▸ Hospital · WV · CCN 511319

Jefferson Medical Center

300 S. PRESTON STREET, RANSON, WV, 25438

25 bedsCritical Access Hospitals2

Compliance grade

86/100

Rates published

404

last crawl 2026-05-24

Procedures tracked

110

of 209 target codes

Payers

with negotiated rates

Procedures tracked

...

Payers

...

▸ Compare with other hospitals All WV hospitals JSON

Source MRF: https://wvumedicine.org/wp-content/uploads/2026/04/550359755_Jefferson-Medical-Center-_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	0	$392	$196	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$366	$183	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$187	$93.5	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$294	$147	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$392	$196	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$295	$147.5	—	—	—
emergency
ED visit level 1	CPT	99281	0	$278	$139	—	—	—
ED visit level 2	CPT	99282	0	$399	$199.5	—	—	—
ED visit level 3	CPT	99283	0	$539	$269.5	—	—	—
ED visit level 4	CPT	99284	0	$892	$446	—	—	—
ED visit level 5	CPT	99285	0	$1,358	$679	—	—	—
Critical care, first hour	CPT	99291	0	$1,898	$949	—	—	—
imaging
CT head without contrast	CPT	70450	0	$1,340	$670	—	—	—
CT head with contrast	CPT	70460	0	$1,839	$919.5	—	—	—
CT head with and without contrast	CPT	70470	0	$2,142	$1,071	—	—	—
CT neck with contrast	CPT	70491	0	$1,839	$919.5	—	—	—
MRI brain without contrast	CPT	70551	0	$2,411	$1,205.5	—	—	—
MRI brain with and without contrast	CPT	70553	0	$3,767	$1,883.5	—	—	—
Chest X-ray single view	CPT	71045	0	$348	$174	—	—	—
Chest X-ray 2 views	CPT	71046	0	$348	$174	—	—	—
CT chest without contrast	CPT	71250	0	$1,468	$734	—	—	—
CT chest with contrast	CPT	71260	0	$1,710	$855	—	—	—
CT chest with and without contrast	CPT	71270	0	$1,983	$991.5	—	—	—
MRI chest without contrast	CPT	71550	0	$150	$75	—	—	—
MRI chest with and without contrast	CPT	71552	0	$3,673	$1,836.5	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$445	$222.5	—	—	—
CT cervical spine without contrast	CPT	72125	0	$1,330	$665	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$1,516	$758	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$1,231	$615.5	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$2,411	$1,205.5	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$2,411	$1,205.5	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$2,411	$1,205.5	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$3,709	$1,854.5	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$3,709	$1,854.5	—	—	—
CT pelvis without contrast	CPT	72192	0	$1,451	$725.5	—	—	—
CT pelvis with contrast	CPT	72193	0	$1,701	$850.5	—	—	—
Shoulder X-ray	CPT	73030	0	$356	$178	—	—	—
Humerus X-ray	CPT	73060	0	$353	$176.5	—	—	—
Hand X-ray 3 views	CPT	73130	0	$346	$173	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$2,411	$1,205.5	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$3,708	$1,854	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$346	$173	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$346	$173	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$2,413	$1,206.5	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$3,708	$1,854	—	—	—
CT abdomen without contrast	CPT	74150	0	$1,429	$714.5	—	—	—
CT abdomen with contrast	CPT	74160	0	$1,703	$851.5	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$2,043	$1,021.5	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$3,000	$1,500	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$3,474	$1,737	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$4,025	$2,012.5	—	—	—
MRI abdomen without contrast	CPT	74181	0	$2,411	$1,205.5	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$3,708	$1,854	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$881	$440.5	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$880	$440	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$881	$440.5	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$931	$465.5	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$895	$447.5	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$987	$493.5	—	—	—
Transvaginal ultrasound	CPT	76830	0	$881	$440.5	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$881	$440.5	—	—	—
Scrotal ultrasound	CPT	76870	0	$881	$440.5	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$424	$212	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$687	$343.5	—	—	—
Screening mammography bilateral	CPT	77067	0	$687	$343.5	—	—	—
EKG tracing only	CPT	93005	0	$234	$117	—	—	—
EKG interpretation only	CPT	93010	0	$19	$9.5	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$3,244	$1,622	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$96	$48	—	—	—
Stress echocardiogram	CPT	93350	0	$151	$75.5	—	—	—
inpatient
Initial hospital care, low complexity	CPT	99221	0	$173	$86.5	—	—	—
Initial hospital care, moderate complexity	CPT	99222	0	$269	$134.5	—	—	—
Initial hospital care, high complexity	CPT	99223	0	$358	$179	—	—	—
Hospital discharge, <30 min	CPT	99238	0	$169	$84.5	—	—	—
Hospital discharge, >30 min	CPT	99239	0	$240	$120	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$78	$39	—	—	—
Electrolyte panel	CPT	80051	0	$65	$32.5	—	—	—
Comprehensive metabolic panel	CPT	80053	0	$98	$49	—	—	—
Lipid panel	CPT	80061	0	$125	$62.5	—	—	—
Renal function panel	CPT	80069	0	$80	$40	—	—	—
Hepatic function panel	CPT	80076	0	$76	$38	—	—	—
Urinalysis non-automated	CPT	81002	0	$27	$13.5	—	—	—
Urinalysis automated	CPT	81003	0	$38	$19	—	—	—
Glucose quantitative	CPT	82947	0	$47	$23.5	—	—	—
Hemoglobin A1c	CPT	83036	0	$134	$67	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$130	$65	—	—	—
Complete blood count with automated differential	CPT	85025	0	$99	$49.5	—	—	—
Complete blood count without differential	CPT	85027	0	$127	$63.5	—	—	—
Urine culture bacterial	CPT	87086	0	$133	$66.5	—	—	—
Urine culture identification	CPT	87088	0	$142	$71	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$268	$134	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$534	$267	—	—	—
Vaginal delivery only	CPT	59409	0	$1,753	$876.5	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$185	$92.5	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$185	$92.5	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$292	$146	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$378	$189	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$185	$92.5	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$185	$92.5	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$144	$72	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$211	$105.5	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$314	$157	—	—	—
preventive
Upper GI endoscopy with biopsy	CPT	43239	0	$281	$140.5	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$120	$60	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$377	$188.5	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$406	$203	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$511	$255.5	—	—	—
surgery
Laparoscopic appendectomy	CPT	44970	0	$1,345	$672.5	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$4,533	$2,266.5	—	—	—
Intravitreal injection	CPT	67028	0	$169	$84.5	—	—	—

Rate history available after the next quarterly refresh. We re-crawl all hospital MRFs each quarter to track rate changes over time.

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