Visits & medical services prices at Braxton County Memorial Hospital

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

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

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ProcedureCash priceGross charge× Medicare
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $41 $82 1.5×
Acupuncture, 1 or more needles; with electrical stimulation, initial 15 minutes of personal one-on-one contact with the… (97813) $41 $82 1.5×
Advance care planning first 30 mins (99497) $126.25 $252.50 1.3×
Airway inhalation treatment (94640) $124 $248 0.6×
Allg test perq & ic drug/biol immed react w/ i&r (95018) $64.50 $129 1.8×
Analyze neurostim complex (95972) $109 $218 1.2×
Analyze neurostim no prog (95970) $127.50 $255 1.0×
Analyze neurostim simple (95971) $91 $182 1.0×
Application on-body injector (96377) $58 $116 1.3×
Bedside Swallowing Eval (92610) $130.50 $261 1.5×
Brief Emotional/Behavioral Assessment (96127) $67.50 $135 1.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $411.50 $823 1.1×
Canalith Repositioning Procedure (95992) $81.50 $163 2.0×
Cardiac Stress Tst,Tracing Only (93017) $207 $414 1.0×
Cardiopulmonary resuscitation (92950) $606.50 $1,213 2.9×
Cardioversion (92960) $1,112.50 $2,225 1.8×
Caregiver hlth risk assmt score doc stnd instrm (96161) $36 $72 1.0×
Caregiver Training Strategies&Tq Ea Addl 15 Min (97551) $22 $44 0.8×
Cbt 1st hour (94644) $127.50 $255 1.0×
Chemo Hormon Antineopl Sq/Im (96402) $69 $138 1.0×
Chemother, IV infusion, 1 hr (96413) $316.50 $633 1.0×
Chemother, IV infusion, ea add hr (96415) $69 $138 1.0×
Chemotx admn IV nfs tq ea seql nfs to 1 hr (96417) $69 $138 1.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $316.50 $633 1.0×
Chronic care management services 1st 20 min (99490) $97.50 $195 1.0×
Color/duplex Doppler, complete (93975) $650.50 $1,301 2.8×
Color/duplex Doppler, limited (93976) $119.50 $239 1.2×
Complex chronic care mgmt svc 1st 60 min cal mo (99487) $170.50 $341 1.0×
Conditioning Play Audiometry (92582) $123 $246 1.0×
Cpap/bipap (94660) $210 $420 1.0×
Cpt initial (94667) $127.50 $255 1.0×
Critical care (99291) $465.50 $931 0.6×
Debridement Open Wound 20 Sq Cm< (97597) $197.50 $395 1.0×
Dup-Scan Aorta Ivc Iliac Vascl/Bpgs Complete (93978) $355.50 $711 1.6×
Dup-Scan Lxtr Art/Artl Bpgs Compl Bi Study (93925) $338.50 $677 1.5×
Dup-Scan Lxtr Art/Artl Bpgs Uni/Lmtd Study (93926) $483 $966 4.8×
Dup-Scan Uxtr Art/Artl Bpgs Compl Bi Study (93930) $417 $834 1.8×
Dup-Scan Uxtr Art/Artl Bpgs Uni/Lmtd Study (93931) $417 $834 4.2×
Dup-Scan Xtr Veins Complete Bilateral Study (93970) $229 $458 1.0×
Dup-scan xtr veins unilateral/limited study (93971) $289.25 $578.50 2.9×
Duplex scan extracranial art compl bi study (93880) $272.50 $545 1.2×
Echo Heart Xthoracic,Limited (93308) $252.25 $504.50 1.1×
Electrocardiogram Tracing (93005) $96 $192 1.7×
Er level 1 (99281) $82 $164 1.0×
Er level ii (99282) $142 $284 1.0×
Er level iii (99283) $207 $414 0.8×
Er level IV (99284) $331 $662 0.8×
Er level v (99285) $496 $992 0.9×
Evaluate Pt Use Of Inhaler (94664) $210 $420 1.0×
External ECG rec>48hr<7d recording (93242) $54.50 $109 1.5×
External ECG rec>7d<15d recording (93246) $88.50 $177 2.5×
External Ecg Scanning Analysis Report (93226) $56.50 $113 1.0×
Group Therapeutic Procedures (97150) $61.50 $123 3.4×
Holter Monitor (93225) $127.50 $255 1.0×
Imaging of retina for detection or monitoring of disease; point-of-care autonomous analysis and report, unilateral or… (92229) $57 $114 1.0×
Img retina detcj/mntr ds rem clin staff uni/bi (92227) $29.50 $59 0.5×
Img Retina Detcj/Mntr Ds Rem Phys/Qhp I&R Uni/Bi (92228) $19.50 $39 0.5×
Imm admn sarscov2 vaccine single dose (90480) $39.50 $79 1.0×
Immune Admin Oral/Nasal (90473) $37 $74 0.5×
Immunization Admin (90471) $39.25 $78.50 0.6×
Interrogate subq defib (93261) $37 $74 1.0×
Irrig drug delivery device (96523) $87.50 $175 1.5×
IV infusion hydration each additional hour (96361) $45 $90 1.0×
IV infusion hydration initial 31 min-1 hour (96360) $290.50 $581 1.4×
IV infusion ther proph addl sequential to 1 hr (96367) $86 $172 1.2×
IV infusion, therap/proph/diagnost,initial,1st hour (96365) $204 $408 1.0×
IV infusion, therap/proph/diagnost,initial,ea add hour (96366) $45 $90 1.0×
IV push ea addl new drug (96375) $45 $90 1.0×
IV push initial (96374) $204 $408 1.0×
Manual therapy 15 min (97140) $52.50 $105 1.9×
Mchnl sclp cool cap sply head meas fitg&educaj (97007) $1,360 $2,720 1.0×
Negative Pressure Wound Therapy Dme </= 50 Sq Cm (97605) $192.50 $385 1.0×
Non-Invas Physiologic Std Extremity Art 2 Level (93922) $216 $432 1.7×
Noninvasive Ear/Pulse Oximetry Overnight Monitor (94762) $154 $308 1.2×
Optokinetic nystagmus test, bidirectional, foveal or peripheral stimulation, with recording Non-Facility (92544) $123 $246 1.0×
Oscillating Tracking Test (92545) $207 $414 1.0×
Ot eval low complex 30 min (97165) $106.50 $213 1.1×
Ot Orthotics/Prosth Mgmt &/Trainj Sbsq Enctr 15 Min (97763) $58.50 $117 1.2×
Ot therapeutic activity 15 min (97530) $29.50 $59 0.8×
Phlebotomy therapeutic (99195) $127.50 $255 1.0×
Prgrmg Eval Implantable Dfb - Cardiac Device Clinic Icd Biv Chamber (93284) $49.50 $99 1.4×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs 1 Njx (95115) $45 $90 1.0×
Prof Svcs Allg Immntx X W/Prv Allgic Xtrcs Njxs (95117) $45 $90 1.0×
Pt eval low complex 20 min (97161) $106.50 $213 1.1×
Pt gait training 15 min (97116) $35.50 $71 1.2×
Pt group caregiver training (97552) $22 $44 1.0×
Pt Neuromusc Reeducat,1+ Areas, Ea 15 Min (97112) $46 $92 1.4×
Pt re-evaluation (97164) $324 $648 4.8×
Pt Self-Care/Home Mgmt Training Each 15 Minutes (97535) $76 $152 2.3×
Pulmonary Service/Procedure (94799) $123.50 $247 1.0×
Pulmonary stress test simple (94618) $197 $394 1.5×
Pure Tone Audiometry Air Only (92552) $127.50 $255 1.0×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $350 $700 1.1×
Remote 30 Day Ecg Rev/Report - Cardiac Event Monitor (93270) $39.50 $79 1.1×
Remote Monitoring Of Physiologic Parameter(s) (Eg, Weight, Blood Pressure, Pulse Oximetry, Respiratory Flow Rate);… (99445) $35.50 $71 1.0×
Rfl&Main Implt Pmp/Rsvr Dlvr Spi/Brn Phy/Qhp (95991) $306.50 $613 1.0×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $192 $384 1.0×
Rt Chest Wall Manipulation,Subsequent (94668) $127.50 $255 1.0×
Slp caregiver training 1st 30 min (97550) $44 $88 0.8×
Smoking cessation > 10 min (99407) $41.50 $83 1.2×
Speech Audiometry Complete (92556) $80.50 $161 1.4×
Spirometry (94010) $260 $520 1.3×
Therapeutic prophylactic/dx injection subq/im (96372) $69 $138 1.0×
Tobacco Use Cessation Intermediate 3-10 Minutes (99406) $36.50 $73 1.0×
Trans Care Mgmt 14 Day Disch (99495) $128 $256 1.0×
Trans Care Mgmt 7 Day Disch (99496) $169 $338 1.3×
Tte w/doppler, complete (93306) $523.50 $1,047 1.0×
Tx Speech Lang Voice Commj &/Auditory Proc Ind (92507) $112.50 $225 1.5×
Tx Swallowing Dysfunction&/Oral Funcj Feeding (92526) $112.50 $225 1.3×
Vasc Duplex Scan Extracranial,Limited (93882) $346.50 $693 3.5×
Vent mgmt inpat init day (94002) $870 $1,740 1.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $870 $1,740 1.5×
Xtrnl Pt Activated Ecg Rec Dwnld 30 Days (93271) $91 $182 1.0×