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Patient Price Information List

Disclaimer: Minnie Hamilton Health Care Center determines its standard charges for patient items and services through the use of a chargemaster system, which is a list of charges for the components of patient care that go into every patient’s bill. These are the baseline rates for items and services provided at the Hospital. The chargemaster is similar in concept to the manufacturer’s suggested retail price (“MSRP”) on a particular product or good. The charges listed provide only a general starting point in determining the potential costs of an individual patient’s care at the Hospital. This list does not reflect the actual out-of-pocket costs that may be paid by a patient for any particular service, it is not binding, and the actual charges for items and services may vary.

Many factors may influence the actual cost of an item or service, including insurance coverage, rates negotiated with payors, and so on. Government payors, such as Medicare and Medicaid for example, do not pay the chargemaster rates, but rather have their own set rates that hospitals are obligated to accept. Commercial insurance payments are based on contract negotiations with payors and may or may not reflect the standard charges. The cost of treatment also may be impacted by variables involved in a patient’s actual care, such as specific equipment or supplies required, the length of time spent in surgery or recovery, additional tests, or any changes in care or unexpected conditions or complications that arise. Moreover, the foregoing list of charges for services only includes charges from the Hospital. It does not reflect the charges for physicians, such as the surgeon, anesthesiologist, radiologist, pathologist, or other physician specialists or providers who may be involved in providing particular services to a patient. These charges are billed separately.

Individuals with questions about their out-of-pocket costs of service and other financial information should contact the hospital or consider contacting their insurers for further information.

LOCAL MARKET HOSPITALS

In order to present a meaningful comparison, Minnie Hamilton Health Care Center has partnered with Hospital Pricing Specialists LLC to analyze current charges, based off CMS adjudicated claims through 3/31/2020. Minnie Hamilton Health Care Center charges are displayed and compared with the local market charge, consisting of the following hospitals:

Hospital Name
Location

Braxton County Memorial Hospital

Gassaway

WV

Camden-Clark Medical Center

Parkersburg

WV

Grafton City Hospital

Grafton

WV

Jackson General Hospital

Ripley

WV

Roane General Hospital

Spencer

WV

Sistersville General Hospital

Sistersville

WV

Summersville Regional Medical Center

Summersville

WV

United Hospital Center

Bridgeport

WV

Wetzel County Hospital

New Martinsville

WV

INPATIENT ROOM AND BOARD DAILY CHARGES

Description

Our Charge
Market Charge

Variance

Private Room

$975
$1,257

22% lower than market

Semi-Private Room

$975
$1,039

6% lower than market

OUTPATIENT EMERGENCY DEPARTMENT CHARGES

Emergency Department charges are based on the level of emergency care provided to our patients. The levels, with Level 1 representing basic emergency care, reflect the type of accommodations needed, the personnel resources, the intensity of care and the amount of time needed to provide treatment. The following charges do not include fees for drugs, supplies or additional ancillary procedures that may be required for a particular emergency treatment. They also do not include fees for Emergency Department physicians, who will bill separately for their services.

Description

Our Charge
Market Charge

Variance

Emergency Department Visit - Level 1

$121
$160

24% lower than market

Emergency Department Visit - Level 2

$212
$265

20% lower than market

Emergency Department Visit - Level 3

$280
$412

32% lower than market

Emergency Department Visit - Level 4

$480
$607

21% lower than market

Emergency Department Visit - Level 5

$657
$1,143

42% lower than market

Emergency Critical Care, Each Additional 30 Minutes

$345
$434

20% lower than market

Emergency Critical Care, First 30 Minutes

$925
$1,357

32% lower than market

OUTPATIENT PHYSICAL THERAPY CHARGES

The following charges reflect the most common services offered by our Physical Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Application of Electrical Stimulation - 15 Minutes

$28
$76

63% lower than market

Electric Stimulation for Therapy

$43
$99

56% lower than market

Gait Training - 15 Minutes

$51
$91

44% lower than market

PT Evaluation - Moderate Complexity

$145
$242

40% lower than market

PT to Re-Educate Brain to Muscle Function (15 min)

$48
$104

54% lower than market

Physical Therapy 1 or More Regions (15 min)

$57
$93

38% lower than market

Physical Therapy Exercise, 15 Minutes

$54
$93

42% lower than market

Physical Therapy, re-evaluation

$79
$164

52% lower than market

Physical Therapy, standard evaluation - 20 minutes

$145
$211

31% lower than market

OUTPATIENT CLINIC CHARGES

Description

Our Charge
Market Charge

Variance

Established patient office or other outpatient visit, typically 10 minutes

$45
$54

17% lower than market

Established patient office visit, complex

$70
$67

4% higher than market

Hospital Outpatient Clinic Visit for Assessment and Management of a Patient

$114
$140

19% lower than market

New patient office or other outpatient visit, typically 45 min

$523
$221

137% higher than market

OUTPATIENT OCCUPATIONAL THERAPY CHARGES

The following charges reflect the most common services offered by our Occupational Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Occupational Therapy Evaluation - Moderate Complexity

$145
$243

40% lower than market

Occupational Therapy, standard evaluation - 30 minutes

$145
$236

38% lower than market

Self Care - Home Management Training - 15 Minutes

$50
$100

50% lower than market

Therapeutic Activities Involving Functional Activities (15 min)

$50
$104

52% lower than market

OUTPATIENT PULMONARY THERAPY CHARGES

The following charges reflect the most common services offered by our Pulmonary Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

Pulmonary rehabilitation, including exercise (includes monitoring), one hour, per session, up to two sessions per day

$142
$131

9% higher than market

OUTPATIENT SPEECH THERAPY CHARGES

Description

Our Charge
Market Charge

Variance

Evaluation of Speech Sound Production and Language Comprehenson

$277
$369

25% lower than market

Speech Therapy

$87
$221

61% lower than market

Swallow Evaluation

$108
$293

63% lower than market

Swallow Treatment

$112
$224

50% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY CHARGES

The following charges reflect our most common laboratory procedures. For all lab specimens collected via blood draw, the venipuncture will be charged separately.

Description

Our Charge
Market Charge

Variance

Acute hepatitis panel

$115
$399

71% lower than market

Ammonia level

$58
$154

62% lower than market

Amylase (enzyme) level

$67
$75

10% lower than market

Analysis for Gastrointestinal Bacteria

$83
$138

40% lower than market

Analysis of Substance Using Immunoassay Technique

$117
$137

15% lower than market

Arterial Blood Gases Measurement

$90
$198

55% lower than market

Bacterial Culture, Any Source Except Urine, Blood, or Stool

$50
$88

43% lower than market

Bacterial urine culture; quantitative colony count

$57
$91

38% lower than market

Bilirubin level (Direct)

$13
$48

73% lower than market

Blood Typing, ABO

$57
$85

33% lower than market

Blood Unit Compatibility Test; Antiglobulin Technique

$181
$204

11% lower than market

Blood creatinine level

$15
$55

73% lower than market

Blood potassium level

$14
$52

73% lower than market

Blood test, basic group of blood chemicals

$56
$110

49% lower than market

Blood test, clotting time

$40
$49

18% lower than market

Blood test, comprehensive group of blood chemicals

$83
$166

50% lower than market

Blood test, lipids (cholesterol and triglycerides)

$70
$149

53% lower than market

Blood test, thyroid stimulating hormone (TSH)

$108
$152

29% lower than market

Coagulation Function Measurement; D-dimer; quantitative

$81
$142

43% lower than market

Complete blood cell count - automated differential WBC count

$38
$70

46% lower than market

Complete blood cell count - automated test with out Differential

$38
$60

37% lower than market

Cortisol Measurement

$100
$162

38% lower than market

Creatine kinase Level (cardiac enzyme) - Total

$50
$70

28% lower than market

Creatine kinase level (cardiac enzyme) - Muscle/Brain

$67
$131

49% lower than market

Creatinine level to test for kidney function or muscle injury

$32
$63

49% lower than market

Cyanocobalamin (vitamin B-12) level

$46
$147

69% lower than market

Digoxin level

$94
$137

31% lower than market

Drug Test(s) by Chemistry Analyzer

$256
$237

8% higher than market

Drug test(s) presumptive, any number of drug classes, includes sample validation when performed

$42
$127

67% lower than market

Ferritin (blood protein) level

$44
$124

64% lower than market

Folic acid; serum

$43
$136

68% lower than market

Gammaglobulin Measurement

$72
$153

53% lower than market

Glutamyltransferase (liver enzyme) level

$27
$65

58% lower than market

Hemoglobin A1C level

$41
$96

57% lower than market

Hemoglobin Measurement

$29
$34

15% lower than market

Immunoassay for analyte other than infectious agent antibody or infectious agent antigen; quantitative, by radioimmunoassay (eg, RIA)

$134
$260

48% lower than market

Ionized Calcium

$42
$152

72% lower than market

Iron Binding Capacity

$83
$93

10% lower than market

Iron level

$70
$68

4% higher than market

Kidney Function Blood Test Panel

$44
$139

68% lower than market

LDL cholesterol level

$36
$106

66% lower than market

Lactic acid level

$58
$108

46% lower than market

Lipase (fat enzyme) level

$37
$82

55% lower than market

Liver enzyme (SGOT), level

$18
$55

67% lower than market

Liver enzyme (SGPT), level

$17
$54

69% lower than market

Liver function blood test panel

$77
$110

30% lower than market

Magnesium Level

$19
$74

74% lower than market

Measurement C-reactive protein

$58
$65

10% lower than market

Measurement of Antibody for Assessment of Autoimmune Disorder

$85
$163

48% lower than market

Microscopic Examination of White Blood Cells with Manual Count

$10
$37

73% lower than market

PSA (prostate specific antigen) measurement

$67
$172

61% lower than market

PSA Measurement; Free

$95
$163

42% lower than market

Parathormone

$150
$335

55% lower than market

Coagulation assessment blood test

$51
$65

21% lower than market

Phenytoin level

$117
$123

5% lower than market

Phosphate level

$15
$52

71% lower than market

Prostate Cancer Screening Test

$67
$176

62% lower than market

Protein Measurement, Serum

$83
$115

28% lower than market

Red Blood Cell Concentration Measurement

$16
$27

42% lower than market

Red blood cell sedimentation rate, to detect inflammation; non-automated

$40
$44

10% lower than market

Screening Test for Autoimmune Disorder

$43
$114

62% lower than market

Screening test for compatible blood unit

$26
$102

75% lower than market

Smear for infectious agents

$34
$40

16% lower than market

Stool culture - salmonella and shigella species

$43
$118

63% lower than market

Stool analysis for blood

$28
$89

69% lower than market

Strep Test

$41
$88

53% lower than market

Streptoccus

$34
$79

57% lower than market

Tacrolimus Level

$200
$226

12% lower than market

Testosterone (hormone) level

$96
$194

50% lower than market

Testosterone Level; Free

$240
$267

10% lower than market

Thyroxine (thyroid chemical) measurement - Free Thyroxine

$81
$104

22% lower than market

Total Protein Level, Urine

$21
$46

54% lower than market

Troponin (protein) analysis

$75
$128

41% lower than market

Urea nitrogen level to assess kidney function

$13
$44

71% lower than market

Uric acid level, blood

$15
$53

71% lower than market

Urinalysis with Examination, using Microscope

$40
$49

18% lower than market

Urinalysis, Automated Test

$16
$25

36% lower than market

Urine sodium level

$15
$51

71% lower than market

Vitamin D-3 Level

$111
$280

60% lower than market

OUTPATIENT MEDICINE CHARGES

Description

Our Charge
Market Charge

Variance

Debridement, open wound; first 20 cm2 or less

$380
$369

3% higher than market

Hydration Infusion into a Vein

$18
$84

79% lower than market

Infusion (Additional) for Therapy, Diagnosis or Prevention

$44
$164

73% lower than market

Infusion of Drug or Substance into Vein for Therapy or Diagnosis

$234
$300

22% lower than market

Injection Beneath the Skin for Therapy, Diagnosis, or Prevention

$75
$84

11% lower than market

Injection of Same Drug into Vein for Therapy or Diagnosis

$25
$120

79% lower than market

Physician services for outpatient heart rehabilitation with continuous EKG monitoring per session

$163
$193

15% lower than market

Pulmonary stress testing, including measurement of heart rate, oximetry and oxygen titration

$135
$237

43% lower than market

Routine electrocardiogram (EKG) using at least 12 leads with interpretation and report

$42
$39

7% higher than market

Therapeutic massage to 1 or more areas, each 15 minutes

$56
$96

42% lower than market

OUTPATIENT OBSERVATION CHARGES

Description

Our Charge
Market Charge

Variance

Hospital Observation per Hour

$50
$53

5% lower than market

Hospital observation care discharge

$190
$161

18% higher than market

Subsequent observation care, typically 15 minutes per day

$50
$125

60% lower than market

Subsequent observation care, typically 25 minutes per day

$69
$179

61% lower than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION CHARGES

Description

Our Charge
Market Charge

Variance

Injection of Drug or Substance into Vein for Therapy or Diagnosis

$234
$236

1% lower than market

Injection of New Drug into Vein for Therapy or Diagnosis

$48
$108

55% lower than market

Injection, lidocaine hcl for intravenous infusion, 10 mg

$7
$10

33% lower than market

OUTPATIENT RESPIRATORY THERAPY CHARGES

The following charges reflect the most common services offered by our Respiratory Therapy department. Patients may have additional charges, depending on the services performed.

Description

Our Charge
Market Charge

Variance

CO Diffusion Capacity

$94
$176

46% lower than market

OUTPATIENT SURGICAL SERVICES CHARGES

Description

Our Charge
Market Charge

Variance

Application of vein wound compression system lower leg below knee including ankle and foot

$135
$261

48% lower than market

Aspiration and/or injection: large joint/bursa

$164
$378

57% lower than market

Collection of capillary blood specimen

$10
$37

73% lower than market

Drainage of Abscess

$181
$261

31% lower than market

Incision and removal of foreign body, subcutaneous tissues; simple

$187
$906

79% lower than market

Insertion of Indwelling Bladder Catheter

$134
$183

27% lower than market

Insertion of Needle into Vein to Collect Blood

$10
$19

48% lower than market

Removal of skin and tissue first 20 sq cm or less

$699
$792

12% lower than market

Repair of Wound (2.6 to 7.5 centimeters)

$265
$373

29% lower than market

Simple wound repair of face, including ears; 2.5 cm or less

$298
$296

1% higher than market

Simple wound repair of scalp, neck, external genitalia; 2.5 cm or less

$245
$294

17% lower than market

Strapping, Unna boot

$339
$287

18% higher than market

OUTPATIENT X-RAY AND RADIOLOGICAL CHARGES

The following charges reflect our most common x-ray and radiological procedures. For all exams requiring contrast, the contrast will be charged separately.

Description

Our Charge
Market Charge

Variance

Bone Density Scan (DEXA Scan)

$141
$431

67% lower than market

Breast Ultrasound - Complete

$245
$357

31% lower than market

CT Abdomen & Pelvis with Contrast

$753
$2,378

68% lower than market

CT Abdomen & Pelvis with and without Contrast

$866
$2,866

70% lower than market

CT Abdomen & Pelvis without Contrast

$389
$1,856

79% lower than market

CT Abdomen with Contrast

$572
$1,525

62% lower than market

CT Abdomen with and without Contrast

$658
$1,825

64% lower than market

CT Angiogram Neck with and without Contrast

$702
$2,111

67% lower than market

CT Arm without Contrast

$443
$1,066

58% lower than market

CT Chest with Contrast

$572
$1,642

65% lower than market

CT Chest with and without Contrast

$705
$1,844

62% lower than market

CT Chest without Contrast

$443
$1,218

64% lower than market

CT Face without Contrast

$330
$1,025

68% lower than market

CT Head Brain with and without Contrast

$438
$1,837

76% lower than market

CT Head Brain without Contrast

$251
$1,093

77% lower than market

CT Leg without Contrast

$444
$1,125

61% lower than market

CT Neck with Contrast

$568
$1,548

63% lower than market

CT Pelvis without Contrast

$313
$1,200

74% lower than market

CT Spine Cervical without Contrast

$449
$1,181

62% lower than market

CT Spine Lumbar without Contrast

$444
$1,273

65% lower than market

CT Spine Thoracic without Contrast

$447
$1,253

64% lower than market

Chest X-Ray; 2 Views

$151
$230

34% lower than market

Chest X-Ray; Single View

$123
$178

31% lower than market

Diagnostic mammography, bilateral

$413
$425

3% lower than market

Diagnostic mammography, unilateral

$154
$332

54% lower than market

Imaging of Abdomen and Chest

$141
$375

62% lower than market

Imaging of Abdomen; 2 Views

$141
$295

52% lower than market

Imaging of Abdomen; Single View

$78
$184

58% lower than market

Physical Therapy, ultrasound therapy - 15 minutes

$60
$69

13% lower than market

Screening Mammography, Bilateral, with CAD

$341
$373

9% lower than market

Ultrasound Abdomen - Complete

$284
$585

51% lower than market

Ultrasound Abdomen - Limited

$215
$461

53% lower than market

Ultrasound Behind Abdominal Cavity - Limited

$141
$521

73% lower than market

Ultrasound Blood Flow Outside the Brain

$559
$782

28% lower than market

Ultrasound Head Neck

$306
$480

36% lower than market

Ultrasound Heart

$621
$1,240

50% lower than market

Ultrasound Joint Soft Tissue - Complete

$148
$257

42% lower than market

Ultrasound Pelvis NonOB

$262
$497

47% lower than market

Ultrasound Pelvis through Vagina

$303
$520

42% lower than market

Ultrasound Veins of Both Arms or Legs

$559
$644

13% lower than market

Ultrasound Veins of One Arm or Leg

$337
$462

27% lower than market

Ultrasound of pelvis

$141
$408

65% lower than market

X-Ray Ankle, 2 Views

$74
$198

63% lower than market

X-Ray Ankle, 3 Views

$78
$192

59% lower than market

X-Ray Both Hips and Pelvis, 3-4 Views

$141
$279

49% lower than market

X-Ray Both Knees

$93
$285

67% lower than market

X-Ray Collar Bone

$66
$208

68% lower than market

X-Ray Elbow, 3 Views

$77
$193

60% lower than market

X-Ray Femus, 2 Views

$80
$177

55% lower than market

X-Ray Fingers, 2 Views

$85
$156

46% lower than market

X-Ray Foot, 2 Views

$63
$221

72% lower than market

X-Ray Foot, 3 Views

$71
$190

63% lower than market

X-Ray Forearm, 2 Views

$78
$183

57% lower than market

X-Ray Hand, 2 Views

$141
$189

25% lower than market

X-Ray Hand, 3 Views

$76
$194

61% lower than market

X-Ray Heel, 2 Views

$78
$231

66% lower than market

X-Ray Hip and Pelvis, 1 View

$70
$194

64% lower than market

X-Ray Hip and Pelvis, 2 Views

$104
$185

44% lower than market

X-Ray Knee, 1-2 Views

$77
$196

61% lower than market

X-Ray Knee, 3 Views

$91
$226

60% lower than market

X-Ray Knee, 4 or More Views

$141
$235

40% lower than market

X-Ray Lower Leg, 2 Views

$70
$188

63% lower than market

X-Ray Lower Sacral Spine, 2-3 Views

$141
$239

41% lower than market

X-Ray Lower Sacral Spine, 4 or More Views

$156
$358

56% lower than market

X-Ray Neck Soft Tissue

$68
$201

66% lower than market

X-Ray Neck Spine, 2-3 Views

$75
$239

69% lower than market

X-Ray Pelvis, 1-2 Views

$141
$186

24% lower than market

X-Ray Pelvis, 2 Views

$77
$198

61% lower than market

X-Ray Ribs One Side, 2 Views

$75
$213

65% lower than market

X-Ray Shoulder Blade

$151
$239

37% lower than market

X-Ray Shoulder, 2 Views

$68
$203

67% lower than market

X-Ray Upper Arm, 2 Views

$71
$200

65% lower than market

X-Ray Upper Spine, 4-5 Views

$141
$371

62% lower than market

X-Ray Wrist, 2 Views

$71
$178

60% lower than market

X-Ray Wrist, 3 Views

$92
$193

52% lower than market

X-Ray of Both Sides of Ribs, Including Chest, Minimum of 4 Views

$141
$393

64% lower than market

X-Ray of Middle Spine; 3 Views

$141
$242

42% lower than market

X-ray lower and sacral spine including bending views minimum 6 views

$156
$416

63% lower than market

X-ray of bones of face, minimum of 3 views

$141
$319

56% lower than market

X-ray of jaw joints on both sides of the face

$122
$253

52% lower than market

X-ray of mandible, minimum of 4 views

$141
$249

43% lower than market

X-ray of paranasal sinus, less than 3 views

$72
$178

60% lower than market

BILLING PROCESS AND INFORMATION

How You Can Help

Thank you for choosing Minnie Hamilton Health Care Center for your healthcare needs. At Minnie Hamilton Health Care Center, we are committed to making the billing process as patient-friendly as possible. Here are some ways you can help the billing process go smoothly.

• Please give us complete health insurance information.

In addition to your health insurance card, we may ask for a photo ID. If you have been seen at Minnie Hamilton Health Care Center, let us know if your personal information or insurance information has changed since your last visit.

• Please understand and follow the requirements of your health plan.

Be sure to know your benefits, obtain proper authorization for services and submit referral claim forms if necessary. Many insurance plans require patients to pay a co-payment or deductible amount. You are responsible for paying co-payments required by your insurance provider and Minnie Hamilton Health Care Center is responsible for collecting co-payments. Please come to your appointment prepared to make your co-payment.

• Please respond promptly to any requests from your insurance provider.

You may receive multiple bills for your hospital visit, including your family doctor, specialists, physicians to read x-rays, give anesthesia, or do blood work. Insurance benefits are the result of your contract with your insurance company. We are a third-party to those benefits and may need your help with your insurance. If your insurance plan does not pay the bill within 90 days after billing, or your claim is denied, you will receive a statement from Minnie Hamilton Health Care Center indicating the bill is now your responsibility. All bills sent to you are due upon receipt.

Questions about Price and Billing Information

Our goal is for each of our patients and their families to have the best healthcare experience possible. Part of our commitment is to provide you with information that helps you make well informed decisions about your own care.

To ask questions or get more information about a bill for services you've received, please contact our Customer Call Center at (304) 354-9244.

If you need more information about the price of a future service, please contact our Price Hotline at (304) 354-9244. A CPT code is strongly encouraged when you call. You can obtain the CPT code from the ordering physician.

Online Payment, Registration, & Scheduling

For the convenience of our patients, a number of online services are available at https://www.mhhs.healthcare/. Minnie Hamilton Health Care Center offers secure online payment.

Minnie Hamilton Health Care Center also offers pre-registration and appointment requests through a secure online form at https://www.mhhs.healthcare/. Patients may pre-register for surgeries, admissions, outpatient procedures and tests at least three business days in advance. Patients may also pre-register for maternity services up to three months prior to their expected delivery date.

Financial Assistance

We are pleased to offer financial assistance to patients with limited resources and inadequate medical insurance coverage. Eligibility is determined by total family income/assets. The patient must agree to apply for other assistance available to pay hospital charges (Medicaid, Medicare, private insurance) before being discharged.

Minnie Hamilton Health Care Center's Charity Care Policy

Minnie Hamilton Health Care Center provides high quality care to everyone, regardless of their ability to pay.

Minnie Hamilton Health Care Center's charity care policy includes:

• Substantial charity care guidelines that provide free care for individuals and families who earn less than 200 percent of the federal poverty level.

• Sliding scale fees to provide substantially discounted care for individuals and families who are between 200 and 400 percent of the federal poverty level.

• Hardship policy for those patients who would not otherwise qualify for charity care but have unique circumstances.

In many cases, Minnie Hamilton Health Care Center offers interest free loans for up to one year to assist patients.

For more information, please contact our Customer Call Center at (304) 354-9244.