Price Transparency

Price Transparency &
Cost Estimator Tool

Healthcare Price Transparency and Affordability

Share Medical Center supports healthcare price transparency to help consumers make informed decisions about their care. As part of this effort, Share Medical Center annually publishes hospital chargemaster information and provides a cost estimator tool for commonly used services in medical offices such as lab tests, office visits or x-rays.

 



In compliance with the Centers for Medicare and Medicaid Services (CMS) Price Transparency Rule, Share Medical Center is making available to the public a machine readable pricing file.


Before you search through this file to learn what it may cost you to receive an item or service provided by the hospital or clinic, it is important to understand that what the hospital or clinic charges for a service IS NOT the same as what you or your insurance company may pay for a service. In fact, virtually no one pays the charges you will see listed in the Hospital Charge Master. 


Charges are simply a tool that health care providers use to negotiate contracts with insurance companies, and to evaluate the financial impact of these negotiations on the financial health of the institution.


Charges are the same for all patients, but a patient’s responsibility may vary depending on payment plans negotiated with individual insurers. Further discounts are available for uninsured or underinsured patients who qualify.     


So before you search this file, we encourage you to use the cost estimator or call us at 580-327-2800 to get a customized quote.

Effective January 1, 2022, the No Surprises Act, which Congress passed as part of the Consolidated Appropriations Act of 2021, is designed to protect patients from surprise bills for emergency services at out-of-network facilities or for out-of-network providers at in-network facilities, holding them liable only for in-network cost-sharing amounts. The No Surprises Act also enables uninsured patients to receive a good faith estimate of the cost of care.

Billing Disclosures – Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or get treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from surprise billing or balance billing.

What is “balance billing” (sometimes called “surprise billing”)?

When you see a doctor or other healthcare provider, you may owe certain out-of-pocket costs, such as a copayment, coinsurance and/or a deductible. You may have other costs or have to pay the entire bill if you see a provider or visit a healthcare facility that isn’t in your health plan’s network.

“Out-of-network” describes providers and facilities that haven’t signed a contract with your health plan. Out-of-network providers may be permitted to bill you for the difference between what your plan agreed to pay and the full amount charged for a service. This is called “balance billing.” This amount is likely more than in-network costs for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unexpected balance bill. This can happen when you can’t control who is involved in your care — like when you have an emergency or when you schedule a visit at an in-network facility but are unexpectedly treated by an out-of-network provider.

You are protected from balance billing for:

Emergency Services

If you have an emergency medical condition and get emergency services from an out-of-network provider or facility, the most the provider or facility may bill you is your plan’s in-network cost-sharing amount (such as copayments and coinsurance). You can’t be balance billed for these emergency services. This includes services you may get after you’re in stable condition, unless you give written consent and give up your protections not to be balanced billed for these post-stabilization services.

Certain Services at an In-Network Hospital or Ambulatory Surgical Center

When you get services from an in-network hospital or ambulatory surgical center, certain providers there may be out-of-network. In these cases, the most those providers may bill you is your plan’s in-network cost-sharing amount. This applies to emergency medicine, anesthesia, pathology, radiology, laboratory, neonatology, assistant surgeon, hospitalist or intensivist services. These providers can’t balance bill you and may not ask you to give up your protections not to be balance billed.

If you get other services at these in-network facilities, out-of-network providers can’t balance bill you, unless you give written consent and give up your protections.

You’re never required to give up your protections from balance billing. You also aren’t required to get care out-of-network. You can choose a provider or facility in your plan’s network.

When balance billing isn’t allowed, you also have the following protections:

  • You are only responsible for paying your share of the cost (like the copayments, coinsurance, and deductibles that you would pay if the provider or facility was in-network). Your health plan will pay out-of-network providers and facilities directly.
  • Your health plan generally must:
  • Cover emergency services without requiring you to get approval for services in advance (prior authorization).
  • Cover emergency services by out-of-network providers.
  • Base what you owe the provider or facility (cost-sharing) on what it would pay an in-network provider or facility and show that amount in your explanation of benefits.
  • Count any amount you pay for emergency services or out-of-network services toward your deductible and out-of-pocket limit.


Cost Estimator

Share Medical Center's Online Cost Estimator tool can be used to estimate the individual cost of our most used services customized specific to you and your insurance.

Cost Estimator Tool

Price Transparency

Share Medical Center is committed to providing meaningful information about our healthcare services, including the amount that patients may be obligated to pay for those services. The amount that patients pay is largely determined by their health insurance coverage. If a patient does not have health insurance, their financial liability will be determined by the application of our self-pay discount to the bill.


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