Pricing

Inpatient & Outpatient Charges

The information provided here is a comprehensive list of charges for each inpatient and outpatient service or item provided by a hospital, also known as a Chargemaster. It is a helpful tool for patients to comparison shop between hospitals or to estimate what health care services are going to cost.

Most patients are more interested in what their exact services are going to cost them personally, after their insurance has considered the charges, and applied the benefits in their insurance policy.

Magruder staff is available to provide you with a customized estimate for your services, as well as working with you to meet the financial costs of your healthcare. If your healthcare provider has ordered services for you, please contact our financial assistance representatives at 419-732-4004.

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Transparency about the cost of health care is important. You can find several resources here to help understand and compare the costs of care, as well as our Price Estimator.

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Chargemaster FAQ

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 amounts are almost never 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 discounts 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 for those who qualify. We have very competitive package prices for patients who want to pay at the time of service, and self pay discounts for patients who pay within our prompt payment period. For more information on our financial assistance policies, please call 419-732-4004.

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 may be $700. If the patient’s insurance plan indicates the patient is responsible for 20 percent of the contract rate, the patient would owe $140 ($700 x 20 percent). For more information, please call 419-732-4004.

Are the charges the same for every patient? 

The list of charges 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 health care services are going to cost them out of their own pocket.

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. For more information, please call 419-732-4004.

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 health care providers who may bill you separately:

  • The physicians who see you in the hospital
  • The surgeon who performs your procedure
  • The Emergency Room doctor who treats you in the Emergency Room
  • The anesthesiologist who works with the surgeon
  • The radiologist who reads your x-rays or other imaging
  • Other doctors who may be consulted by your doctor during your time in the hospital
  • The pathologists who evaluate pathology specimens

Content for the additional accordion section.

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 hospitals’ financial assistance policy, please contact 419-732-4004.

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

Your Rights and Protections Against Surprise Medical Bills

Effective January 2022

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. In these cases, you shouldn’t be charged more than your plan’s copayments, coinsurance and/or deductible.

 

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

When you see a doctor or other health care provider, you may owe certain out-of-pocket costs, such as a copay, coinsurance, or deductible.  You may have other costs or have to pay the entire bill if you see a provider or visit a health care 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 cost for the same service and might not count toward your annual out-of-pocket limit.

“Surprise billing” is an unacceptable 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 scheduled a visit at an in-network facility but are unexpectedly treated by an out-of-network provider. Surprise Medical Bills could cost thousands of dollars depending on the procedure or service.

You are protected from balance billing for:

Emergency Services

If you have an emergency medical condition and get emergency services for 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, coinsurance, and deductibles).  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. 

Applicable Ohio State Balance Billing OCR 3902.50 -.54

This incorporates the Surprises Act, but two differences should be noted:

• Ground Ambulances: Extends to surprise billing by ground ambulances, where the Act’s

protections do not; and

• Applicable to Fully-Insured: Applies only to fully-insured health plans, whereas, the Act covers both fully-insured and self-insured patients.

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.
  • Generally, your health plan must: 
  • Cover emergency services without requiring you get approval for services in advance (also known as “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.

If you believe you’ve been wrongly billed, you may contact the Magruder Hospital Financial Counselors at (419) 732-4004.  The federal phone number for information or complaints is 1-800-985-3059.    

Visit www.cms.gov/nosurprises/consumers for more information about your rights under federal law or the Ohio Department of Health at 1-800-342-0553. 

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Avoiding Surprise in Your Medical Bills Avoiding Surprises in Your Medical Bills: A Guide for Consumers

This guide will help you understand how you can avoid receiving an unexpected medical bill by asking the right questions, scheduling care ahead of time and other tips to help you stay aware of costs.

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Download the Magruder Medical Group Pricing List for a machine-readable version of our service costs.

There are also typically additional physician fees that will be added to your financial responsibility. In order to get a better understanding of your financial obligations, please contact our financial counselors at 419-732-4004.

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