▸ Hospital · WV · CCN 511322

Summersville Regional Medical Center

400 FAIRVIEW HEIGHTS ROAD, SUMMERSVILLE, WV, 26551

25 bedsCritical Access Hospitals2

Compliance grade

78/100

Procedures tracked

143

of 209 target codes

Payers

with negotiated rates

Rates published

1,426

last crawl 2026-05-24

▸ Compare with other hospitals All WV hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://wvumedicine.org/wp-content/uploads/2026/04/550650441_West-Virginia-Health-Care-Cooperative-Inc._standardcharges.csv · CSV

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychiatric diagnostic evaluation	CPT	90791	0	$308	$154	—	—	—
Psychiatric eval with medical services	CPT	90792	0	$378	$189	—	—	—
Psychotherapy 30 minutes	CPT	90832	0	$148	$74	—	—	—
Psychotherapy 45 minutes	CPT	90834	0	$196	$98	—	—	—
Psychotherapy 60 minutes	CPT	90837	0	$378	$189	—	—	—
Crisis psychotherapy 60 minutes	CPT	90839	0	$281	$140.5	—	—	—
emergency
ED visit level 1	CPT	99281	0	$254	$127	—	—	—
ED visit level 2	CPT	99282	0	$368	$184	—	—	—
ED visit level 3	CPT	99283	0	$830	$415	—	—	—
ED visit level 4	CPT	99284	0	$1,308	$654	—	—	—
ED visit level 5	CPT	99285	0	$2,041	$1,020.5	—	—	—
Critical care, first hour	CPT	99291	0	$1,329	$664.5	—	—	—
imaging
CT head without contrast	CPT	70450	0	$1,158	$579	—	—	—
CT head with contrast	CPT	70460	0	$1,419	$709.5	—	—	—
CT head with and without contrast	CPT	70470	0	$1,734	$867	—	—	—
CT neck with contrast	CPT	70491	0	$1,482	$741	—	—	—
MRI brain without contrast	CPT	70551	0	$2,081	$1,040.5	—	—	—
MRI brain with contrast	CPT	70552	0	$2,796	$1,398	—	—	—
MRI brain with and without contrast	CPT	70553	0	$3,381	$1,690.5	—	—	—
Chest X-ray single view	CPT	71045	0	$231	$115.5	—	—	—
Chest X-ray 2 views	CPT	71046	0	$299	$149.5	—	—	—
Chest X-ray 3 views	CPT	71047	0	$384	$192	—	—	—
CT chest without contrast	CPT	71250	0	$2,101	$1,050.5	—	—	—
CT chest with contrast	CPT	71260	0	$2,458	$1,229	—	—	—
CT chest with and without contrast	CPT	71270	0	$3,014	$1,507	—	—	—
MRI chest without contrast	CPT	71550	0	$2,081	$1,040.5	—	—	—
MRI chest with and without contrast	CPT	71552	0	$3,381	$1,690.5	—	—	—
Lumbosacral spine X-ray	CPT	72100	0	$329	$164.5	—	—	—
CT cervical spine without contrast	CPT	72125	0	$1,474	$737	—	—	—
CT thoracic spine without contrast	CPT	72128	0	$2,101	$1,050.5	—	—	—
CT lumbar spine without contrast	CPT	72131	0	$2,102	$1,051	—	—	—
MRI cervical spine without contrast	CPT	72141	0	$2,081	$1,040.5	—	—	—
MRI thoracic spine without contrast	CPT	72146	0	$2,081	$1,040.5	—	—	—
MRI lumbar spine without contrast	CPT	72148	0	$2,081	$1,040.5	—	—	—
MRI lumbar spine with and without contrast	CPT	72149	0	$2,796	$1,398	—	—	—
MRI cervical spine with and without contrast	CPT	72156	0	$3,381	$1,690.5	—	—	—
MRI lumbar spine with contrast	CPT	72158	0	$3,381	$1,690.5	—	—	—
CT pelvis without contrast	CPT	72192	0	$2,074	$1,037	—	—	—
CT pelvis with contrast	CPT	72193	0	$2,364	$1,182	—	—	—
Shoulder X-ray	CPT	73030	0	$542	$271	—	—	—
Humerus X-ray	CPT	73060	0	$510	$255	—	—	—
Hand X-ray 3 views	CPT	73130	0	$281	$140.5	—	—	—
MRI upper extremity joint without contrast	CPT	73221	0	$2,081	$1,040.5	—	—	—
MRI upper extremity joint with and without contrast	CPT	73223	0	$3,381	$1,690.5	—	—	—
Knee X-ray 1-2 views	CPT	73560	0	$279	$139.5	—	—	—
Ankle X-ray 3 views	CPT	73610	0	$486	$243	—	—	—
MRI lower extremity joint without contrast	CPT	73721	0	$2,081	$1,040.5	—	—	—
MRI lower extremity joint with and without contrast	CPT	73723	0	$3,381	$1,690.5	—	—	—
CT abdomen without contrast	CPT	74150	0	$2,040	$1,020	—	—	—
CT abdomen with contrast	CPT	74160	0	$2,408	$1,204	—	—	—
CT abdomen with and without contrast	CPT	74170	0	$2,916	$1,458	—	—	—
CT abdomen and pelvis without contrast	CPT	74176	0	$2,040	$1,020	—	—	—
CT abdomen and pelvis with contrast	CPT	74177	0	$2,408	$1,204	—	—	—
CT abdomen and pelvis with and without contrast	CPT	74178	0	$2,916	$1,458	—	—	—
MRI abdomen without contrast	CPT	74181	0	$2,081	$1,040.5	—	—	—
MRI abdomen with and without contrast	CPT	74183	0	$3,381	$1,690.5	—	—	—
Abdominal ultrasound complete	CPT	76700	0	$945	$472.5	—	—	—
Abdominal ultrasound limited	CPT	76705	0	$734	$367	—	—	—
Retroperitoneal ultrasound complete	CPT	76770	0	$945	$472.5	—	—	—
Obstetric ultrasound first trimester	CPT	76801	0	$325	$162.5	—	—	—
Obstetric ultrasound after first trimester	CPT	76805	0	$1,098	$549	—	—	—
Obstetric ultrasound with fetal anatomy	CPT	76811	0	$183	$91.5	—	—	—
Transvaginal ultrasound	CPT	76830	0	$786	$393	—	—	—
Pelvic ultrasound complete	CPT	76856	0	$786	$393	—	—	—
Scrotal ultrasound	CPT	76870	0	$764	$382	—	—	—
Diagnostic mammography unilateral	CPT	77065	0	$370	$185	—	—	—
Diagnostic mammography bilateral	CPT	77066	0	$468	$234	—	—	—
Screening mammography bilateral	CPT	77067	0	$465	$232.5	—	—	—
EKG complete	CPT	93000	0	$333	$166.5	—	—	—
EKG tracing only	CPT	93005	0	$542	$271	—	—	—
EKG interpretation only	CPT	93010	0	$18	$9	—	—	—
Transthoracic echocardiogram complete	CPT	93306	0	$2,125	$1,062.5	—	—	—
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	$285	$142.5	—	—	—
Initial hospital care, high complexity	CPT	99223	0	$377	$188.5	—	—	—
Hospital discharge, <30 min	CPT	99238	0	$175	$87.5	—	—	—
Hospital discharge, >30 min	CPT	99239	0	$247	$123.5	—	—	—
lab
Basic metabolic panel (BMP)	CPT	80048	0	$209	$104.5	—	—	—
General health panel	CPT	80050	0	$470	$235	—	—	—
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	$18	$9	—	—	—
Urinalysis automated	CPT	81003	0	$37	$18.5	—	—	—
Glucose quantitative	CPT	82947	0	$76	$38	—	—	—
Hemoglobin A1c	CPT	83036	0	$114	$57	—	—	—
Thyroid stimulating hormone (TSH)	CPT	84443	0	$150	$75	—	—	—
Complete blood count with automated differential	CPT	85025	0	$71	$35.5	—	—	—
Complete blood count without differential	CPT	85027	0	$66	$33	—	—	—
Urine culture bacterial	CPT	87086	0	$168	$84	—	—	—
Urine culture identification	CPT	87088	0	$97	$48.5	—	—	—
Tissue exam by pathologist level IV	CPT	88305	0	$2,684	$1,342	—	—	—
maternity
Fetal non-stress test	CPT	59025	0	$403	$201.5	—	—	—
Routine obstetric care including vaginal delivery	CPT	59400	0	$5,180	$2,590	—	—	—
Vaginal delivery only	CPT	59409	0	$6,304	$3,152	—	—	—
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	$108	$54	—	—	—
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	$649	$324.5	—	—	—
Office visit, established patient, 5 min	CPT	99211	0	$56	$28	—	—	—
Office visit, established patient, 10-19 min	CPT	99212	0	$77	$38.5	—	—	—
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 diagnostic	CPT	43235	0	$1,769	$884.5	—	—	—
Upper GI endoscopy with biopsy	CPT	43239	0	$1,525	$762.5	—	—	—
Sigmoidoscopy diagnostic	CPT	45330	0	$732	$366	—	—	—
Sigmoidoscopy with biopsy	CPT	45331	0	$1,342	$671	—	—	—
Colonoscopy diagnostic	CPT	45378	0	$3,294	$1,647	—	—	—
Colonoscopy with biopsy	CPT	45380	0	$3,843	$1,921.5	—	—	—
Colonoscopy with polyp removal	CPT	45385	0	$3,700.67	$1,850.34	—	—	—
surgery
Total shoulder arthroplasty	CPT	23472	0	$23,077	$11,539	—	—	—
Hip hemiarthroplasty	CPT	27125	0	$2,496	$1,248	—	—	—
Total hip replacement	CPT	27130	0	$19,665	$9,832.5	—	—	—
Total knee replacement	CPT	27447	0	$19,500	$9,750	—	—	—
Knee revision arthroplasty single component	CPT	27486	0	$9,464	$4,732	—	—	—
Knee revision arthroplasty all components	CPT	27487	0	$3,874	$1,937	—	—	—
Shoulder arthroscopy with decompression	CPT	29826	0	$3,347.66	$1,673.83	—	—	—
Shoulder arthroscopy with rotator cuff repair	CPT	29827	0	$11,737	$5,868.5	—	—	—
Knee arthroscopy with meniscectomy	CPT	29881	0	$18,560	$9,280	—	—	—
ACL reconstruction	CPT	29888	0	$15,488	$7,744	—	—	—
CABG single arterial graft	CPT	33533	0	$3,988	$1,994	—	—	—
Open appendectomy	CPT	44950	0	$1,383	$691.5	—	—	—
Laparoscopic appendectomy	CPT	44970	0	$20,300	$10,150	—	—	—
Laparoscopic cholecystectomy	CPT	47562	0	$20,010	$10,005	—	—	—
Lap cholecystectomy with cholangiography	CPT	47563	0	$1,550	$775	—	—	—
Lap inguinal hernia repair	CPT	49650	0	$46,400	$23,200	—	—	—
Total abdominal hysterectomy	CPT	58150	0	$2,150	$1,075	—	—	—
Vaginal hysterectomy	CPT	58260	0	$1,767	$883.5	—	—	—
Lap-assisted vaginal hysterectomy	CPT	58550	0	$1,863	$931.5	—	—	—
Lap-assisted vaginal hysterectomy >250g	CPT	58552	0	$2,073	$1,036.5	—	—	—
Lap salpingo-oophorectomy	CPT	58661	0	$1,380	$690	—	—	—
Complex cataract surgery	CPT	66982	0	$8,990	$4,495	—	—	—
Cataract surgery with lens implant	CPT	66984	0	$7,540	$3,770	—	—	—
Intravitreal injection	CPT	67028	0	$186	$93	—	—	—