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Information about pricing

The pricing information displayed here is representative of hospitals charges. If you have insurance, you will also be interested in the amount you will be responsible for – coinsurance (the amount of covered charges you are responsible for) and deductibles (the amount you must pay before the insurance company begins to pay). The actual charges on the statement you receive from the hospital will vary from the charges reported here. And what you actually will be responsible for paying will depend on your insurance policy and factors such as whether you have satisfied your insurance plan’s deductible, the amount of charges your plan does not cover, etc. If you do not have insurance, contact the hospital and ask them about their payment policies. Hospitals have charity care policies for patients who qualify.

The information presented here should be considered a starting point when comparing the cost of care between hospitals.

Here are some other things to remember:

  • Physician charges are not included. You will receive a separate bill from your personal physician, and may receive a bill from a radiologist if you had x-rays or other radiology procedures, or from a pathologist if you had surgery or other lab tests performed, or from the Emergency Department physician if you were treated in the Emergency Department. Your surgeon and anesthesiologist will also send you a separate bill. Those charges are not included in the information displayed on this web site.
  • Practice decisions vary from physician to physician, and collectively may explain some differences in charges and outcomes across facilities.
  • Severity of illness and intensity of care may vary. Patients within the same diagnosis or procedure category may need very different levels of service and staff attention, causing a variation in charges.
  • Current charges and outcomes may be different than those displayed here. The information presented is a snapshot of the data from the most recently available 12-month time period.
  • Some reasons why charges may differ among facilities
    • The equipment facilities use to provide services differs in age and frequency of use and may impact the charges of the hospital.
    • Salary scales may differ by region and are typically higher in urban areas than in rural areas.
    • Shortages of nurses and other medical personnel may affect regions differently. Where shortages are more severe, staffing costs, and, therefore charges, may be higher.
    • Facilities differ in their approach to pricing based on operational costs. Some facilities try to spread the cost of all services and equipment among all patients. Others establish charges for specific services based on the cost to provide each specific service. Some facilities may provide certain services at a loss while other facility operations subsidize the losses. Any of these situations can result in significantly different charges among hospitals for a given type of service.
  • Charges shown are the facility’s billed charges. Patients rarely are required to pay the full charges. Actual amounts paid are usually less.

The information shown here is based on Diagnosis Related Groups (DRGs). A DRG is a grouping of diagnoses which represent similar, but not the same, diseases, and the resources provided to care for patients with similar diseases. For example, there is more than one DRG for pneumonia; that is, a patient may group into a different pneumonia DRG depending on the type and severity of the pneumonia and the resources necessary to treat it.

Continue to NHA Pricing Information


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