How many shoppable procedure prices are published for Charleston Area Medical Center?

Charleston Area Medical Center in Charleston, WV currently has 125 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

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

Across scored shoppable procedures, Charleston Area Medical Center's median negotiated commercial rate is 0.8× the regionally adjusted fair BaseRate benchmark.

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

CMS Care Compare assigns Charleston Area Medical Center an overall hospital quality rating of 2 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 803 Beds · urban Updated: 4/1/2026

Charleston Area Medical Center

501 Morris Street, Charleston, WV 25301 · 125 Priced Procedures · 69% Patient Recommendation

CMS Overall Rating 2 / 5 Stars

Good Deal · Below Fair Market

0.82×vs. Fair Market Price

Typical commercial prices here are 18% below the fair benchmark (0.82×) after accounting for local nurse/doctor wages and patient complexity.

56/100 · Caution

56/100Self-Pay Cash Beats Insurance 18% of the Time

File Completeness45

Price Logic76

Peer Alignment57

Clean Billing86

Real Cash Discount6

Regional Benchmark Tier

3-Star CMS clinical quality rating paired with 0.82× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Charleston Area Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.80× Fair BaseRate) and emergency/ancillary services (0.9× Medicare, p75 0.96× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#6 of 28 in WV · 17th State Percentile#338 of 3,385 in U.S. · 9th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 18% below peer Fair BaseRate (0.82×)
Self-pay cash beats commercial insurance on 18% of shoppable procedures (25/100 Cash Honesty)
2-Star CMS clinical rating with 69% patient recommendation (61/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (45.6% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.82× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.1×) & laboratory (1.5×) services average 1.13× higher multiples than routine shoppable care (0.8×)
Upper-quartile procedures (Q75 0.96×) jump +20% above the median procedure ratio (Q50 0.80×)
Consolidated metro market (HHI 6,304) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

0.8× Medicare

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

Back-Door Captive & ER1.13× Divergence

0.9× Medicare

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

Quantile Tail Spread+20% Upper Tail

Q25 0.63× · Q50 0.80× · Q75 0.96×

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

0.8× MedicareGood

Outpatient Surgery & ORBack-Door Captive

1.0× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.6× MedicareFair

Back-Door Captive ER VisitsBack-Door Captive

1.1× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

1.5× MedicareGood

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

0.8× MedicareGood

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

18% Cash Edge · 25/100Watchout

CMS Clinical Safety & Star ValueIntegrity & Outcomes

2 CMS · 61/100Elevated

Procedure Prices at Charleston Area Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 125 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`	$231,226	$20,264	$30,775	0.7×
Gallbladder removal (laparoscopic) CPT Code: `47562`	$19,625	$19,625	$6,109	3.2×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	$100,719	$12,406	$19,087	0.6×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	$123,790	$12,323	$19,432	0.6×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	$140,508	$11,311	$17,936	0.6×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	$49,154	$5,310	$8,223	0.6×
Total hip replacement CPT Code: `27130`	$3,718	$3,718	$13,413	0.3×
Total knee replacement CPT Code: `27447`	$3,718	$3,718	$13,523	0.3×
C-section delivery (full package) CPT Code: `59510`	$7,876	$2,573	$2,975	unverified
Vaginal delivery (full package) CPT Code: `59400`	$7,100	$2,284	$2,680	0.9×
Trauma team activation HCPCS Code: `G0390`	$4,233	$1,362	$1,453	0.9×
Hepatitis B immune globulin HCPCS Code: `90371`	$1,089	$1,089	$151	7.2×
Bunion correction surgery CPT Code: `28296`	$1,399	$784	$3,446	0.2×
Breast lump removal CPT Code: `19120`	$4,880	$551	$3,875	0.1×
Knee arthroscopy with meniscus repair CPT Code: `29881`	$7,459	$505	$3,372	0.1×
Inguinal hernia repair CPT Code: `49505`	$17,151	$513	$3,629	0.1×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$433	$433	$64	6.8×
Blood transfusion CPT Code: `36430`	$680	$451	$498	0.9×
Cataract surgery with lens implant CPT Code: `66984`	$8,643	$444	$2,540	0.2×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$7,116	$356	$448	0.8×
MRI, brain (with and without contrast) CPT Code: `70553`	$7,343	$356	$511	0.7×
Colonoscopy with biopsy CPT Code: `45380`	$1,999	$347	$1,256	0.3×
Sleep study (overnight, in lab) CPT Code: `95810`	$5,331	$306	$1,021	0.3×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$4,453	$244	$303	0.8×
MRI, lower back (no contrast) CPT Code: `72148`	$4,380	$244	$338	0.7×
MRI, brain (no contrast) CPT Code: `70551`	$4,212	$244	$343	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$4,250	$244	$369	0.7×
Colonoscopy (diagnostic) CPT Code: `45378`	$1,711	$242	$981	0.2×
Upper endoscopy with biopsy CPT Code: `43239`	$1,610	$240	$987	0.2×
Psychotherapy session (60 minutes) CPT Code: `90837`	$273	$155	$181	0.9×
CT scan, head (with contrast) CPT Code: `70460`	$2,294	$179	$242	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$3,011	$179	$258	0.7×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,703	$168	$272	0.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$2,030	$173	$583	0.3×
Psychiatric evaluation (first visit) CPT Code: `90791`	$372	$168	$185	unverified
Breathing treatment (nebulizer) CPT Code: `94640`	$136	$134	$201	0.7×
X-ray, chest (single view) CPT Code: `71045`	$301	$89	$92	1.0×
X-ray, shoulder CPT Code: `73030`	$503	$89	$92	1.0×
X-ray, foot CPT Code: `73630`	$503	$89	$92	1.0×
X-ray, chest (two views) CPT Code: `71046`	$400	$89	$93	1.0×
X-ray, hand CPT Code: `73130`	$503	$89	$93	1.0×
X-ray, ankle CPT Code: `73610`	$503	$89	$93	1.0×
X-ray, lower back CPT Code: `72110`	$774	$107	$112	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$239	$105	$123	0.9×
New patient office visit (30-44 min) CPT Code: `99203`	$289	$89	$110	0.8×
Screening mammogram (both breasts) CPT Code: `77067`	$459	$97	$123	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$1,418	$105	$134	0.8×
Ultrasound, pelvis CPT Code: `76856`	$1,174	$96	$130	0.7×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$496	$105	$148	0.7×
CT scan, head (no contrast) CPT Code: `70450`	$2,170	$107	$160	0.7×
CT scan, pelvis CPT Code: `72192`	$2,382	$107	$163	0.7×
CT scan, sinuses CPT Code: `70486`	$2,327	$107	$166	0.6×
CT scan, chest (no contrast) CPT Code: `71250`	$2,170	$107	$167	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$2,382	$107	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$2,382	$107	$169	0.6×
Psychotherapy session (45 minutes) CPT Code: `90834`	$273	$105	$166	0.6×
Family therapy session CPT Code: `90847`	$397	$108	$173	0.6×
Neurobehavioral status check CPT Code: `96116`	$393	$91	$231	0.4×
X-ray, neck (cervical spine) CPT Code: `72040`	$503	$89	$93	unverified
X-ray, pelvis CPT Code: `72170`	$541	$107	$110	unverified
Typhoid vaccine HCPCS Code: `90675`	$1,123	$1,123	$347	3.2×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$473	$473	$203	2.3×
Pneumococcal vaccine HCPCS Code: `90732`	$323	$323	$140	2.3×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$238	$238	$111	2.1×
Hepatitis B vaccine HCPCS Code: `90744`	$203	$203	$37	5.5×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$122	$122	$56	2.2×
Drug screening test HCPCS Code: `G0480`	$135	$135	$116	1.2×
Flu vaccine (high dose) HCPCS Code: `90656`	$58	$58	$25	2.3×
Speech therapy (language evaluation) CPT Code: `92507`	$415	$72	$86	0.8×
Office visit, established patient (20-29 min) CPT Code: `99213`	$257	$71	$87	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$1,109	$79	$126	0.6×
Ultrasound, thyroid and neck CPT Code: `76536`	$1,210	$75	$132	0.6×
Flu vaccine injection HCPCS Code: `G0008`	$94	$74	$48	unverified
Pneumonia vaccine injection HCPCS Code: `G0009`	$94	$48	$49	1.0×
Colorectal cancer screening HCPCS Code: `G0010`	$70	$70	$49	unverified
Extended office visit (prolonged) HCPCS Code: `G2212`	$89	$34	$33	1.0×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$211	$26	$27	1.0×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$238	$19	$20	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$217	$33	$40	0.8×
Orthotic fitting and training CPT Code: `97760`	$280	$42	$51	0.8×
X-ray, hip CPT Code: `73502`	$454	$44	$93	0.5×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$260	$11	$11	1.0×
Blood test, creatinine (kidney) CPT Code: `82565`	$87	$5	$5	1.0×
Blood test, magnesium CPT Code: `83735`	$95	$7	$7	1.0×
Blood test, vitamin D CPT Code: `82306`	$124	$30	$31	1.0×
Physical therapy (functional capacity test) CPT Code: `97750`	$202	$31	$38	0.8×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$134	$3	$3	1.0×
Blood test, calcium CPT Code: `82310`	$90	$5	$5	1.0×
Blood test, ferritin (iron stores) CPT Code: `82728`	$187	$14	$14	1.0×
Blood test, glucose (blood sugar) CPT Code: `82947`	$85	$4	$4	1.0×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$171	$10	$10	1.0×
Blood test, lipase CPT Code: `83690`	$166	$7	$7	1.0×
Blood test, potassium CPT Code: `84132`	$84	$5	$5	1.0×
Blood test, sodium CPT Code: `84295`	$104	$5	$5	1.0×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$72	$4	$4	1.0×
Blood test, complete blood count (CBC) CPT Code: `85025`	$189	$8	$8	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$98	$6	$6	1.0×
Culture, bacterial CPT Code: `87070`	$180	$9	$9	1.0×
Blood test, PSA (prostate screen) CPT Code: `84153`	$234	$18	$19	0.9×
Blood test, thyroid (TSH) CPT Code: `84443`	$207	$17	$18	0.9×
Blood test, vitamin B12 CPT Code: `82607`	$261	$15	$16	0.9×
Hepatitis C antibody test CPT Code: `86803`	$239	$14	$15	0.9×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$216	$13	$14	0.9×
Culture, blood CPT Code: `87040`	$219	$10	$11	0.9×
Blood test, basic metabolic panel CPT Code: `80048`	$207	$8	$9	0.9×
Blood test, liver function panel CPT Code: `80076`	$262	$8	$9	0.9×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$269	$31	$38	0.8×
Occupational therapy (self-care training) CPT Code: `97535`	$229	$30	$38	0.8×
Prosthetic fitting and training CPT Code: `97761`	$339	$34	$45	0.8×
Hospital observation (per hour) HCPCS Code: `G0378`	$158	$54	$86	0.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$97	$4	$5	0.8×
Electrical stimulation therapy HCPCS Code: `G0283`	$271	$11	$14	0.8×
Speech therapy (group session) CPT Code: `92508`	$215	$20	$27	0.7×
Physical therapy (gait training) CPT Code: `97116`	$269	$24	$33	0.7×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$360	$25	$35	0.7×
Physical therapy (manual therapy) CPT Code: `97140`	$302	$22	$34	0.6×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	$263	$14	$25	0.6×
Diagnostic procedure preparation HCPCS Code: `G0279`	$228	$17	$35	0.5×
Group therapy session CPT Code: `90853`	$231	$29	$100	0.3×
Blood test, hemoglobin CPT Code: `85018`	$61	$2	$3	0.7×
Blood antibody screen CPT Code: `86850`	$146	$10	$46	0.2×
Psychological testing evaluation CPT Code: `96136`	$152	$27	$128	0.2×
Mental health services (assessment) HCPCS Code: `H0031`	$17	$17	$140	0.1×
Psychological testing by technician CPT Code: `96138`	$94	$33	$395	0.1×
Blood test, amylase CPT Code: `82150`	$137	$6	$7	0.9×

Showing top 25 high-impact procedures of 125 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 45.6%

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

CMS CCN: 510022

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash $231,226

Insurer Median $20,264

1. Amount on Your Bill or Quote ($) Pre-filled with Charleston Area 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: $105,485 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $105,485

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (45.6% of gross = $105,485).

Step 2 · Cash vs. Insurance Arbitrage Published Cash: $231,226

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Charleston Area Medical Center's published 45 CFR § 180 self-pay cash rate is $231,226 (vs. $20,264 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.

Step 3 · Fair BaseRate Target +$200,451 Above Fair BaseRate

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

Your bill ($231,226) is $200,451 above the denoised Fair BaseRate ($30,775) and 9.8× 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: 550526150

Filing Period: 197203

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 (45.6% 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 Overall3/5 Stars (3/5)

Safety Composite61/100

Would Recommend69%

Rated 9 or 10 (HCAHPS)69%

Median ER Wait181 min

Left ER Before Seen4%

30-Day Mortality vs U.S.same

Unplanned Readmissionworse

Hip/Knee Complication Rate3.7%

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 Charleston Area Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-03-18·administrative_or_closure
Met Requirements
Recorded
2023-04-13·administrative_or_closure
Closure Notice
Recorded
2022-11-23·cap_corrective_action
CAP Request
Recorded
2021-09-29·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (2,707 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

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

Price Index: 1.00× regional baseline

Quality: 49/100 CMS composite

Median Household Income$58,887U.S. Census ACS

Local Uninsured Share4.7%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 56/100 · Caution CMS CCN 510022 EIN 550526150

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

Download Official Hospital MRF ↗ Verify on CMS Medicare.gov (CCN 510022) ↗ Verify IRS Form 990 (EIN 550526150) ↗ CMS HCRIS Cost Reports ↗

Published MRF Filesbpdvwskj3p5v03pymtbh1rk1xx1hx27.csv

Publication / Vintage4/1/2026 · 75.33 MB

Validated Rate Rows6,943 (CMS v3.0.0)

File Integrity DigestVerified · CCN 510022

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