Aspirus St. Luke's Chargemaster
The Charge Description Master (CDM), or chargemaster, is a comprehensive listing of items that could be billed to a patient or payer. Hospital chargemasters are lengthy and complex documents. Persons interested in estimating the cost of future care or comparing similar services of various hospitals should consider the following additional information.
Hospitals are required by the federal government to utilize uniform charges as the starting point for all bills. Since payment rates for hospital care provided to insured patients are either negotiated with health plans, set by the federal government for Medicare, or set by state governments for Medicaid, the payment amounts hospitals receive for patient care do not necessarily reflect the prices reflected on either the chargemaster or the hospital’s average Diagnostic Related Group (DRG) charge. Further, uninsured patients are not generally expected to pay the hospital’s standard charges in full, and may be eligible for financial assistance. The submitted pricing information reflects hospital charges in effect on January 1, 2023. As a result, a patient’s bill for hospital services provided at a different date may contain different charges.
The prices in the estimator tool are for hospital services only. Hospital charges may include bundled procedures, personnel, services and supplies. An example would be room rates that include the space, equipment, nursing personnel and some supplies. A DRG is how Medicare and some health insurance companies categorize hospitalization costs and determine how much to pay for a patient's inpatient hospital stay. Rather than paying the hospital for what it spent caring for a hospitalized patient, Medicare pays the hospital a fixed amount based on the patient’s DRG or diagnosis.
Typical Charges
Hospital charges typically do not include physician services or the necessary services of other providers, such as personnel retained by the physician, or the services of outside facilities. Patients will be responsible for these other charges in addition to the hospital charges.
Hospital charges are based on what type of care is actually provided and can differ from patient to patient for the same service. The differences between patients are related to complications or varying treatments needed due to the patient's health. Even though the hospital's prices on this list are the same for all patients, actual charges for each specific patient may vary from the listed standard charges due to a combination of factors.
Drug prices are subject to change as the sales price for the drug changes throughout the year. It is also difficult to estimate the cost of drugs upfront because the price for each patient can vary depending on the specific medication ordered, the dose and method of administration. It is also important to note that medication plans may have to be altered depending on the patient’s response or other medications the patient may be taking.
Patient’s Responsibility
A patient's responsibility may vary, depending on payment plans negotiated with individual health insurers, or the terms of coverage under a governmental or other healthcare payment program.
Many patients who seek hospital charge information are interested in knowing their potential out-of-pocket financial responsibility. This is an opportunity to have important conversations regarding finances. Those with health insurance can be directed to contact their health plan for specific financial obligations. Those without health insurance will be provided information related to the hospital's financial assistance policy or other discounts that could be applied.
Please contact us at 218.249.5340 or 866.303.5340 for more specific price estimates or for further assistance with our financial counselors.
For patients seeking emergency care, we provide medical screening by a physician and necessary stabilizing treatment without delay to all individuals who come to the hospital and request care, regardless of their ability to pay.