Newman Memorial Hospital is dedicated to making our pricing available so that you can make more informed decisions about your healthcare costs.
We provide a variety of resources to help you better understand the costs of your medical care and assist you in planning ahead for medical expenses.
Newman Memorial Hospital's Standard Charges
To improve price transparency, all U.S. hospitals and health systems are required to provide lists of standard hospital charges — also called a chargemaster — so patients can compare prices across hospitals. Here are a few considerations to keep in mind as you view the list of standard charges.
- These charges are rarely the price that patients pay. The chargemaster lists the dollar amount set for each service prior to insurance contract/benefit plan discounts or self-pay discounts being applied, so the price patients pay tends to be less than the standard charge.
- Hospital charges differ from patient to patient for the same service depending upon variations in treatment.
- Patients who are eligible for financial assistance also receive additional discounts.
- Items included in a charge vary across hospital systems. For example, what's included in one hospital's charge for room and board may differ from other hospital's charge — some hospitals bundle services together into a single charge that others may list separately.
- Looking at various hospital charges does not provide any indication of quality of service and outcomes.
Pricing Lists
To make medical pricing more transparent, all U.S. hospitals are required to provide the following pricing lists. The pricing is listed by the Current Procedural Terminology (CPT) code used by insurance companies. The lists are in a spreadsheet format.
PLEASE NOTE: The price lists below show standard charges as well as contract negotiated rates with individual insurance providers. They may be useful for comparing pricing with other hospitals but they may not indicate actual costs to patients.
- Standard Charges (Chargemaster Pricing) | January 30, 2024 - This list shows preliminary pricing for thousands of different services and medical procedures performed at Newman Memorial Hospital.
- Average Charges by Patient Group | January 30, 2024 - This list shows pricing by types of patient groups, referred to as MS-DRGs (Medicare Severity Diagnosis Related Groups).
- Shoppable Services Pricing | January 30, 2024 - This list shows Newman Memorial Hospital pricing for the most common 300 medical services. It includes gross charges, discounted cash prices, and payer-specific negotiated charges.
- Unavailable Shoppable Services Pricing | January 30, 2024 - This list shows Newman Memorial Hospital's unavailable shoppable services.
Patient Price Estimator
Newman Memorial Hospital's Patient Price Estimator provides approximate out-of-pocket costs for a specific medical procedure or service. This pricing only includes the most common 300 medical services required by CMS. It includes gross charges, discounted cash prices, and payer-specific negotiated charges. If the Service or the specific Insurance plan you are wanting is not found, please call the number in the Contact Us section.
Frequently Asked Questions
How are charges (prices) established for services?
Each hospital has its own policy for setting prices. Hospital charges vary because they reflect the individual hospital's mission and the Patient population it serves. A hospital that provides highly specialized services, such as trauma units or dedicated intensive care services, like Newman Memorial Hospital , has a different cost structure and pricing than one that does not. Prices are reviewed each year on Jan. 1, and are subject to change during the year. To establish prices, we consider many factors including:
- The cost of staff, equipment, medications and other supplies involved in Patient care
- The amount of time our facilities and staff are involved in providing services
- The cost of administrative expenses such as billing, technology, housekeeping, etc.
- Insurance company contracts
- Information provided by the Centers for Medicare and Medicaid Services, the federal agency that manages the Medicare and Medicaid programs
What is the No Surprises Act?
Here's an excerpt from the American Hospital Association's "Detailed Summary of No Surprises Act":
Do these charges (prices) reflect the total cost?
Not necessarily. In addition to your hospital charges, you could receive separate bills for physician's fees from your surgeon, anesthesiologist, radiologist, emergency room physician and other specialists. Please contact those offices directly for price information (580) 938-2551.
What is a CPT Code?
CPT stands for Current Procedural Terminology. A CPT code is a five-digit code used by all hospitals, physicians, and insurance companies to identify a type of service or procedure. You will see CPT codes located on our pricing lists to help ensure that you are viewing the price information for the specific procedure your physician has ordered.
What is DRG?
DRG stands for Diagnosis Related Group. A DRG is only assigned to an inpatient hospital service. DRGs are universal groupings used by Medicare and most insurance companies to clarify the type of inpatient care a Patient receives. Insurance companies use the DRG code, along with a diagnosis/CPT code and the length of the inpatient stay, to determine payment and reimbursement for claims.
What if the procedure (service) I need is not listed on this website?
Charges for many common, high-volume procedures are listed on our site. Additional service areas are being added regularly. Please contact Newman Memorial Hospital Patient Estimates Team at (580) 938-2551 for estimates information on a procedure not listed.
Will my bill be different than the price listed here?
The amount you owe may vary due to a number of circumstances: Additional testing, medications, services or procedures ordered by your physician. The procedure planned may not be the procedure performed based on your physician's assessment.
Where can I get information on the quality of health care at Newman Memorial Hospital?
Our Patients' safety and preventing hospital-acquired infections is a major focus at Newman Memorial Hospital . We are proud that we perform better than national benchmarks in the majority of categories of hospital-acquired infection rates. Our Caregivers are dedicated to improving in this area, and it remains a constant priority for Newman Memorial Hospital. For more information on the quality and transparency commitment, please see our Website.
What insurance companies does Newman Memorial Hospital accept?
Call your insurance provider directly to verify that Newman Memorial Hospital is in your network. Newman Memorial Hospital will file claims to any insurance company you authorize, but your employer and insurance company determine your level of coverage. An insurance contract between your insurance company and Newman Memorial Hospital doesn't guarantee that your claims will be paid in full. You're responsible for payment of services not authorized by your insurance company and any balance remaining after insurance payments and adjustments have been applied.
If Newman Memorial Hospital is "out-of-network", may I still receive care at Newman Memorial Hospital?
Yes. In an emergency, always go to the closest hospital. Your insurance provider generally will cover emergency department costs or recommend a transfer to an "in-network" hospital when it is safe to do so. If you choose to go to an "out-of-network" hospital in a non-emergency, you may be required to pay a larger deductible or a greater portion of your bill. Call your insurance company to find out your health plan's "out-of-network" options.
How will I know how much I owe?
We will do our best to provide you with an estimate price based on our hospital's charges for comparable services and your insurance information, if applicable.
What if my estimate is different than what I was billed for?
We do our best to provide you with an accurate estimate. However, your actual bill might vary, and our estimates are not guaranteed because the services each patient requires can vary, and your bill will be dependent on your individual circumstances at the time your services are rendered. Your health plan may require a co-payment or deductible that will be due during appointment registration. Check with your provider on the amount that you will be responsible for at this time. Following your healthcare services, your insurance provider will send you an Explanation of Benefits (EOB), which will detail the amount it has paid, any non-covered or denied amounts, and the remaining balance that you are responsible for paying to Newman Memorial Hospital . Review this EOB, compare it to your Newman Memorial Hospital billing statement, and call your insurance provider or a Newman Memorial Hospital Customer Service if you have questions or concerns.
What services are excluded from the pricing information on this website?
Your personal physician or other physicians providing you with services related to your hospital stay or visit will bill you separately. This can include fees related to specialists, anesthesiologists, pathologists, and radiologists.
Is this hospital in-network or out-of-network?
Prices can vary widely depending on whether your hospital is in- or out-of-network for your specific health plan. Out-of-network hospitals have not been able to negotiate a discounted price with your insurer, thus making you potentially responsible for higher personal payments.
Is the hospital physician providing care in-network or out-of-network?
Even if your hospital is in-network, you may receive care from an out-of-network physician. If possible, always find out if all physicians who will treat you are within your health plan's network. This includes but is not limited to: anesthesiologists for surgery or pregnancy delivery along with pathologists, radiologists or consulting doctors. If they are not within network, ask if they will accept in-network payment for services provided to you. If you're concerned that your doctor may be out-of-network, contact your insurance company.
Is it possible my bill will be higher than expected?
Yes, services and procedures may be different based on age and level of health (for example, uncontrolled diabetes and high blood pressure).
Is there help if my health insurance does not cover my bills?
Yes. Newman Memorial Hospital Financial Assistance Specialists assist individuals and families that have health insurance but who need additional financial resources to cover medical bills. We can identify and help you apply for programs including Medicaid, Social Security, and other financial assistance.
What if I don't have health insurance?
We can help you determine if you are eligible for government programs, a product on the Health Insurance Marketplace, or financial assistance through Newman Memorial Hospital 's Community Financial Aid program. Please note: emergency services will never be delayed or withheld on the basis of a patient's ability to pay.
For general care, if you do not have health insurance, call the Newman Memorial Hospital Patient Financial Services Department at (580) 938-2551. The Newman Memorial Hospital Financial Assistance Specialist will review payment and financial assistance options that may be available to you. Discounts vary and are based on family income and size. To receive discounts and payment plans, or to apply for other financial aid programs, you will need to fill out an application and meet certain requirements.
