St Joseph's Hospital of Buckhannon, Inc
1 Amalia Drive, Buckhannon, WV 26201 · 117 Priced Procedures · 77% Patient Recommendation
Typical commercial prices here are +47% above the fair benchmark (1.47×) even after accounting for local nurse/doctor wages and patient complexity.
5-Star CMS clinical quality rating paired with 1.47× fair market pricing.
Cash-Arbitrage Bifurcated Pricer
St Joseph's Hospital of Buckhannon, Inc maintains elevated commercial insurance contracts (1.47× Fair BaseRate) while offering direct self-pay cash discounts that beat commercial negotiated medians on 70% of procedures. High-deductible and uninsured patients should always request the self-pay cash rate prior to billing.
Where They're Good (Patient & Payer Edge)
- Bottom-quartile procedures (Q25) price at 1.19× the peer BaseRate benchmark
- Self-pay cash beats commercial insurance on 70% of shoppable procedures (99/100 Cash Honesty)
- CMS clinical safety score (80/100 safety score) with 77% patient recommendation
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (29.4% AGB cap)
Where You Can Get Burned (Markup Traps)
- Even at low-cost facilities (1.47× 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.
- Commercial insurance median sits at 1.51× Fair BaseRate (1.6× Medicare), so insured patients should always compare the self-pay cash price before paying.
- Even at low-cost facilities (1.47× 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.
- Unnegotiated chargemaster list prices average 9.8× Medicare (15¢ true HCRIS cost per $1 gross)
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 St Joseph's Hospital of Buckhannon, Inc
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 117 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,790 | 0.9× |
| Inguinal hernia repair CPT Code: 49505 | $3,035 | 0.8× |
| Breast lump removal CPT Code: 19120 | $2,983 | 0.8× |
| C-section delivery (full package) CPT Code: 59510 | $2,947 | 1.0× |
| Vaginal delivery (full package) CPT Code: 59400 | $2,615 | 1.0× |
| Bunion correction surgery CPT Code: 28296 | $2,391 | 0.7× |
| CT scan, head (with contrast) CPT Code: 70460 | $1,442 | 6.0× |
| Cataract surgery with lens implant CPT Code: 66984 | $1,409 | 0.6× |
| Total hip replacement CPT Code: 27130 | $1,339 | 0.1× |
| Total knee replacement CPT Code: 27447 | $1,336 | 0.1× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $1,267 | 2.5× |
| Trauma team activation HCPCS Code: G0390 | $1,049 | 0.7× |
| CT scan, head (with and without contrast) CPT Code: 70470 | $878 | 3.4× |
| Colonoscopy with biopsy CPT Code: 45380 | $883 | 0.7× |
| MRI, lower back (no contrast) CPT Code: 72148 | $811 | 2.4× |
| MRI, brain (no contrast) CPT Code: 70551 | $811 | 2.4× |
| MRI, knee or other leg joint CPT Code: 73721 | $808 | 2.2× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $768 | 1.7× |
| CT scan, head (no contrast) CPT Code: 70450 | $689 | 4.3× |
| CT scan, chest (no contrast) CPT Code: 71250 | $690 | 4.1× |
| CT scan, lower back (lumbar spine) CPT Code: 72131 | $689 | 4.1× |
| CT scan, neck (cervical spine) CPT Code: 72125 | $689 | 4.1× |
| CT scan, abdomen and pelvis (no contrast) CPT Code: 74176 | $712 | 2.3× |
| Hospital observation (per hour) HCPCS Code: G0378 | $709 | unverified |
| CT scan, pelvis CPT Code: 72192 | $589 | 3.6× |
Audit a Bill or Quote at St Joseph's Hospital of Buckhannon, Inc (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $3,410
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (29.4% of gross = $3,410).
Self-Pay Cash Rate ($5,790) Beats Your Bill
St Joseph's Hospital of Buckhannon, Inc's published 45 CFR § 180 self-pay cash rate is $5,790 (vs. $5,790 commercial insurer median). Ask billing to reclassify the visit to prompt-pay self-pay if it beats your deductible.
Negotiate Toward $6,109 Fair BaseRate ($6,176 Medicare)
Your bill ($11,579) is $5,470 above the denoised Fair BaseRate ($6,109) and 1.9× the $6,176 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (29.4% 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)Source: CMS Hospital Care Compare (253 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 St Joseph's Hospital of Buckhannon, Inc.
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.