Where the data comes from

Hospital Standard Charges

The prices you see on WV Health Prices come directly from machine-readable files (MRFs) that hospitals are required to publish under federal law.

Under 45 CFR § 180.50, enforced by the Centers for Medicare & Medicaid Services (CMS), every hospital in the United States must publish a machine-readable file listing their standard charges — including payer-specific negotiated rates — for every item and service they provide. Hospitals update these files at least annually.

We download MRF files directly from all 46 CMS-registered acute care and critical access hospitals in West Virginia, normalize them into a consistent format, and load them into our searchable database. We do not estimate, model, or adjust any rate. Every price shown is exactly what the hospital published.

Note: These are negotiated rates — the amount a hospital has agreed to accept from an insurer as full payment. They are not your out-of-pocket cost. Your actual cost depends on your plan’s deductible and coinsurance. See our About page for a full explanation.

Hospital Quality and Facility Data

To provide context for the prices we show, we enrich each hospital’s profile with quality ratings and facility characteristics from two CMS datasets.

Overall Hospital Quality Star Ratings

The overall 1–5 star rating shown on each hospital page comes from the CMS Provider Data Catalog. CMS calculates these ratings based on performance across five quality measure groups: mortality, safety of care, readmission, patient experience, and timely and effective care.

Facility Characteristics

Bed counts, facility type classification (short-term acute, critical access, etc.), accreditation status, and trauma level designations come from the CMS Provider of Services File. This file contains Medicare certification and facility characteristic data for all certified providers.

Procedure Codes

Procedures in our database are identified using standard medical billing codes. Two code systems are used:

CPT codes (Current Procedural Terminology) identify specific outpatient procedures and physician services. CPT codes are published by the American Medical Association and are the national standard for outpatient procedure billing under HIPAA.

DRG codes (Diagnosis Related Groups) are used for inpatient hospital stays. MS-DRG codes are maintained by the Centers for Medicare & Medicaid Services and are in the public domain.

HCPCS Level II codes cover items and services not included in CPT, such as durable medical equipment, ambulance services, and certain drugs.

The codes shown on WV Health Prices are taken directly from hospital MRF files as published by the hospitals. We display them to help you identify and search for specific procedures.

What we build and maintain

The following elements of this site are built and maintained by Civic Health Data LLC and are not derived from any external data source:

The normalization pipeline that parses, standardizes, and loads hospital MRF files. Hospital MRF files vary significantly in structure and format — we handle CSV Wide, CSV Tall, and JSON formats as well as multiple CMS template versions. The normalized output is our own work product.

The payer name normalization that consolidates variant spellings and plan names (for example, “Anthem BCBS WV,” “Anthem Blue Cross Blue Shield of WV,” and “Anthem/BCBS” are unified under a single canonical name so results are comparable across hospitals).

The search index, comparison interface, cost estimator, and all other application features.

The interactive hospital map and geographic data layer.

Data accuracy and limitations

We publish this data in good faith based on what hospitals have filed. We do not independently verify the accuracy of hospital-published rates.

Known limitations:

Hospital MRF files are not always complete or accurate. CMS enforcement of the price transparency rule is ongoing and improving, but some hospitals publish incomplete files, use non-standard formats, or include placeholder values. We flag unusual rates in our quality checks but cannot guarantee every value is correct.

Rates may not reflect current contracts. Hospitals update MRF files annually at minimum, but negotiated rates can change between updates. A rate published in January may not reflect a contract renegotiated in October.

Facility fees and professional fees are often separate. A hospital procedure frequently generates two bills: a facility fee (what you see here) and a separate charge from the treating physician or specialist. Both may apply to your final bill.

Not every procedure appears for every hospital. Hospitals are required to publish charges for all services they provide, but code coverage varies. If a procedure does not appear for a hospital, it may mean the hospital does not provide that service, not that the rate is zero.

If you believe a rate shown on this site is incorrect, please contact us. We will investigate and correct our data.

Contact and corrections

WV Health Prices is operated by Civic Health Data LLC, a West Virginia company.

For data corrections, data access inquiries, or press inquiries:
contact@wvhealthprices.com

For employer partnership or data licensing inquiries:
contact@wvhealthprices.com

This site is not affiliated with any hospital, health system, insurer, or government agency.