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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ProcedurePosted cashPosted gross× Medicare
Acupunct W/Stimul 15 Min (97813) $41 $82 1.5×
Acupuncture 1/> ndles w/o elec stimj init 15 min (97810) $41 $82 1.5×
Admn Sarscov2 Vacc 1 Dose (90480) $39.50 $79 1.0×
Advncd Care Plan 30 Min (99497)
range across 2 matching MRF lines		 $97.50–$155 $195–$310 varies
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)
range across 2 matching MRF lines		 $91–$127 $182–$254 varies
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×
Brief Emotional/Behav Assmt (96127) $67.50 $135 1.9×
Brncdilat rspse spmtry pre&post-brncdilat admn (94060) $411.50 $823 1.1×
Canalith repositioning proc (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×
Chemo IV infusion addl 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 nfs tq up 1 hr 1/1st sbst/drug (96413) $316.50 $633 1.0×
Chemotx admn IV push tq 1/1st sbst/drug (96409) $316.50 $633 1.0×
Chest Wall Manipulation (94668) $127.50 $255 1.0×
Chron Care Mgmt Srvc 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×
Continuous Pulse Ox (94762) $154 $308 1.2×
Cpap Ventilation Cpap Initiation&Mgmt (94660) $210 $420 1.0×
Cpt initial (94667) $127.50 $255 1.0×
Critical care first hour (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 Xtr Veins Complete Bilateral Study (93970) $229 $458 1.0×
Dup-scan xtr veins unilateral/limited study (93971)
range across 2 matching MRF lines		 $282–$296.50 $564–$593 varies
Duplex up extrem art bilat (93930) $417 $834 1.8×
Duplex up extrem art unilat/ltd (93931) $417 $834 4.2×
ECG/monitoring and analysis (93271) $91 $182 1.0×
Echo Heart Xthoracic,Limited (93308)
range across 2 matching MRF lines		 $246–$258.50 $492–$517 varies
Electrocardiogram Tracing (93005) $96 $192 1.7×
Emergency Dept Visit Level 2 (99282) $142 $284 1.0×
Emergency Dept Visit Level 3 (99283) $207 $414 0.8×
Emergency Dept Visit Level 4 (99284) $331 $662 0.8×
Er level 1 (99281) $82 $164 1.0×
Er level v (99285) $496 $992 0.9×
Evaluate pt use of inhaler (94664) $210 $420 1.0×
Evaluate Swallowing Function (92610) $130.50 $261 1.5×
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×
Extracranial Bilat Study (93880) $272.50 $545 1.2×
Extracranial Uni/Ltd Study (93882) $346.50 $693 3.5×
Group Therapeutic Procedures (97150) $61.50 $123 3.4×
Holter monitor recording (93225) $127.50 $255 1.0×
Icd Device Progr Eval Mult (93284) $49.50 $99 1.4×
Im Adm Intransl/Oral 1 Vaccine (90473) $37 $74 0.5×
Img retina detcj/mntr ds poc auton a/r uni/bi (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×
Immunization administration (90471)
range across 2 matching MRF lines		 $9.50–$69 $19–$138 varies
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 therapy prophylaxis/dx ea hour (96366) $45 $90 1.0×
IV push initial (96374) $204 $408 1.0×
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×
Neuromuscular Reeducation (97112) $46 $92 1.4×
Optokinetic Nystagmus Test (92544) $123 $246 1.0×
Oral Function Therapy (92526) $112.50 $225 1.3×
Orthc/Prostc Mgmt Sbsq Enc (97763) $58.50 $117 1.2×
Oscillating Tracking Test (92545) $207 $414 1.0×
Ot Eval Low Complex (97165) $106.50 $213 1.1×
Ot manual therapy 15 min (97140) $52.50 $105 1.9×
Phlebotomy therapeutic (99195) $127.50 $255 1.0×
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 Re-Eval Est Plan Care (97164) $324 $648 4.8×
Pulmonary service/procedure (94799) $123.50 $247 1.0×
Pulmonary Stress Testing (94618) $197 $394 1.5×
Pure Tone Audiometry Air (92552) $127.50 $255 1.0×
Refill&Maintenance Pump Drug Dlvr Spinal/Brain (95990) $350 $700 1.1×
Rem Mntr Physiol Param Dev Sply W/Rec 2-15 Days (99445) $35.50 $71 1.0×
Remote 30 Day Ecg Rev/Report (93270) $39.50 $79 1.1×
Rmvl Devital Tiss N-Slctv Dbrdmt W/O Anes 1 Sess (97602) $192 $384 1.0×
Self Care Mngment Training (97535) $76 $152 2.3×
Slp caregiver training 1st 30 min (97550) $44 $88 0.8×
Speech Audiometry Complete (92556) $80.50 $161 1.4×
Spin/Brain Pump Refil & Main (95991) $306.50 $613 1.0×
Spirometry (94010) $260 $520 1.3×
Ther/Proph/Diag Inj Sc/Im (96372) $69 $138 1.0×
Ther/Proph/Diag Iv Inf Init (96365) $204 $408 1.0×
Therapeutic Activities (97530) $29.50 $59 0.8×
Tobacco Use Cessation Intensive >10 Minutes (99407) $41.50 $83 1.2×
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/Pro/Dx Inj New Drug Addon (96375) $45 $90 1.0×
Upr/L Xtremity Art 2 Levels (93922) $216 $432 1.7×
Vent Mgmt Inpat Init Day (94002) $870 $1,740 1.5×
Ventilation Assist & Mgmt Inpatient Ea Sbsq Da (94003) $870 $1,740 1.5×

A range means this hospital published different amounts on matching machine-readable-file lines. We show the lowest–highest posted amount because we cannot tell from the published file which line would apply to a particular visit.