CMS Price Transparency Data

Extended office visit (prolonged)

Facility: Charleston Area Medical Center

Billing Code: G2212 (HCPCS)

Factual Cost Summary (Answer Capsule)

CPT Billing Code: G2212
Insurance Median: $31
Cash Discount Price: $89
vs. Medicare Baseline: 0.91x Medicare

The contracted insurance negotiated median rate for a Extended office visit (prolonged) at Charleston Area Medical Center is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $89. Compared to the federal Medicare reimbursement reference rate of $34.07, this hospital’s rate is 0.91x the Medicare baseline. Located in 501 Morris Street, Charleston, WV.

Cash / Self-Pay

$89

Average discount available for prompt cash payment at this facility.

Insurance Median

$31

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate

$34.07

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $34.07 (100%)

Cash / Self-Pay: $89 (261%)

Insurance Median: $31 (91%)

Cash: $89 (261% of Medicare)

Ins. Median: $31 (91% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $34.07 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Billing Status

Remaining Deductible ($)

Your Coinsurance Rate (%)

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group	Contract Rate Range	vs. Medicare Reference
The Health Plan of West Virginia Inc.	$21 - $36	62%
Aetna	$21 - $25	62%
Triwest VA	$21 - $22	62%
Unicare Health Plan of West Virginia Inc.	$21 - $22	62%
Choicecare Network	$21 - $89	62%
Blue Cross Blue Shield	$21 - $78	62%
West Virginia Senior Advantage Inc.	$22 - $24	65%
UnitedHealthcare	$22 - $89	65%
City of Charleston	$28 - $30	82%
Naphcare	$29 - $31	85%
Integrated Medical Solutions	$31 - $33	91%
Caresource	$32 - $34	94%
Optimum Choice Inc.	$33 - $36	97%
Tricare	$51 - $55	150%
Three Rivers Providers Network	$82 - $88	241%
Multiplan	$83 - $89	244%
Healthsmart	$83 - $89	244%
Cigna	$84 - $90	247%

Self-Pay Upfront Cash Action Plan

Request a "Self-Pay classification" with the billing desk before receiving care.
Ask for a written "Prompt-Pay Discount" agreement quoting the price of $89.
Request and sign a "Waiver of Insurance Submission" to prevent automatic billing.
Verify HCPCS Code matches exactly: G2212.

Insurance In-Network Protection Plan

Contact your insurance company to confirm Charleston Area Medical Center is fully in-network.
Ask your insurer if "Prior Authorization" is required for HCPCS code G2212.
Confirm the specific physician or imaging center is also in-network (not just the hospital building).
Audit your Explanation of Benefits (EOB) against the final itemized hospital invoice.