Hospital Pricing Transparency

Hospital Pricing & Chargemasters

Effective January 1, 2019, the Centers for Medicare and Medicaid Services (CMS) required hospitals to make their chargemasters available online. A chargemaster is a master listing of all items that a hospital may charge or use while providing various healthcare services. The chargemaster is updated frequently.

What you need to know

Chargemasters for Wellstar Health System hospitals are available on this page as required by CMS, but may not be exactly what you are looking for.

The chargemaster details inpatient and outpatient services or items provided by a hospital. This listing includes thousands of entries which cover each test, exam, surgical procedure, room charge and more that a patient may receive during hospital care.

Chargemaster information is not particularly helpful for patients, because:

You have different insurance coverage. Not every patient has the same coverage. This means they will be billed in accordance with contracted rates between the hospital and insurance company, Medicare or Medicaid, which are often lower than the fees listed on the Chargemaster.
What your insurance plan requires of you is different than other patients. Each patient’s share of what they need to pay based on their own insurance policy is different (for example, a patient may be expected to pay 10% or 20% of their insurance company’s contracted hospital costs). There are also different deductibles and out-of-pocket maximums.
Each patient’s treatment is different. While two patients may need similar treatments, total care may differ depending on various factors like length of recovery, complications, other health conditions that may affect treatment, medications required, and more.
Services by providers aren’t included. While the Chargemaster includes hospital services, it does not include charges for services provided by health providers such as personal physicians, surgeons, anesthesiologists, radiologists or lab testing. These are billed for separately from the hospital.

More detailed information about Chargemasters is available below. For patients who are uninsured, underinsured or experiencing financial hardship due to a catastrophic medical event, visit our financial assistance page to learn more.

How to get a more accurate picture

To learn more about estimated expenses to expect from an upcoming procedure, please contact your insurance company, Medicare or Medicaid.

Shoppable Services

If you would like more information about the chargemaster, what your care will cost you or the hospital’s financial assistance policy, Wellstar has several consumer-friendly options available to assist you:

Price Estimates

Wellstar offers hospital price estimates for insured and non-insured patients. Such estimates are designed to help in understanding what to expect financially before receiving services. The estimate provided is based on many factors including anticipated service specific charges, historical averages, and information received from the patient’s insurance company, when available. Wellstar understands that medical care is not always a defined course of treatment for every patient and there is a need to rely on one’s physician(s) to ensure tailored care for specific health care needs. Just as no two patients are the same, Wellstar uses the best information available in advance of services being provided to estimate costs in advance of care actually being provided. The final bill, however, may be significantly different from the hospital price estimate provided, and Wellstar is not liable for any discrepancies between the estimate and the price of the actual, individualized care provided. Further, the estimate does not include associated professional fees, like fees for costs of Anesthesiologists, Pathologists, and Radiologists.

For assistance with Hospital Pricing Estimates, please contact our Price Estimation Specialists at (470) 245-9998 or, visit MyChart and select, "Get an Estimate", or use our contact form. The information contained in Wellstar estimates is intended for informational purposes only and does not represent any obligation or agreement.

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.

What is a chargemaster?

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 prices can change at any time, and services and items may be added or deleted.

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 Medicaid, and those insurers then apply their contracted rates 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. More information on our financial assistance policies can be found here.

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 maybe $700. If the patient’s insurance plan indicates the patient is responsible for 20% of the contract rate, the patient would owe $140 ($700 x 20%).

Are charges the same for every patient?

The list of charges for each service or item 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 you require.
Whether you experience complications and need additional treatment.
Other health conditions you may have that may affect your care.

Is the charge the same as what a patient pays?

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

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.

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.

What is not included in the chargemaster list?

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 healthcare providers who may bill you separately:

Your personal doctor, if he/she sees you in the hospital.
The surgeon who performs your procedure.
The anesthesiologist who works with the surgeon.
The radiologist who reads your X-rays or other imaging.
Other doctors may be consulted by your doctor during your time in the hospital.
Laboratory testing.

Where can I find more information about hospital costs?

If you would like more information about the chargemaster, what your care will cost you or the hospital’s financial assistance policy, please contact our customer service team at (470) 245-9998 or use our contact form.

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.