-friendly designation	Yes (meets CMS criteria)
CMS Certification Number	510046
Name in Medicare records	PRINCETON COMMUNITY HOSPITAL ASSN INC
Profile level	Medicare data + hospital website
Name on the hospital’s website	WVU Medicine Princeton Community Hospital
Official website	wvumedicine.org
Corrections	Report an error or suggest an update →

Sources

Hospital General Information — Centers for Medicare & Medicaid Services (CMS), data updated 2026-07-22, retrieved 2026-10-29
Medicare Care Compare — official Medicare profile of this hospital
U.S. Census Bureau Geocoder — map position used for distances

From the hospital’s website

Numbers match the citations above. Checked 2026-10-30.

Princeton Community Hospital — wvumedicine.org
About Princeton Community Hospital — wvumedicine.org
Patients and Visitors — wvumedicine.org
During Your Visit | Princeton Community Hospital — wvumedicine.org
Before Your Visit | Princeton Community Hospital — wvumedicine.org
Visitation Guidelines | Princeton Community Hospital — wvumedicine.org