Healthcare services

Health Care Cost Lookup

Health care costs are a huge part of household spending. But, the actual cost of a service can vary widely.

Our tool provides information about the gross charges for procedures performed at a hospital or an ambulatory surgery center. This compares to the negotiated rate that providers receive from insurance companies.

How to use the tool

The calculator estimates your total yearly costs for health services that aren’t reimbursed by insurance, like copayments and deductibles. Your actual deductibles, co-payments and coinsurance will vary depending on the health plans you have selected and the services you use during a year.

The tool is based on FAIR Health’s nationally averaged, market-driven data. It provides a more transparent view of healthcare costs and gives you the information you need to shop wisely for care.

The cost estimate tool does not take into account differences in national averages between hospitals, for example the difference between hospital outpatient departments and ambulatory surgical centers. It also does not provide pricing for members who are covered under an accountable care organization (ACO) arrangement. This includes members of Child Health Plus, Family Health Plus and most Essential plans. The cost estimate does not include physician fees. These can be found through the searchable Medicare Physician Fee Schedule Booklet. This is available online and can be downloaded in PDF form.

Estimate your out-of-pocket costs

A patient’s out-of-pocket costs are influenced by many factors. In an effort to make these costs more transparent, federal rules require hospitals to provide cost estimation tools that allow patients a quick understanding of what they may be responsible for after insurance pays. These tools typically include service details, estimated insurance coverage and remaining deductible amounts.

The tool can be searched by billing code or a general description of the service, such as “repair knee joint” or “MRI of abdomen.” Patients who choose to be self-pay can also receive pricing information that includes a 30 percent discount.

Out-of-pocket expenses are any portion of a healthcare bill not paid or reimbursed by insurance. These costs can range from a copayment to an annual deductible, depending on the type of plan a person has. A patient services representative can help patients determine what they may need to pay for a given service, as well as explore available resources to help them.

Contact us

We can help answer your questions and provide more information about our cost estimates. Our team of patient services representatives can also help explore programs, payment options and discounts that might be available to you.

A CHI Health representative can help you understand your potential costs for a specific service or procedure. These estimates are only based on the hospital’s charges and fees, not physician fees (such as those for an emergency room doctor or radiologist). They do not take into account your insurance coverage or other factors that might affect the actual amount you’ll have to pay.

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