Pricing / Price Transparency

A Chargemaster is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital – each test, exam, surgical procedure, room charge, etc. Given the many services provided by hospitals 24 hours a day, seven days a week, a Chargemaster contains thousands of services and related charges.

Chargemaster amounts are almost never received as payment by a hospital. The Chargemaster amounts are billed to an insurance company, Medicare, or Medicaid, and those insurers then apply their contracted discounts to the services that are billed. In situations where a patient does not have insurance, our hospital has financial assistance policies that apply discounts to the amounts charged for those who qualify. We have very competitive prices and self pay discounts. For more information on our financial assistance policies, please call 419-732-4004.

Health insurance companies contract with hospitals to care for their customers. Hospitals are paid the insurance company’s contract rate, which generally is significantly less than the amount listed on the Chargemaster. The insurance company’s contract rate, not the Chargemaster, is the basis for determining the patient’s actual out of pocket costs. As an example, a hospital may charge $1,000 for a particular service, while the insurer’s contract rate may be $700. If the patient’s insurance plan indicates the patient is responsible for 20 percent of the contract rate, the patient would owe $140 ($700 x 20 percent). For more information, please call 419-732-4004.

The list of charges is the same for all patients. However, the total charges for an individual patient often vary from one patient to another for a number of reasons, including:

• How long it takes to perform the service or how long it takes you to recover in the hospital
• Whether the service or procedure you receive is more or less difficult than expected
• What kinds of medication and testing you require
• Whether you experience complications and need additional treatment
• Other health conditions you may have that may affect your care

Chargemaster information is not particularly helpful for patients to estimate what health care services are going to cost them out of their own pocket.

The charge listed in the Chargemaster is generally not the amount a patient will pay. If you have health insurance, the amount you will be billed and expected to pay for your services depends on your specific health insurance coverage and your insurance company’s contract with the hospital.

Your health plan may require a co-payment or deductible that will be due during appointment registration.  Check with your insurance provider on the amount that you will be responsible for at this time.  

Following your healthcare services, your insurance provider will send you an Explanation of Benefits (EOB) which will detail the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to Magruder Hospital.  Review the EOB, compare it to your Magruder hospital billing statement, and call your insurance provider or Magruder Patient Financial Counselors if you have questions or concerns. 

Costs can vary widely on whether your hospital and the physicians who care for you are in- or out-of-network based on your specific health plan.  

If you do not have health insurance, you may be eligible for reduced costs under the hospital’s financial assistance policy, or you may be eligible for Medicaid coverage. For more information, please call 419-732-4004.

The hospital’s Chargemaster does not include charges for services provided by the doctor (or doctors) who treat you while you are at the hospital. You may receive separate bills from the hospital and the doctors involved in your care.

Here is a partial list of health care providers who may bill you separately:

• The physicians who see you in the hospital
• The surgeon who performs your procedure
• The Emergency Room doctor who treats you in the Emergency Room
• The anesthesiologist who works with the surgeon
• The radiologist who reads your x-rays or other imaging
• Other doctors who may be consulted by your doctor during your time in the hospital
• The pathologists who evaluate pathology specimens

Items included in a charge vary across hospital systems. For example, what's included in one hospital's charge for room and board may differ from other hospitals' charges - some hospitals bundle services together into a single charge that others may list separately. 

Looking at various hospital charges does not provide any indication of quality of service and outcome. 

Please consult with your insurance provider to understand your insurance coverage, which charges will be covered, how much you will be billed, information on deductibles and your expected out-of-pocket responsibility