This tool helps you estimate the cost of common hospital services and procedures. You can base your estimate on your insurance coverage or self-pay options. Self-service estimates for Medicare are not available at this time and are not required under the price transparency rules.
A hospital chargemaster is a comprehensive list of all the billable services and items provided by a hospital. The chargemaster captures the costs of each procedure, service, supply, prescription drug, and diagnostic test provided at the hospital, as well as any fees associated with services, such as equipment fees and room charges. Because hospitals operate 24 hours a day, seven days a week, a chargemaster can contain thousands of services and related charges.
Chargemaster amounts are almost never billed to a patient or received as payment by a hospital. The chargemaster amounts are billed to an insurance company, Medicare, or MassHealth. In most circumstances, the chargemaster rates are not reflective of the actual payment to the hospital. These payers then apply their reimbursement terms or contracted rates to the services that are billed. If a patient co-payment, co-insurance, or deductible is owed, these too are most often not based on chargemaster amounts but rather the payment terms determined by the insurer or government program.
Costs vary among healthcare providers based on several factors including whether they are an academic medical center, a teaching hospital, a community service provider and other factors.
In situations where a patient does not have insurance, patients may be eligible for free or reduced cost of healthcare services through various state public assistance programs as well as the hospital financial assistance programs (including but not limited to MassHealth, the premium assistance payment program operated by the Health Connector, the Children’s Medical Security Program, the Health Safety Net and Medical Hardship). Such programs are intended to assist low-income patients taking into account each individual’s ability to contribute to the cost of their care. For those individuals who are uninsured or underinsured, the hospital will, when requested, help them with applying for coverage through public assistance programs or hospital financial assistance programs that may cover all or some of their unpaid hospital bills.
The list of charges is the same for all patients. However, the total charges for an individual patient often vary from 1 patient to another for a number of reasons, including but not limited to:
- 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 you require;
- Whether you experience complications and need additional treatment; and/or
- Other health conditions you may have that may affect your care.
As mentioned above, Chargemaster amounts are almost never billed to a patient or received as payment by a hospital.