It is important to note, a hospital “charge” is not the same as “expected payment.” A charge is the amount billed for a service. In the vast majority of cases, hospitals are paid considerably less than the billed amount. Hospital charges are based on the type of care provided and can differ from patient to patient for the same service. The differences between patients are related to complications or varying treatments needed due to the patient’s health.
Even though the hospital’s prices on our list are the same for all patients, actual charges for each specific patient may vary from the listed standard charges due to a combination of factors.
The Healthcare Financial Management Association has published a booklet, “Understanding Healthcare Prices: A Consumer Guide,” which can help you better understand where to get answers to your questions about healthcare prices, how to compare prices among providers and how to manage your out-of-pocket costs. View the guidebook online >
The No Surprises Act protects patients from large and unexpected surprise bills for out-of-network emergencies and certain non-emergency services provided in in-network health care facilities. When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance, and/or deductible.
Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills
When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.
What is “balance billing” (sometimes called “surprise billing”)?
When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance, and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a health care facility that isn’t in your health plan’s network.
“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.
“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care–like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.
Patients have the right to receive a "good faith estimate" of the cost of non-emergency services from a provider before receiving care.
For questions or more information about your right to a Good Faith Estimate, visit cms.gov/nosurprises or call 1-800-MEDICARE (1-800-633-4227).