Mon Health Medical Center
1200 Jd Anderson Drive, Morgantown, WV 26505 · 110 Priced Procedures · 77% Patient Recommendation
Typical commercial prices here are 13% below the fair benchmark (0.87×) after accounting for local nurse/doctor wages and patient complexity.
4-Star CMS clinical quality rating paired with 0.87× fair market pricing.
Uniform Value Leader · Low-Cost Across Departments
Mon Health Medical Center maintains low, disciplined commercial pricing across both routine shoppable procedures (0.8× Medicare, p50 0.88× Fair BaseRate) and emergency/ancillary services (1.0× Medicare, p75 0.95× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.
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 82% of shoppable procedures (99/100 Cash Honesty)
- 4-Star CMS clinical rating with 77% patient recommendation (75/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (33.8% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 1.3× markup over Medicare rates
- Captive ER (1.6×) & laboratory (1.4×) services average 1.25× higher multiples than routine shoppable care (0.8×)
- Even at low-cost facilities (0.87× 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.
- Consolidated metro market (HHI 6,886) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))
Pre-scheduled outpatient procedures where patients can comparison-shop.
Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.
Detects median-gaming when upper-quartile codes spike above the p50 median.
Procedure Prices at Mon Health Medical Center
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 110 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Cataract surgery with lens implant CPT Code: 66984 | $2,232 | 0.9× |
| Total hip replacement CPT Code: 27130 | $1,369 | 0.1× |
| Total knee replacement CPT Code: 27447 | $1,367 | 0.1× |
| Trauma team activation HCPCS Code: G0390 | $1,289 | 0.9× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $1,208 | 0.2× |
| Blood transfusion CPT Code: 36430 | $847 | 1.7× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $831 | 0.8× |
| Injection procedure for pain management HCPCS Code: G0260 | $683 | 0.8× |
| Rabies immune globulin HCPCS Code: 90375 | $662 | unverified |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $529 | 0.9× |
| Bunion correction surgery CPT Code: 28296 | $538 | 0.2× |
| Inguinal hernia repair CPT Code: 49505 | $517 | 0.1× |
| Breast lump removal CPT Code: 19120 | $449 | 0.1× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $337 | 0.8× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $337 | 0.7× |
| Colonoscopy with biopsy CPT Code: 45380 | $357 | 0.3× |
| MRI, brain (no contrast) CPT Code: 70551 | $236 | 0.7× |
| Neurobehavioral status check CPT Code: 96116 | $209 | 0.9× |
| MRI, lower back (no contrast) CPT Code: 72148 | $231 | 0.7× |
| MRI, knee or other leg joint CPT Code: 73721 | $236 | 0.6× |
| Upper endoscopy with biopsy CPT Code: 43239 | $246 | 0.2× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $231 | unverified |
| Ultrasound, leg veins (duplex) CPT Code: 93970 | $231 | unverified |
| Breathing treatment (nebulizer) CPT Code: 94640 | $212 | unverified |
| CT scan, head (with contrast) CPT Code: 70460 | $170 | 0.7× |
Audit a Bill or Quote at Mon Health Medical Center (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $5,841
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (33.8% of gross = $5,841).
Self-Pay Cash Rate ($8,632) Beats Your Bill
Mon Health Medical Center's published 45 CFR § 180 self-pay cash rate is $8,632 (vs. $2,232 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $2,540 Fair BaseRate ($2,358 Medicare)
Your bill ($17,265) is $14,725 above the denoised Fair BaseRate ($2,540) and 7.3× the $2,358 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (33.8% 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.
Clinical Quality, Patient Experience & Infection Benchmarks
Healthcare-Associated Infections (CDC NHSN / CMS HAI)
1.00 SIR = National Predicted Baseline (Lower Is Safer)CMS Price Transparency Administrative Enforcement Log
Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Mon Health Medical Center. Prior administrative notices do not necessarily reflect current compliance status.
- 2022-10-05·administrative_or_closure
Closure Notice
Recorded - 2021-12-01·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (1,348 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.
How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings
2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Mon Health Medical Center.
Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings
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.