Prices and Charges
As part of our commitment to helping our patients understand their financial obligations and rights associated with their medical care, we offer several ways to find pricing estimates on services. When you have a procedure or are treated in the hospital, your care is customized to exactly what you need. So the way hospitals charge for care is based on individual charges for each part of your care, and they are all added together to determine what we bill your insurance provider, Medicare or Medicaid, or whoever is paying for your care. This is like a “sticker price” and is generally not what we get paid. Government payers, like Medicare and Medicaid, have a formula they use to determine what they will pay a hospital, and we negotiate discounts with commercial insurance companies. Our Price Estimator tool can be used to generate an estimate for your care based on these negotiated rates.
Online Price Estimator for Common Services
Englewood Hospital’s price estimator tool provides estimates for 300 common tests and procedures. The tool allows you to estimate out-of-pocket costs based on your insurance. It can also be used to determine the discounted self-pay price, if you do not have insurance.
The price estimator tool is part of our MyChart patient portal. You can use the tool as a guest to get a general estimate by manually entering insurance information. You can also log into MyChart to get customized estimates based on your insurance that is already in our system.
Download File of All Charges
You can download a machine-readable file of all standard charges (600+ MB JSON format, updated 12/30/2021). These are defined by Medicare as:
- Gross charge means the charge for an individual item or service that is reflected on a hospital’s chargemaster, absent any discounts.
- De-identified maximum negotiated charge means the highest charge that a hospital has negotiated with all third party payers for an item or service.
- De-identified minimum negotiated charge means the lowest charge that a hospital has negotiated with all third party payers for an item or service.
- Discounted cash price means the charge that applies to an individual who pays the self pay rate (or cash equivalent) for a hospital item or service.
The services are defined by the codes we bill with. DRGs (Diagnosis Related Groups), are used in most cases for inpatient stays. CPT codes are used for outpatient procedures. NDCs (National Drug Codes), are used to define the drug and manufacturer. If you have insurance and would like to know your out-of-pocket rate, please use our Estimator Tool by clicking on the link above.
The information on this site is provided as required by The Centers for Medicare & Medicaid Services’ Price Transparency Final Rule and is not a guarantee of final billed charges, which may vary from these estimates for many reasons including the individual patient’s unique medical condition, complications, unknown circumstances, other diagnoses and recommended treatments. Please note that physician services are billed directly from the physician practice, and Englewood Hospital is not able to provide that pricing information.
If you need additional information, we are available at 201-894-3099 (Monday through Friday from 9 a.m. to 5 p.m.) to answer any questions you may have on pricing, CPT coding and out-of-pocket costs.