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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 3/31/2022. 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

$1,100
$1,605

31% lower than market

Semi-Private Room

$1,100
$1,257

12% lower than market

CMS SHOPPABLE SERVICE

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan with contrast for injury, foreign bodies, or tumors [HCPCS 74177]

$866
$2,649

67% lower than market

Abdominal ultrasound (complete) [HCPCS 76700]

$327
$684

52% lower than market

Head or brain CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70450]

$289
$1,265

77% lower than market

Imaging of pelvis by ultrasound through vagina [HCPCS 76830]

$348
$641

46% lower than market

Lab analysis of urine specimen by dipstick with microscope (automated) [HCPCS 81001]

$46
$47

3% lower than market

Lab analysis of urine specimen by dipstick without microscope (automated) [HCPCS 81003]

$18
$29

38% lower than market

Lab analysis to evaluate kidney function via a blood test panel [HCPCS 80069]

$51
$155

67% lower than market

Lab analysis to evaluate the clotting time in plasma specimen and monitor drug effectiveness [HCPCS 85610]

$46
$59

22% lower than market

Lab analysis to identify the thyroid stimulating hormone (tsh) in blood specimen [HCPCS 84443]

$124
$169

27% lower than market

Lab analysis to measure coagulation in plasma or whole blood specimen [HCPCS 85730]

$59
$76

23% lower than market

Lab analysis to measure complete blood cell count (red cells, white blood cell, and platelets), automated test and automated differential white blood cell count [HCPCS 85025]

$44
$72

39% lower than market

Lab analysis to measure the amount of albumin, total and direct bilirubin, alkaline phosphatase, total protein, alanine amino transferase, and asparate amino transferase in blood specimen to evaluate liver function [HCPCS 800

$89
$125

29% lower than market

Lab analysis to measure the amount of free PSA (prostate specific antigen) in serum specimen [HCPCS 84154]

$109
$170

36% lower than market

Lab analysis to measure the amount of lipids (cholesterol and triglycerides) in blood specimen [HCPCS 80061]

$81
$156

48% lower than market

Lab analysis to measure the amount of total calcium, carbon dioxide (bicarbonate), chloride, creatinine, glucose, potassium, sodium, and urea nitrogen (BUN) in blood specimen [HCPCS 80048]

$64
$121

47% lower than market

Lab analysis to measure the amount of total PSA (prostate specific antigen) in serum specimen [HCPCS 84153]

$77
$190

60% lower than market

Lab analysis via blood test to measure a comprehensive group of blood chemicals [HCPCS 80053]

$95
$180

47% lower than market

Mammography of both breasts (screening exam) [HCPCS 77067]

$392
$516

24% lower than market

Mammography of both breasts for diagnosis [HCPCS 77066]

$475
$564

16% lower than market

Mammography of one breast for diagnosis [HCPCS 77065]

$177
$400

56% lower than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 30-44 minutes) [HCPCS 99203]

$273
$208

31% higher than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 45-59 minutes) [HCPCS 99204]

$301
$340

11% lower than market

New patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 60-74 minutes) [HCPCS 99205]

$317
$191

66% higher than market

Physical therapy exercise to develop strength, endurance, range of motion, and flexibility (each 15 minutes) [HCPCS 97110]

$62
$66

7% lower than market

Spinal x-ray of lower and sacral spine (minimum of 4 views) [HCPCS 72110]

$179
$423

58% lower than market

OUTPATIENT CLINIC

Description

Our Charge
Market Charge

Variance

Established patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 10-19 minutes) [HCPCS 99212]

$52
$129

60% lower than market

Established patient office or outpatient visit with physician to diagnose and treat illness or injury (total time 20-29 minutes) [HCPCS 99213]

$242
$136

78% higher than market

OUTPATIENT EMERGENCY DEPARTMENT

Description

Our Charge
Market Charge

Variance

Emergency department visit for problem of high severity [HCPCS 99284]

$552
$849

35% lower than market

Emergency department visit for problem of low to moderate severity [HCPCS 99282]

$193
$313

38% lower than market

Emergency department visit for problem of moderate severity [HCPCS 99283]

$322
$525

39% lower than market

Emergency department visit for problem with significant threat to life [HCPCS 99285]

$756
$1,292

41% lower than market

OUTPATIENT LABORATORY AND PATHOLOGY

Description

Our Charge
Market Charge

Variance

Cov-19 amp prb hgh thruput [HCPCS U0003]

$144
$146

1% lower than market

Drug screening read by chemistry analyzers [HCPCS 80307]

$294
$311

6% lower than market

Drug screening read by direct visual reading [HCPCS 80305]

$48
$354

86% lower than market

Lab analysis by immunoassay to identify Strep (streptococcus) [HCPCS 87880]

$47
$119

60% lower than market

Lab analysis of any culture (except urine, blood, or stool) to identify bacteria [HCPCS 87070]

$64
$111

42% lower than market

Lab analysis of stool culture to identify bacteria [HCPCS 87045]

$49
$116

58% lower than market

Lab analysis of urine culture to measure the amount of bacteria [HCPCS 87086]

$66
$91

28% lower than market

Lab analysis of wet mount to identify bacteria, fungi, or parasites [HCPCS 87210]

$39
$52

25% lower than market

Lab analysis to evaluate an antimicrobial drug (antibiotic, antifungal, antiviral) by microdilution or agar dilution (each multi-antimicrobial, per plate) [HCPCS 87186]

$39
$91

57% lower than market

Lab analysis to identify antibodies for autoimmune disorder assessment (any method) [HCPCS 86235]

$81
$61

33% higher than market

Lab analysis to identify antibodies to Helicobacter pylori (gastrointestinal bacteria) [HCPCS 86677]

$95
$157

39% lower than market

Lab analysis to identify substances by immunoassay technique (multiple step method) [HCPCS 83516]

$137
$87

58% higher than market

Lab analysis to identify white blood cells (manual) with microscope [HCPCS 85007]

$12
$42

71% lower than market

Lab analysis to measure blood count (hemoglobin) [HCPCS 85018]

$33
$35

5% lower than market

Lab analysis to measure coagulation function measurement of D-dimer (quantitative) [HCPCS 85379]

$93
$163

43% lower than market

Lab analysis to measure free testosterone (hormone) level in serum specimen [HCPCS 84402]

$276
$251

10% higher than market

Lab analysis to measure free thyroxine (thyroid chemical) in serum specimen [HCPCS 84439]

$93
$113

17% lower than market

Lab analysis to measure red blood cell concentration [HCPCS 85014]

$18
$26

31% lower than market

Lab analysis to measure red blood cell sedimentation rate to detect inflammation (non-automated) [HCPCS 85651]

$46
$45

2% higher than market

Lab analysis to measure the ammonia level [HCPCS 82140]

$67
$175

62% lower than market

Lab analysis to measure the amount of blood gases [HCPCS 82803]

$104
$219

53% lower than market

Lab analysis to measure the amount of blood in stool specimen by fecal hemoglobin determination and immunoassay [HCPCS 82274]

$32
$84

62% lower than market

Lab analysis to measure the amount of C-reactive protein in serum to identify infection or inflammation [HCPCS 86140]

$67
$66

2% higher than market

Lab analysis to measure the amount of gammaglobulin (immune system protein) [HCPCS 82784]

$83
$78

7% higher than market

Lab analysis to measure the amount of hepatitis A antibody, hepatitis B core antibody, hepatitis B surface antigen, and hepatitis C antibody in blood specimen to evaluate acute hepatitis [HCPCS 80074]

$132
$460

71% lower than market

Lab analysis to measure the amount of protein in serum specimen [HCPCS 84165]

$95
$119

20% lower than market

Lab analysis to measure the amount of substance by radioimmunoassay [HCPCS 83519]

$154
$167

8% lower than market

Lab analysis to measure the amount of tacrolimus in blood specimen [HCPCS 80197]

$230
$203

13% higher than market

Lab analysis to measure the amount of total cortisol (hormone) [HCPCS 82533]

$115
$174

34% lower than market

Lab analysis to measure the amount of total digoxin in blood specimen [HCPCS 80162]

$108
$155

30% lower than market

Lab analysis to measure the amount of total phenytoin in blood specimen [HCPCS 80185]

$135
$144

6% lower than market

Lab analysis to measure the amount of troponin (protein) in serum specimen [HCPCS 84484]

$86
$153

44% lower than market

Lab analysis to measure the amylase (enzyme) level in serum specimen [HCPCS 82150]

$77
$78

1% lower than market

Lab analysis to measure the blood potassium level in blood specimen [HCPCS 84132]

$16
$60

73% lower than market

Lab analysis to measure the creatine kinase (cardiac enzyme) level (MB fraction only) [HCPCS 82553]

$77
$116

33% lower than market

Lab analysis to measure the creatinine level in blood specimen to test for kidney function or muscle injury [HCPCS 82565]

$17
$64

74% lower than market

Lab analysis to measure the creatinine level to test for kidney function or muscle injury (other than blood specimen) [HCPCS 82570]

$37
$63

41% lower than market

Lab analysis to measure the cyanocobalamin (vitamin b-12) level [HCPCS 82607]

$53
$160

67% lower than market

Lab analysis to measure the direct bilirubin level [HCPCS 82248]

$15
$54

72% lower than market

Lab analysis to measure the ferritin (blood protein) level [HCPCS 82728]

$51
$136

62% lower than market

Lab analysis to measure the folic acid level in serum specimen [HCPCS 82746]

$49
$153

68% lower than market

Lab analysis to measure the glutamyltransferase (liver enzyme) level [HCPCS 82977]

$31
$76

59% lower than market

Lab analysis to measure the hemoglobin A1C level in blood specimen [HCPCS 83036]

$47
$101

53% lower than market

Lab analysis to measure the ionized calcium level in blood specimen [HCPCS 82330]

$48
$162

70% lower than market

Lab analysis to measure the iron binding capacity [HCPCS 83550]

$95
$100

5% lower than market

Lab analysis to measure the iron level [HCPCS 83540]

$81
$82

1% lower than market

Lab analysis to measure the lactic acid level in blood, plasma, or cerbrospinal fluid specimen [HCPCS 83605]

$67
$129

48% lower than market

Lab analysis to measure the LDL cholesterol level [HCPCS 83721]

$41
$96

57% lower than market

Lab analysis to measure the lipase (fat enzyme) level [HCPCS 83690]

$43
$93

54% lower than market

Lab analysis to measure the liver enzyme (sgot), level in serum or plasma specimen [HCPCS 84450]

$21
$66

68% lower than market

Lab analysis to measure the liver enzyme (sgpt), level in serum or plasma specimen [HCPCS 84460]

$20
$60

67% lower than market

Lab analysis to measure the magnesium level in body fluids and cells [HCPCS 83735]

$22
$90

76% lower than market

Lab analysis to measure the parathormone (parathyroid hormone) level [HCPCS 83970]

$173
$374

54% lower than market

Lab analysis to measure the phosphate level [HCPCS 84100]

$17
$57

70% lower than market

Lab analysis to measure the sodium level in urine specimen [HCPCS 84300]

$31
$56

45% lower than market

Lab analysis to measure the total creatine kinase (cardiac enzyme) level in blood specimen [HCPCS 82550]

$58
$84

31% lower than market

Lab analysis to measure the total protein level in urine specimen [HCPCS 84156]

$24
$53

55% lower than market

Lab analysis to measure the uric acid level in blood specimen [HCPCS 84550]

$17
$60

72% lower than market

Lab analysis to measure the vitamin D-3 level in serum or plasma specimen [HCPCS 82306]

$128
$276

54% lower than market

Lab analysis to measure total testosterone (hormone) level in serum specimen [HCPCS 84403]

$110
$183

40% lower than market

Lab analysis to measure urea nitrogen level in serum or plasma specimen to assess kidney function (quantitative) [HCPCS 84520]

$15
$51

70% lower than market

Lab analysis to screen for autoimmune disorders [HCPCS 86038]

$49
$122

60% lower than market

Lab blood analysis to confirm blood unit compatibility by antiglobulin technique [HCPCS 86922]

$208
$118

76% higher than market

Lab blood analysis to identify antigens on red blood cell surface and determine the patient's blood group type (ABO) [HCPCS 86900]

$66
$94

30% lower than market

Lab blood analysis to screen for compatible blood before transfusion with reagent serum (each antigen test) [HCPCS 86902]

$30
$58

48% lower than market

Psa screening [HCPCS G0103]

$77
$178

57% lower than market

OUTPATIENT MEDICINE

Description

Our Charge
Market Charge

Variance

Drug administration beneath the skin or into muscle by injection for therapy, diagnosis, or prevention [HCPCS 96372]

$86
$100

14% lower than market

Drug administration into vein by infusion for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96365]

$269
$360

25% lower than market

Drug administration into vein by infusion of additional sequential infusion of new drug for therapy, prevention, or diagnosis (up to 1 hour) [HCPCS 96367]

$56
$168

67% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of same drug) [HCPCS 96376]

$29
$140

79% lower than market

Exercise-induced lung stress test [HCPCS 94618]

$155
$296

48% lower than market

Hydration administration into vein by infusion (each additional hour) [HCPCS 96361]

$2
$96

98% lower than market

Physician services for outpatient heart rehab with continuous EKG monitoring (per session) [HCPCS 93798]

$187
$257

27% lower than market

Therapeutic massage to 1 or more areas (each 15 minutes) [HCPCS 97124]

$64
$20

220% higher than market

Tissue removal from wounds per session (first 20 sq cm or less) [HCPCS 97597]

$243
$402

40% lower than market

OUTPATIENT OBSERVATION

Description

Our Charge
Market Charge

Variance

Hospital observation per hr [HCPCS G0378]

$4
$4

10% higher than market

OUTPATIENT PHARMACY AND DRUG ADMINISTRATION

Description

Our Charge
Market Charge

Variance

Drug administration into vein by push technique for therapy, diagnosis, or prevention (each additional push of new drug) [HCPCS 96375]

$55
$126

56% lower than market

Drug administration into vein by push technique for therapy, diagnosis, or prevention (initial drug) [HCPCS 96374]

$269
$284

5% lower than market

Lidocaine injection [HCPCS J2001]

$3
$9

66% lower than market

OUTPATIENT PHYSICAL/OCCUPATIONAL/SPEECH THERAPY

Description

Our Charge
Market Charge

Variance

Elec stim other than wound [HCPCS G0283]

$49
$99

50% lower than market

Electrical stimulation application to 1 or more areas (each 15 minutes) [HCPCS 97032]

$32
$66

52% lower than market

Function improvement activities with one-on-one contact between patient and provider (each 15 minutes) [HCPCS 97530]

$58
$83

30% lower than market

Occupational therapy evaluation (typically 30 minutes) [HCPCS 97165]

$167
$239

30% lower than market

Occupational therapy evaluation (typically 45 minutes) [HCPCS 97166]

$167
$255

35% lower than market

Physcial therapy exercise of walking training to 1 or more areas (each 15 minutes) [HCPCS 97116]

$59
$95

38% lower than market

Physical therapy evaluation (typically 20 minutes) [HCPCS 97161]

$167
$252

34% lower than market

Physical therapy evaluation (typically 30 minutes) [HCPCS 97162]

$167
$275

39% lower than market

Physical therapy procedure to re-educate brain-to-nerve-to-muscle function (each 15 minutes) [HCPCS 97112]

$33
$98

66% lower than market

Physical therapy re-evaluation (typically 20 minutes) [HCPCS 97164]

$91
$164

45% lower than market

Physical therapy techniques to 1 or more regions (each 15 minutes) [HCPCS 97140]

$66
$92

28% lower than market

Speech sound production evaluation with evaluation of language comprehension and expression [HCPCS 92523]

$319
$424

25% lower than market

Speech, language, voice, communication, and/or hearing processing disorder treatment [HCPCS 92507]

$100
$253

61% lower than market

Swallowing and/or oral feeding function treatment [HCPCS 92526]

$129
$323

60% lower than market

Swallowing function evaluation [HCPCS 92610]

$124
$352

65% lower than market

Training activities for home and self-care management (each 15 minutes) [HCPCS 97535]

$58
$106

45% lower than market

OUTPATIENT PULMONARY THERAPY

Description

Our Charge
Market Charge

Variance

Pulmonary rehab w exer [HCPCS G0424]

$163
$173

6% lower than market

OUTPATIENT RESPIRATORY THERAPY

Description

Our Charge
Market Charge

Variance

Lung diffusing capacity measurement [HCPCS 94729]

$108
$220

51% lower than market

OUTPATIENT SURGICAL SERVICES

Description

Our Charge
Market Charge

Variance

Blood sample collection by skin puncture [HCPCS 36416]

$59
$227

74% lower than market

Large joint or joint capsule fluid removal and/or injection with needle [HCPCS 20610]

$365
$1,319

72% lower than market

Needle insertion into vein for collection of blood sample [HCPCS 36415]

$12
$20

39% lower than market

Skin and tissue removal (first 20 sq cm or less) [HCPCS 11042]

$1,356
$1,740

22% lower than market

Strapping application of unna boot [HCPCS 29580]

$426
$1,063

60% lower than market

Vein wound compression system application to lower leg below knee including ankle and foot [HCPCS 29581]

$291
$1,070

73% lower than market

OUTPATIENT X-RAY AND RADIOLOGICAL

Description

Our Charge
Market Charge

Variance

Abdominal and pelvic CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 74176]

$447
$2,158

79% lower than market

Abdominal and pelvic CT scan without contrast, followed by contrast for injury, foreign bodies, or tumors [HCPCS 74178]

$996
$3,280

70% lower than market

Abdominal ultrasound (limited) [HCPCS 76705]

$247
$540

54% lower than market

Abdominal x-ray (2 views) [HCPCS 74019]

$162
$340

52% lower than market

Abdominal x-ray (single view) [HCPCS 74018]

$90
$222

59% lower than market

Abdominal x-ray, complete study including 2 or more views of abdomen and single view of chest [HCPCS 74022]

$162
$451

64% lower than market

Ankle x-ray (2 views) [HCPCS 73600]

$85
$207

59% lower than market

Ankle x-ray (minimum of 3 views) [HCPCS 73610]

$90
$233

61% lower than market

Arm or leg ultrasound (complete) [HCPCS 76881]

$170
$297

43% lower than market

Arm x-ray of forearm (2 views) [HCPCS 73090]

$90
$221

59% lower than market

Arm x-ray of upper arm (minimum of 2 views) [HCPCS 73060]

$82
$244

66% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (complete, both arms or legs) [HCPCS 93970]

$643
$671

4% lower than market

Arms or legs veins ultrasound with assessment of compression and functional maneuvers (limited, one arm or leg) [HCPCS 93971]

$388
$512

24% lower than market

Blood flow (outside of the brain) ultrasound on both sides of head and neck [HCPCS 93880]

$643
$815

21% lower than market

Bone density measurement of the axial skeleton (hips, pelvis, spine) [HCPCS 77080]

$162
$529

69% lower than market

Breast ultrasound (one breast, complete) [HCPCS 76641]

$282
$363

22% lower than market

Chest CT scan with contrast to examine injury, foreign bodies, or tumors [HCPCS 71260]

$658
$1,895

65% lower than market

Chest CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 71250]

$509
$1,387

63% lower than market

Chest x-ray (2 views) [HCPCS 71046]

$174
$273

36% lower than market

Chest x-ray (single view) [HCPCS 71045]

$141
$208

32% lower than market

Collar bone x-ray, complete study [HCPCS 73000]

$76
$231

67% lower than market

CTA scan of neck blood vessels with contrast to examine blood clots or aneurysms [HCPCS 70498]

$807
$2,040

60% lower than market

Elbow x-ray, complete study (minimum of 3 views) [HCPCS 73080]

$89
$233

62% lower than market

Facial CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 70486]

$380
$1,172

68% lower than market

Finger(s) x-ray (minimum of 2 views) [HCPCS 73140]

$98
$187

48% lower than market

Foot x-ray (2 views) [HCPCS 73620]

$72
$215

66% lower than market

Foot x-ray at heel of foot (minimum of 2 views) [HCPCS 73650]

$90
$242

63% lower than market

Foot x-ray, complete study (minimum of 3 views) [HCPCS 73630]

$82
$230

64% lower than market

Hand x-ray (2 views) [HCPCS 73120]

$162
$241

33% lower than market

Hand x-ray (minimum of 2 views) [HCPCS 73130]

$87
$236

63% lower than market

Head and neck ultrasound [HCPCS 76536]

$352
$593

41% lower than market

Head or brain CT scan without contrast, followed by contrast to examine injury, foreign bodies, or tumors [HCPCS 70470]

$504
$2,029

75% lower than market

Heart ultrasound including color-depicted blood flow rate, direction, and valve function [HCPCS 93306]

$714
$1,664

57% lower than market

Hip x-ray of both hips with pelvis (3 to 4 views) [HCPCS 73522]

$162
$321

50% lower than market

Hip x-ray of hip with pelvis (2 to 3 views) [HCPCS 73502]

$120
$218

45% lower than market

Jaw joint x-ray in two presentations, open and closed (both sides of mouth) [HCPCS 70330]

$140
$334

58% lower than market

Knee x-ray (1 or 2 views) [HCPCS 73560]

$89
$221

60% lower than market

Knee x-ray (4 or more views) [HCPCS 73564]

$162
$275

41% lower than market

Knee x-ray of both knees, standing (front to back view) [HCPCS 73565]

$107
$277

61% lower than market

Leg CT scan without contrast for injury, foreign bodies, or tumors [HCPCS 73700]

$511
$1,252

59% lower than market

Lower leg x-ray (2 views) [HCPCS 73590]

$81
$227

64% lower than market

Neck CT scan of the soft tissue of the neck with contrast to examine injury, foreign bodies, or tumors [HCPCS 70491]

$653
$1,862

65% lower than market

Neck x-ray to examine soft tissue for any obstructions and/or foreign bodies within the throat or neck [HCPCS 70360]

$78
$215

64% lower than market

Pelvis CT scan without contrast to examine injury, foreign bodies, or tumors [HCPCS 72192]

$360
$1,358

73% lower than market

Pelvis ultrasound, not pregrnancy related (complete) [HCPCS 76856]

$301
$554

46% lower than market

Pelvis x-ray (1 or 2 views) [HCPCS 72170]

$162
$224

28% lower than market

Rib cage x-ray of ribs on both sides of body including chest (minimum of 4 views) [HCPCS 71111]

$162
$406

60% lower than market

Rib cage x-ray of ribs on one side of body (2 views) [HCPCS 71100]

$86
$268

68% lower than market

Shoulder blade x-ray complete study [HCPCS 73010]

$174
$254

31% lower than market

Shoulder x-ray, complete study (minimum of 2 views) [HCPCS 73030]

$78
$242

68% lower than market

Spinal CT scan of lower spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72131]

$511
$1,406

64% lower than market

Spinal CT scan of middle spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72128]

$514
$1,413

64% lower than market

Spinal CT scan of upper spine without contrast to examine injury, foreign bodies, or tumors [HCPCS 72125]

$516
$1,207

57% lower than market

Spinal x-ray of lower and sacral spine (2 or 3 views) [HCPCS 72100]

$162
$291

44% lower than market

Spinal x-ray of middle spine (3 views) [HCPCS 72072]

$162
$294

45% lower than market

Spinal x-ray of upper spine (2 or 3 views) [HCPCS 72040]

$86
$266

68% lower than market

Spinal x-ray of upper spine (4 or 5 views) [HCPCS 72050]

$162
$449

64% lower than market

Thighbone x-ray (minimum of 2 views) [HCPCS 73552]

$92
$210

56% lower than market

Ultrasound application to 1 or more areas (each 15 minutes) [HCPCS 97035]

$69
$82

15% lower than market

Ultrasound of area behind abdominal cavity (limited) [HCPCS 76775]

$162
$637

75% lower than market

Wrist x-ray (2 views) [HCPCS 73100]

$82
$237

65% lower than market

Wrist x-ray, complete study (minimum of 3 views) [HCPCS 73110]

$106
$228

53% lower than market

X-ray of paranasal sinuses including side to side and back to front views (less than 3 views) [HCPCS 70210]

$83
$245

66% lower than market

X-ray of sacrum and tailbone (minimum of 2 views) [HCPCS 72220]

$89
$246

64% 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.