CHI Mercy Health Hospital Price Transparency

We are committed to price transparency and empowering patients to understand their health care costs. Basic information about pricing and costs is provided below. For a more complete understanding of your financial responsibility, we encourage you to contact your insurance provider.

Estimate Cost of Care

We want to help you make informed decisions about your care. To obtain cost estimates for common health care services, please access our easy-to-use cost estimator tool.  You may also contact our financial counselors for assistance.

Standard Charges

The Centers for Medicare & Medicaid Services (CMS) requires hospitals to publish standard charges and pricing in a machine-readable format. The Standard Charges file does not include insurance deductibles or other patient-specific insurance information or financial assistance discounts. To obtain an estimate of your out-of-pocket costs, we recommend using our cost estimator tool or contacting your insurance provider

We want to help you make informed decisions about your care. To obtain cost estimates for common health care services, please access our easy-to-use cost estimator tool.  You may also contact our financial counselors for assistance. For the most accurate estimate of out-of-pocket costs, contact your insurance provider.

Cost Estimator Tool

Hospital Pricing Transparency – Standard Charges

Our Standard Charges file includes information from our hospital chargemaster and payer contracts but does not reflect a patient’s financial liability. If you have insurance, we encourage you to contact your insurance provider to confirm your payment responsibilities, deductibles, and other details of your insurance plan. You may also be eligible for financial assistance.

The Standard Charges file is intended to comply with the CMS price transparency requirements. A brief description of the key pricing terms as defined by are outlined below:

  • “Gross Charge” is the charge for an individual item or service that is reflected on the hospital’s chargemaster, absent any discounts.
  • “Discounted Cash Price” is the charge that applies to an individual who pays cash (or cash equivalent) for a hospital item or service.
  • “Payer-specific negotiated charge” is the reimbursement rate that the hospital has negotiated with a third-party payer for an item or service.
  • “De-Identified Maximum Negotiated Charge” is the highest reimbursement rate that a hospital has negotiated with all third-party payers for an item or service.
  • “De-Identified Minimum Negotiated Charge” is the lowest reimbursement rate that a hospital has negotiated with all third-party payers for an item or service.

Important Notes

  • The hospital charges listed do not include patient-specific insurance deductibles or copayments, potential self-pay, or financial assistance discounts and therefore are not a reflection of patient responsibility.
  • The pricing is in effect as of the applicable period prior to the publication date; pricing is subject to change. Any changes to charges, rates, network participation, or other data elements on or after the publication date are not reflected. There may be differences between the Charge Description Master and Standard Charges files due to update timelines.
  • Actual reimbursement for services is dependent on many factors, such as the length of stay, the specific medical services provided, the medications and supplies provided with the service, and other variable factors that vary by payer and pricing methodology. Payer-specific pricing in this file does not incorporate all variable factors.
  • Payer-specific pricing does not include all alternate rates for claims which may have additional or unexpected services.
  • Comparisons of rates within the file between payers or comparison of files between hospitals will not necessarily reflect accurate distinctions in prices due to variations in pricing methodology.
  • Services that do not have payer-specific pricing may reflect services that are not reimbursed outside of a bundled/case payment.
  • Pricing does not include charges for all physician services or other professional services that may be rendered.
  • Not all services listed in this file may be currently available at the hospital.

Please note the intent of this file is to be machine-readable in accordance with  federal requirements. Please refer to our Cost Estimator Tool for access to consumer-friendly pricing information on shoppable services.

The following Standard Charges Machine Readable File is posted in a CMS-compliant .JSON file format. Per 45 CFR 180.20, Machine Readable File format means “a digital representation of data or information in a file that can be imported or read into a computer system for further processing. Examples of machine-readable formats include, but are not limited to, .XML, .JSON and .CSV formats.”  Because the files are intended to be read by machines for further processing, these files are not intended to be user-friendly. Please use our Cost Estimator Tool for access to user-friendly consumer pricing information on shoppable services.

Our hospital used the recommended format/schema provided by CMS for .JSON machine-readable file development. The detailed schema can be found here on the CMS Hospital Price Transparency Resources page.

Standard Charges

Download our Machine Readable Standard Charge Files (MRF)

 

Standard Charge Descriptions

Download our standard Charge Description Master (CDM) files.