Cost Estimates & Pricing
Good information helps patients and families make smart decisions about their health care. In 2012, UR Medicine created the Health Care Cost Estimator service. Our billing experts work with patients and families to estimate how much they could pay for UR Medicine health care services.
Be sure to have the following information available:
- A description of the medical service you are seeking (or the CPT procedure code, which you can get from your health care team)
- Name of your insurance, and your subscriber ID number.
Please note: The pricing information offered by this service is an estimate based on information you provide to us. Its accuracy is not guaranteed. Unanticipated charges related to an individual’s health care such as unforeseen complications, additional tests, or procedures can increase the ultimate cost of services provided.
Why is Health Care Pricing So Complicated?
Many things affect the cost of health care services. For example, the price of a CT scan (used to obtain images of soft tissue and blood vessels) depends on what part of the body is being scanned and whether a contrast agent (special dye) is needed to make the organs and tissue more visible.
Hospitals and physicians set their own prices for the services they provide, but those prices can change for a number of reasons. For example, insurance companies negotiate their own rates with hospitals. And some government programs (like Medicare) set their own rates. For these reasons, “standard” prices are not much help in figuring out what you will have to pay.
In addition to using our Cost Estimator Service, your insurance carrier can help you understand insurance terms such as out-of-pocket maximums, deductibles and copayments that will affect what you ultimately pay. Patients enrolled in Medicare can find insurance information at www.Medicare.gov.
UR Medicine provides compassionate, medically necessary healthcare to anyone in need – regardless of insurance status or ability to pay. If you cannot afford to pay for part or all of your essential health care services, you may be eligible for Financial Assistance.
How Can I Compare Hospital Charges?
Due to new federal government regulations, all hospitals are posting a list of "standard" hospital charges.
Please note some very important guidelines about this information:
- Standard pricing listed by hospitals likely does not apply to you if you have government insurance (Medicare/Medicaid), commercial insurance, or both. That’s because insurers have different rules for coverage. What you ultimately pay depends on what type of plan you have.
- Pricing reflects hospital charges only; it does not include physician or other provider fees that are billed separately from hospital fees.
- Our Health Care Cost Estimator team can figure in both hospital charges and other fees. We are happy to help you estimate your health care costs – whether you have insurance or not. Please see cost estimator information above for this service.
Medicare Price Lookup Tools
Medicare pricing for common inpatient procedures at Strong Memorial Hospital and Highland Hospital (such as a total hip replacement) have been obtained from the Centers for Medicaid & Medicare Services (CMS). CMS also just launched a new price lookup tool for outpatient procedures performed at hospital outpatient departments and ambulatory surgical centers.