Wheeling Hospital, Inc
1 Medical Park, Wheeling, WV 26003 · 121 Priced Procedures · 55% Patient Recommendation
Typical commercial prices here are 7% below the fair benchmark (0.93×) after accounting for local nurse/doctor wages and patient complexity.
2-Star CMS clinical quality rating paired with 0.93× fair market pricing.
Aligned Regional Benchmark Peer
Wheeling Hospital, Inc prices shoppable and inpatient services (1.0× to 1.1× Medicare, divergence 1.10×) in alignment with regional hospital peers (0.93× Fair BaseRate). Reviewing plan-specific negotiated rates and cash discounts helps lock in the lowest out-of-pocket tier.
Where They're Good (Patient & Payer Edge)
- Elective shoppable care is priced 7% below peer Fair BaseRate (0.93×)
- Self-pay cash beats commercial insurance on 15% of shoppable procedures (99/100 Cash Honesty)
- 2-Star CMS clinical rating with 55% patient recommendation (56/100 safety score)
- IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (14.1% AGB cap)
Where You Can Get Burned (Markup Traps)
- Outpatient surgery & OR suites carry a 2.0× markup over Medicare rates
- Captive ER (4.0×) & laboratory (1.7×) services average 1.10× higher multiples than routine shoppable care (1.0×)
- Even at low-cost facilities (0.93× 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 5,174) 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 Wheeling Hospital, Inc
High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 121 published procedures.
| Procedure & Billing Code | This Hospital | vs. Fair |
|---|---|---|
| Spinal fusion, single level (inpatient stay) MS-DRG Code: 451 | $25,897 | 0.8× |
| Sepsis treatment (inpatient stay) MS-DRG Code: 871 | $15,572 | 0.8× |
| Hip or knee replacement (inpatient stay) MS-DRG Code: 470 | $15,468 | 0.8× |
| Heart stent placement (inpatient stay) MS-DRG Code: 322 | $14,477 | 0.8× |
| Total hip replacement CPT Code: 27130 | $12,729 | 0.9× |
| Total knee replacement CPT Code: 27447 | $12,729 | 0.9× |
| Digestive disorders treatment (inpatient stay) MS-DRG Code: 392 | $6,694 | 0.8× |
| Gallbladder removal (laparoscopic) CPT Code: 47562 | $5,994 | 1.0× |
| Breast lump removal CPT Code: 19120 | $4,146 | 1.1× |
| Inguinal hernia repair CPT Code: 49505 | $3,619 | 1.0× |
| Knee arthroscopy with meniscus repair CPT Code: 29881 | $3,464 | 1.0× |
| Bunion correction surgery CPT Code: 28296 | $3,464 | 1.0× |
| Trauma team activation HCPCS Code: G0390 | $1,418 | 1.0× |
| Colonoscopy with biopsy CPT Code: 45380 | $1,186 | 0.9× |
| Colonoscopy (diagnostic) CPT Code: 45378 | $940 | 1.0× |
| Upper endoscopy with biopsy CPT Code: 43239 | $899 | 0.9× |
| Injection procedure for pain management HCPCS Code: G0260 | $747 | 0.9× |
| Echocardiogram (heart ultrasound) CPT Code: 93306 | $542 | 0.9× |
| Psychological testing by technician CPT Code: 96138 | $414 | 1.0× |
| Blood transfusion CPT Code: 36430 | $437 | 0.9× |
| MRI, knee or other leg joint CPT Code: 73721 | $323 | 0.9× |
| CT scan, abdomen and pelvis (with contrast) CPT Code: 74177 | $346 | 0.8× |
| MRI, brain (with and without contrast) CPT Code: 70553 | $346 | 0.7× |
| Sleep study (overnight, in lab) CPT Code: 95810 | $371 | 0.4× |
| Rabies immune globulin HCPCS Code: 90375 | $306 | 1.0× |
Audit a Bill or Quote at Wheeling Hospital, Inc (Zero PHI Required)
Statutory 501(r) AGB Cap Limits Bill to $8,782
At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (14.1% of gross = $8,782).
Compare Prompt-Pay Cash Rate Against Remaining Deductible
Ask Wheeling Hospital, Inc's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.
Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)
Your bill ($62,153) is $31,378 above the denoised Fair BaseRate ($30,775) and 2.6× the $23,504 Medicare rate.
Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)
Hospital-Specific CMS HCRIS Benchmark (14.1% 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 Wheeling Hospital, Inc. Prior administrative notices do not necessarily reflect current compliance status.
- 2022-02-07·administrative_or_closure
Closure Notice
Recorded - 2021-10-27·cap_corrective_action
CAP Request
Recorded - 2021-05-18·warning_notice
Warning Notice
Recorded
Source: CMS Hospital Care Compare (1,632 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 Wheeling Hospital, 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.