Hospital Pricing FAQs
How can I tell which diagnosis-related group (DRG) applies to me?
A DRG provides a way to categorize the type of patients a hospital treats and covers all charges associated with an inpatient stay from admission to discharge. To find out which DRG applies to you, ask your doctor for your exact treatment plan, including the DRG codes associated with it, so that you can estimate pricing. You can also use the hospital’s price estimator service.
How will the hospital standard charges differ from my actual costs?
Our spreadsheets include only hospital-related charges. Hospital charges include the room, equipment, supplies, technicians and nurses who cared for you. The hospital and the professional services provided in the hospital are billed separately. Any physicians or allied health professionals that treated you during your stay will have a separate bill. These may include:
- Specialists
- Emergency Department Physicians
- Anesthesiologists
- Pathologists
- Radiologists
You also may receive a separate bill from independent laboratory and radiology services. These services include having specialists read and interpret EKGs, X-rays, EEGs and lab work.
How does insurance coverage affect the standard charges?
When reviewing standard charges, it is important to note that actual payment rates for hospital care provided to insured patients are:
- Negotiated with health plans
- Set by the federal government for Medicare
- Set by state governments for Medicaid
If you have insurance or governmental plan coverage, please visit our Hospital Pricing Information page to learn how to get a personalized estimate from one of our financial counselors.
How will the financial counselor’s hospital cost estimates differ from my actual costs?
Our financial counselor’s estimates include only hospital-related charges. Hospital charges include the room, equipment, supplies, technicians and nurses who cared for you. The hospital and the professional services provided in the hospital are billed separately. Any physicians or allied health professionals that treated you during your stay will have a separate bill. These may include:
- Specialists
- Emergency Department Physicians
- Anesthesiologists
- Pathologists
- Radiologists
You also may receive a separate bill from independent laboratory and radiology services. These services include having specialists read and interpret EKGs, X-rays, EEGs and lab work. In addition, these independent providers may not be participants in your health plan, which may increase your overall cost.
What if I have questions about my bill or can’t afford it?
If you have a question or concern about a bill we have sent to you, please visit our Billing Questions page to submit a question or call our customer service team. We are here to help you.
If you have a question about a bill that is related to your hospital stay but came from another provider (such as the ones listed above), please call the customer service number located on the bill you received.
