▸ Hospital · WV · CCN 511320

Jackson General Hospital

122 PINNELL STREET, RIPLEY, WV, 25271

25 bedsCritical Access Hospitals2

Compliance grade

78/100

Procedures tracked

143

of 209 target codes

Payers

with negotiated rates

Rates published

1,546

last crawl 2026-05-24

▸ Compare with other hospitals All WV hospitals JSON

Source MRF: https://wvumedicine.org/wp-content/uploads/2026/04/550462730_Community-Health-Association_standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	0	$329	$164.5	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$409	$204.5	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$153	$76.5	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$201	$100.5	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$430	$215	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$287	$143.5	—	—	—
emergency
ED visit level 1	CPT	99281	0	$312	$156	—	—	—
ED visit level 2	CPT	99282	0	$582	$291	—	—	—
ED visit level 3	CPT	99283	0	$1,171	$585.5	—	—	—
ED visit level 4	CPT	99284	0	$2,046	$1,023	—	—	—
ED visit level 5	CPT	99285	0	$3,335	$1,667.5	—	—	—
Critical care, first hour	CPT	99291	0	$6,728	$3,364	—	—	—
imaging
CT head without contrast	CPT	70450	0	$1,605	$802.5	—	—	—
CT head with contrast	CPT	70460	0	$1,569	$784.5	—	—	—
CT head with and without contrast	CPT	70470	0	$1,977	$988.5	—	—	—
CT neck with contrast	CPT	70491	0	$1,884	$942	—	—	—
MRI brain without contrast	CPT	70551	0	$2,769	$1,384.5	—	—	—
MRI brain with contrast	CPT	70552	0	$2,319	$1,159.5	—	—	—
MRI brain with and without contrast	CPT	70553	0	$4,592	$2,296	—	—	—
Chest X-ray single view	CPT	71045	0	$470	$235	—	—	—
Chest X-ray 2 views	CPT	71046	0	$333	$166.5	—	—	—
Chest X-ray 3 views	CPT	71047	0	$224	$112	—	—	—
CT chest without contrast	CPT	71250	0	$1,661	$830.5	—	—	—
CT chest with contrast	CPT	71260	0	$2,035	$1,017.5	—	—	—
CT chest with and without contrast	CPT	71270	0	$2,354	$1,177	—	—	—
MRI chest without contrast	CPT	71550	0	$3,067	$1,533.5	—	—	—
MRI chest with and without contrast	CPT	71552	0	$4,528	$2,264	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$296	$148	—	—	—
CT cervical spine without contrast	CPT	72125	0	$1,822	$911	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$1,822	$911	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$1,822	$911	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$2,824	$1,412	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$2,568	$1,284	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$2,834	$1,417	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$2,752	$1,376	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$3,660	$1,830	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$4,059	$2,029.5	—	—	—
CT pelvis without contrast	CPT	72192	0	$1,671	$835.5	—	—	—
CT pelvis with contrast	CPT	72193	0	$1,812	$906	—	—	—
Shoulder X-ray	CPT	73030	0	$360	$180	—	—	—
Humerus X-ray	CPT	73060	0	$554	$277	—	—	—
Hand X-ray 3 views	CPT	73130	0	$315	$157.5	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$2,752	$1,376	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$2,353	$1,176.5	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$223	$111.5	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$361	$180.5	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$2,865	$1,432.5	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$3,302	$1,651	—	—	—
CT abdomen without contrast	CPT	74150	0	$1,884	$942	—	—	—
CT abdomen with contrast	CPT	74160	0	$1,977	$988.5	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$2,259	$1,129.5	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$3,701	$1,850.5	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$3,944	$1,972	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$4,811	$2,405.5	—	—	—
MRI abdomen without contrast	CPT	74181	0	$2,693	$1,346.5	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$3,633	$1,816.5	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$878	$439	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$753	$376.5	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$508	$254	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$875	$437.5	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$875	$437.5	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$183	$91.5	—	—	—
Transvaginal ultrasound	CPT	76830	0	$830	$415	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$754	$377	—	—	—
Scrotal ultrasound	CPT	76870	0	$583	$291.5	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$381	$190.5	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$795	$397.5	—	—	—
Screening mammography bilateral	CPT	77067	0	$714	$357	—	—	—
EKG complete	CPT	93000	0	$254	$127	—	—	—
EKG tracing only	CPT	93005	0	$432	$216	—	—	—
EKG interpretation only	CPT	93010	0	$18	$9	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$2,441	$1,220.5	—	—	—
Transthoracic echocardiogram	CPT	93307	0	$88	$44	—	—	—
Stress echocardiogram	CPT	93350	0	$139	$69.5	—	—	—
inpatient
Initial hospital care, low complexity	CPT	99221	0	$182	$91	—	—	—
Initial hospital care, moderate complexity	CPT	99222	0	$390	$195	—	—	—
Initial hospital care, high complexity	CPT	99223	0	$453	$226.5	—	—	—
Hospital discharge, <30 min	CPT	99238	0	$282	$141	—	—	—
Hospital discharge, >30 min	CPT	99239	0	$247	$123.5	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$78	$39	—	—	—
General health panel	CPT	80050	0	$456	$228	—	—	—
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	$44	$22	—	—	—
Urinalysis automated	CPT	81003	0	$42	$21	—	—	—
Glucose quantitative	CPT	82947	0	$59	$29.5	—	—	—
Hemoglobin A1c	CPT	83036	0	$114	$57	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$189	$94.5	—	—	—
Complete blood count with automated differential	CPT	85025	0	$196	$98	—	—	—
Complete blood count without differential	CPT	85027	0	$89	$44.5	—	—	—
Urine culture bacterial	CPT	87086	0	$177	$88.5	—	—	—
Urine culture identification	CPT	87088	0	$170	$85	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$1,224	$612	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$399	$199.5	—	—	—
Routine obstetric care including vaginal delivery	CPT	59400	0	$5,180	$2,590	—	—	—
Vaginal delivery only	CPT	59409	0	$1,741	$870.5	—	—	—
Vaginal delivery with postpartum	CPT	59410	0	$2,349	$1,174.5	—	—	—
Routine obstetric care with C-section	CPT	59510	0	$5,792	$2,896	—	—	—
C-section delivery only	CPT	59514	0	$1,986	$993	—	—	—
C-section with postpartum	CPT	59515	0	$2,927	$1,463.5	—	—	—
office
Office visit, new patient, 15-29 min	CPT	99202	0	$126	$63	—	—	—
Office visit, new patient, 30-44 minutes	CPT	99203	0	$180	$90	—	—	—
Office visit, new patient, 45-59 min	CPT	99204	0	$292	$146	—	—	—
Office visit, new patient, 60-74 min	CPT	99205	0	$396	$198	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$221	$110.5	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$126	$63	—	—	—
Office visit, established patient, 20-29 minutes	CPT	99213	0	$144	$72	—	—	—
Office visit, established patient, 30-39 minutes	CPT	99214	0	$400	$200	—	—	—
Office visit, established patient, 40-54 min	CPT	99215	0	$314	$157	—	—	—
preventive
Upper GI endoscopy diagnostic	CPT	43235	0	$4,004	$2,002	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$1,638	$819	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$2,093	$1,046.5	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$5,642	$2,821	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$3,731	$1,865.5	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$6,552	$3,276	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$7,280	$3,640	—	—	—
surgery
Total shoulder arthroplasty	CPT	23472	0	$3,187	$1,593.5	—	—	—
Hip hemiarthroplasty	CPT	27125	0	$2,496	$1,248	—	—	—
Total hip replacement	CPT	27130	0	$29,603	$14,802	—	—	—
Total knee replacement	CPT	27447	0	$26,624	$13,312	—	—	—
Knee revision arthroplasty single component	CPT	27486	0	$3,098	$1,549	—	—	—
Knee revision arthroplasty all components	CPT	27487	0	$3,874	$1,937	—	—	—
Shoulder arthroscopy with decompression	CPT	29826	0	$6,191.75	$3,095.88	—	—	—
Shoulder arthroscopy with rotator cuff repair	CPT	29827	0	$6,191.75	$3,095.88	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	$9,139	$4,569.5	—	—	—
ACL reconstruction	CPT	29888	0	$24,643	$12,322	—	—	—
CABG single arterial graft	CPT	33533	0	$3,988	$1,994	—	—	—
Open appendectomy	CPT	44950	0	$33,731	$16,866	—	—	—
Laparoscopic appendectomy	CPT	44970	0	$10,183	$5,091.5	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	$15,171	$7,585.5	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	$4,690	$2,345	—	—	—
Lap inguinal hernia repair	CPT	49650	0	$27,248	$13,624	—	—	—
Total abdominal hysterectomy	CPT	58150	0	$3,718	$1,859	—	—	—
Vaginal hysterectomy	CPT	58260	0	$1,864	$932	—	—	—
Lap-assisted vaginal hysterectomy	CPT	58550	0	$1,963	$981.5	—	—	—
Lap-assisted vaginal hysterectomy >250g	CPT	58552	0	$25,584	$12,792	—	—	—
Lap salpingo-oophorectomy	CPT	58661	0	$8,779	$4,389.5	—	—	—
Complex cataract surgery	CPT	66982	0	$3,455	$1,727.5	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$2,643	$1,321.5	—	—	—
Intravitreal injection	CPT	67028	0	$186	$93	—	—	—

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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