Supplies, drugs & other prices at Braxton County Memorial Hospital

Gassaway, WV · every code in this section with a posted price and a Medicare benchmark.

31 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Admin hepatitis b vaccine (G0010) $45 $90 1.0×
Admin influenza virus vac (G0008) $45 $90 1.0×
Admin pneumococcal vaccine (G0009) $45 $90 1.0×
Alcohol/subs interv 15-30mn (G0396) $36 $72 1.0×
Autolog prp not diab ulcer (G0460) $1,976.50 $3,953 1.0×
Ca screen;pelvic/breast exam (G0101) $97.50 $195 1.0×
Catheterize for urine spec (P9612) $18.50 $37 2.0×
Covid-19 lab test non-cdc (U0002) $104.50 $209 2.0×
Depression screen annual (G0444) $36 $72 1.0×
Direct refer hospital observ (G0379) $570.50 $1,141 1.0×
Drug test def 1-7 classes (G0480) $95.50 $191 0.8×
Drug test def 15-21 classes (G0482) $165 $330 0.8×
Drug test def 22+ classes (G0483) $41 $82 0.2×
Drug test def 8-14 classes (G0481) $90 $180 0.6×
Fecal blood scrn immunoassay (G0328) $109 $218 6.0×
Hiv combination assay (G0475) $85 $170 3.5×
Hospital outpt clinic visit (G0463) $25 $50 0.2×
Hpv combo assay ca screen (G0476) $71 $142 2.0×
Inj for sacroiliac jt anesth (G0260) $681.50 $1,363 1.0×
Intens behave ther cardio dx (G0446) $39.50 $79 1.1×
Neuro csf prion prtn qual (0035U) $202 $404 0.4×
Obtaining screen pap smear (Q0091) $44.50 $89 1.6×
Ppps, initial visit (G0438) $155.50 $311 0.9×
Ppps, subseq visit (G0439) $122.50 $245 0.9×
Psa screening (G0103) $42.50 $85 2.2×
Risk ascvd tst once pr 12 mo (G0537) $36 $72 1.0×
Screen cerv/vag thin layer (G0123) $68 $136 3.4×
Tomosynthesis, mammo (G0279) $59 $118 4.6×
Trauma respons w/hosp criti (G0390) $1,395.50 $2,791 1.1×
Tte w or wo fol wcon,doppler (C8929) $1,302 $2,604 1.7×
Visit to determ ldct elig (G0296) $86.50 $173 0.9×