Price Transparency

Clear, upfront information to help you understand healthcare costs and make informed decisions.

Know Your Healthcare Costs

Overview

In compliance with the Centers for Medicare and Medicaid Services (CMS), North Runnels Hospital is making available to the public a copy of its standard charges known as a “Charge Master,” “Charge Description Master” or “CDM.” Before you search through this file to learn what it may cost you to receive an item or service provided by the hospital or clinics, it is important to understand that what the hospital or clinics charge for a service IS NOT the same as what you or your insurance company may pay for a service. In fact, virtually no one pays the charges you will see listed. Charges are simply a tool that health care providers use to negotiate contracts with insurance companies, and to evaluate the financial impact of these negotiations on the financial health of the institution. Charges are the same for all patients, but a patient’s responsibility may vary depending on payment plans negotiated with individual insurers. Further discounts are available for uninsured or underinsured patients who qualify.

Using the CDM File

The CDM, available below here in an Excel format, includes a separate line or listing for over 3,100 items and services that may be provided by the hospital or clinics. Each line includes:

  • Column 1: Charge Code – a number that is assigned by the hospital and unique to an individual item or service

  • Column 2: Description – a description of the item or service

  • Column 3: Rate – the charge for each item or service

Downloadable Charge Description Master

Updated As Of January 3, 2025

Please note that during most hospital and clinic visits, you will likely receive more than one of the items or services listed on the CDM.

Understanding healthcare charges and payments can be complex. Here’s a breakdown of key aspects:

  • Charges are determined based on both direct costs (e.g., professional fees, staffing, supplies, equipment) and indirect costs (e.g., administration, medical records, billing, housekeeping, maintenance, facility expenses) associated with providing services. Hospitals often compare their charges with those of regional hospitals to ensure competitiveness. These charges encompass the direct services patients receive, the behind-the-scenes support enabling those services, and the availability of services around the clock.

  • The amount a hospital receives varies and is typically less than the listed charges. Payments are influenced by negotiated rates with insurance companies, government program reimbursements (e.g., Medicare, Medicaid), and patient out-of-pocket payments. Therefore, the actual payment is often lower than the standard charges due to these negotiated agreements and reimbursements.

  • Patient financial responsibility is influenced by insurance plan details:

    • Deductibles: The amount patients pay out-of-pocket before insurance coverage begins. Deductibles vary by insurance company, ranging from as little as $500 per year to $10,000 or more per year, depending on the plan selected and the premium paid for that coverage.

    • Coinsurance: After meeting the deductible, patients pay a percentage of the remaining costs.

    • Copayments: Fixed amounts paid for specific services, regardless of the total charge.

    These elements are defined by individual insurance plans and affect the total out-of-pocket expenses for patients.

  • Medicaid reimburses hospitals at rates typically lower than standard charges. Patients covered by Medicaid often have minimal out-of-pocket expenses, as the program covers most costs.

  • Medicare sets predetermined reimbursement rates for services, which are generally lower than standard charges. Patients may be responsible for deductibles and coinsurance, depending on their specific Medicare plan.

  • Uninsured patients are often eligible for discounts on standard charges. Hospitals may offer financial assistance programs to help reduce out-of-pocket expenses for these patients.

Patient Liability Estimator

The web-based Patient Liability estimator generates print patient-friendly, facility-specific estimates that can be used to discuss the potential charges before the procedure.

We encourage you to reach out with any questions to ensure you have a clear understanding of your financial responsibilities.