How many shoppable procedure prices are published for Berkeley Medical Center?

Berkeley Medical Center in Martinsburg, WV currently has 123 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Berkeley Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Berkeley Medical Center's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Berkeley Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Berkeley Medical Center an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 161 Beds · urban Updated: 7/9/2026

Berkeley Medical Center

2500 Hospital Drive, Martinsburg, WV 25401 · 123 Priced Procedures · 54% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.87×vs. Fair Market Price

Typical commercial prices here are 13% below the fair benchmark (0.87×) after accounting for local nurse/doctor wages and patient complexity.

88/100 · Verified

88/100Self-Pay Cash Beats Insurance 12% of the Time

File Completeness90

Price Logic97

Peer Alignment63

Clean Billing86

Real Cash Discount100

Regional Benchmark Tier

2-Star CMS clinical quality rating paired with 0.87× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Berkeley Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.9× Medicare, p50 0.87× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 1.01× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#9 of 28 in WV · 28th State Percentile#520 of 3,385 in U.S. · 15th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 13% below peer Fair BaseRate (0.87×)
Self-pay cash beats commercial insurance on 12% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (60/100 safety score) with 54% patient recommendation
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (17.3% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 2.1× markup over Medicare rates
Captive ER (4.1×) & laboratory (1.2×) services average 1.11× higher multiples than routine shoppable care (0.9×)
Upper-quartile procedures (Q75 1.01×) jump +16% above the median procedure ratio (Q50 0.87×)
Consolidated metro market (HHI 4,728) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.9× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.11× Divergence

1.0× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+16% Upper Tail

Q25 0.62× · Q50 0.87× · Q75 1.01×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.9× MedicareGood

Outpatient Surgery & ORBack-Door Captive

2.1× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.5× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

4.1× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

1.2× MedicareGood

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

0.6× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

12% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 60/100Elevated

Procedure Prices at Berkeley Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 123 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$21,078	$30,775	0.7×
Total hip replacement CPT Code: `27130`	$15,405	$18,534	$13,413	1.4×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$15,641	$17,936	0.9×
Total knee replacement CPT Code: `27447`	$14,350	$12,974	$13,523	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$11,374	$19,087	0.6×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$11,225	$19,432	0.6×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$30,947	$6,109	$6,109	1.0×
Inguinal hernia repair CPT Code: `49505`	$19,286	$6,083	$3,629	unverified
Bunion correction surgery CPT Code: `28296`	$7,355	$4,724	$3,446	1.4×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$4,746	$8,223	0.6×
Breast lump removal CPT Code: `19120`	$4,308	$3,957	$3,875	1.0×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$2,338	$2,338	$3,372	0.7×
Trauma team activation HCPCS Code: `G0390`	$1,488	$1,934	$1,453	1.3×
Colonoscopy (diagnostic) CPT Code: `45378`	$801	$940	$981	1.0×
Colonoscopy with biopsy CPT Code: `45380`	$912	$864	$1,256	0.7×
Injection procedure for pain management HCPCS Code: `G0260`	$1,300	$654	$855	0.8×
Upper endoscopy with biopsy CPT Code: `43239`	$631	$655	$987	0.7×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,474	$552	$583	0.9×
Rabies immune globulin HCPCS Code: `90375`	$3,854	$422	$322	1.3×
Blood transfusion CPT Code: `36430`	$720	$446	$498	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	$2,544	$434	$1,021	0.4×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,077	$353	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$1,899	$353	$511	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$1,720	$344	$369	unverified
Neurobehavioral status check CPT Code: `96116`	$249	$218	$231	0.9×
MRI, lower back (no contrast) CPT Code: `72148`	$1,161	$241	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$1,215	$241	$343	0.7×
Psychological testing by technician CPT Code: `96138`	$449	$237	$395	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$1,503	$241	$303	unverified
Hepatitis B immune globulin HCPCS Code: `90371`	$374	$205	$151	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$224	$224	$86	unverified
Family therapy session CPT Code: `90847`	$186	$179	$173	1.0×
Breathing treatment (nebulizer) CPT Code: `94640`	$184	$184	$201	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$1,082	$177	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,260	$177	$258	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$598	$138	$272	0.5×
Group therapy session CPT Code: `90853`	$116	$103	$100	1.0×
CT scan, head (no contrast) CPT Code: `70450`	$817	$106	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$790	$106	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$782	$106	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$790	$106	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$790	$106	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$815	$106	$169	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$142	$103	$166	0.6×
Psychiatric evaluation (first visit) CPT Code: `90791`	$84	$114	$185	0.6×
Psychotherapy session (60 minutes) CPT Code: `90837`	$84	$108	$181	0.6×
X-ray, chest (single view) CPT Code: `71045`	$165	$88	$92	unverified
Typhoid vaccine HCPCS Code: `90675`	$353	$498	$347	1.4×
Pneumococcal vaccine HCPCS Code: `90732`	$105	$209	$140	1.5×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$179	$178	$203	0.9×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$84	$161	$111	unverified
Drug screening test HCPCS Code: `G0480`	$68	$120	$116	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$39	$68	$49	1.4×
Flu vaccine injection HCPCS Code: `G0008`	$32	$58	$48	1.2×
Pneumonia vaccine injection HCPCS Code: `G0009`	$48	$58	$49	1.2×
Speech therapy (language evaluation) CPT Code: `92507`	$167	$76	$86	0.9×
Office visit, established patient (30-39 min) CPT Code: `99214`	$91	$74	$123	0.6×
Psychological testing evaluation CPT Code: `96136`	$65	$77	$128	0.6×
Hepatitis B vaccine HCPCS Code: `90744`	$21	$42	$37	1.1×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$27	$43	$39	1.1×
Orthotic fitting and training CPT Code: `97760`	$128	$45	$51	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$52	$13	$14	0.9×
Diagnostic procedure preparation HCPCS Code: `G0279`	$58	$29	$35	0.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$90	$50	$87	0.6×
New patient office visit (30-44 min) CPT Code: `99203`	$79	$63	$110	0.6×
Blood test, PSA (prostate screen) CPT Code: `84153`	$31	$19	$19	1.0×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$122	$32	$38	0.8×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$45	$37	$56	0.7×
X-ray, pelvis CPT Code: `72170`	$185	$60	$110	0.5×
X-ray, shoulder CPT Code: `73030`	$273	$50	$92	0.5×
X-ray, foot CPT Code: `73630`	$273	$50	$92	0.5×
X-ray, chest (two views) CPT Code: `71046`	$165	$50	$93	0.5×
X-ray, neck (cervical spine) CPT Code: `72040`	$185	$50	$93	0.5×
X-ray, hand CPT Code: `73130`	$273	$50	$93	0.5×
X-ray, hip CPT Code: `73502`	$191	$50	$93	0.5×
X-ray, ankle CPT Code: `73610`	$185	$50	$93	0.5×
X-ray, lower back CPT Code: `72110`	$321	$60	$112	0.5×
Ultrasound, abdomen (limited) CPT Code: `76705`	$420	$60	$126	0.5×
Ultrasound, pelvis CPT Code: `76856`	$421	$60	$130	0.5×
Ultrasound, thyroid and neck CPT Code: `76536`	$421	$60	$132	0.5×
Ultrasound, abdomen (complete) CPT Code: `76700`	$421	$60	$134	0.4×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$334	$48	$148	0.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$49	$11	$11	1.0×
Blood test, vitamin D CPT Code: `82306`	$42	$31	$31	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$325	$36	$123	0.3×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$57	$57	$27	unverified
Blood test, basic metabolic panel CPT Code: `80048`	$39	$9	$9	1.0×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$63	$14	$14	1.0×
Blood test, liver function panel CPT Code: `80076`	$38	$9	$9	1.0×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$34	$3	$3	1.0×
Blood test, amylase CPT Code: `82150`	$47	$7	$7	1.0×
Blood test, calcium CPT Code: `82310`	$22	$5	$5	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$45	$5	$5	1.0×
Blood test, vitamin B12 CPT Code: `82607`	$101	$16	$16	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$112	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$20	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$62	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$45	$7	$7	1.0×
Blood test, magnesium CPT Code: `83735`	$19	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$27	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$37	$5	$5	1.0×
Blood test, thyroid (TSH) CPT Code: `84443`	$67	$18	$18	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$43	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$49	$8	$8	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$42	$5	$5	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$53	$6	$6	1.0×
Hepatitis C antibody test CPT Code: `86803`	$85	$15	$15	1.0×
Culture, blood CPT Code: `87040`	$90	$11	$11	1.0×
Culture, bacterial CPT Code: `87070`	$75	$9	$9	1.0×
Speech therapy (group session) CPT Code: `92508`	$57	$24	$27	0.9×
Physical therapy (gait training) CPT Code: `97116`	$79	$29	$33	0.9×
Physical therapy (functional capacity test) CPT Code: `97750`	$84	$33	$38	0.9×
Prosthetic fitting and training CPT Code: `97761`	$128	$39	$45	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$77	$34	$40	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$77	$29	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$87	$27	$34	0.8×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$236	$34	$64	0.5×
Blood test, hemoglobin CPT Code: `85018`	$46	$2	$3	0.7×
Flu vaccine (high dose) HCPCS Code: `90656`	$14	$16	$25	0.6×
Community mental health services HCPCS Code: `H0038`	$9	$9	$16	0.6×
Blood antibody screen CPT Code: `86850`	$87	$25	$46	0.5×
Occupational therapy (self-care training) CPT Code: `97535`	$84	$32	$38	unverified
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$82	$29	$20	unverified

Showing top 25 high-impact procedures of 123 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 17.3%

Audit a Bill or Quote at Berkeley Medical Center (Zero PHI Required)

CMS CCN: 510008

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $21,078

1. Amount on Your Bill or Quote ($) Pre-filled with Berkeley Medical Center’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 501(r) AGB Cap: $8,746 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $8,746

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (17.3% of gross = $8,746).

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Berkeley Medical Center's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$19,812 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($50,587) is $19,812 above the denoised Fair BaseRate ($30,775) and 2.2× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) 501(c)(3) Nonprofit Hospital

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

EIN: 550383321

Filing Period: 194002

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (17.3% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall2/5 Stars (2/5)

Safety Composite60/100

Would Recommend54%

Rated 9 or 10 (HCAHPS)57%

Median ER Wait160 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate2.6%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionsame

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Berkeley Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2022-03-07·administrative_or_closure
Closure Notice
Recorded
2021-08-25·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (525 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark Pareto Frontier (Price + Quality)

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Berkeley Medical Center.

Price Index: 0.58× regional baseline

Quality: 46/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Blue Cross Blue Shield

-44.9%

CareSource

+78.5%

Median Household Income$77,329U.S. Census ACS

Local Uninsured Share6.2%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 88/100 · Verified CMS CCN 510008 EIN 550383321

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 510008) ↗ Verify IRS Form 990 (EIN 550383321) ↗ CMS HCRIS Cost Reports ↗

Published MRF File550383321_City-Hospital-Inc._standardcharges.csv

Publication / Vintage7/9/2026 · 82.24 MB

Validated Rate Rows6,293 (CMS v3.0.0)

File Integrity Digest2893dacef58a83f72cb6…

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy