Each Ascension hospital's machine-readable pricing file contains a Legal Notice worksheet (or tab) and a Standard Charges worksheet. The Legal Notice worksheet contains important notices and legal information, so please review it carefully. The Standard Charges worksheet displays the hospital's gross charges, discounted cash prices, payer negotiated rates, and minimum and maximum payer negotiated rates. The hospital may have payer negotiated rates for services or service package s that are not included in the hospital's chargemaster. If the hospital's chargemaster does not include a service or service package, the applicable gross charge and cash charge cells will indicate "N/A." If a payer does not have a negotiated rate for the applicable service, the applicable cell will indicate “N/A.”

Financial Assistance

From payment options and guidelines to insurance programs and financial aid, Ascension is here to assist you. If you do not have health insurance or are unable to pay your balance in full at time of service or discharge, you may be eligible for our financial assistance program. Upon your request, Ascension will help determine whether you qualify for financial assistance – a service provided to you at no cost. Please visit Financial Assistance. You may download the financial assistance form and bring with you when you meet with a counselor. Assistance is provided based on income and household size. Ascension provides healthcare services without regard to race, creed, color, sex, age, national origin or disability.

Pricing Does Not Reflect Your Actual Costs

This pricing file is a snapshot of the Ascension hospital’s pricing and is not a contract or guarantee of the actual costs for the services that may be provided to you. The pricing in this pricing file reflects the hospital’s standard pricing, and your final charges and out-of-pocket costs may be greater than the amount in this pricing file. The pricing in this pricing file is based on the healthcare services, hospital location, and health plan you select. A hospital visit or encounter might include multiple items or services and might vary from patient-to-patient for the same primary service depending on any complications, length of stay, or service provided due to the patient's health status. Your actual costs may vary depending upon the hospital location, the actual services provided, variation in complexity, and timing of other outstanding payments affecting your deductible or out-of-pocket costs. You are encouraged to consult with your insurance provider to confirm your payment responsibilities, deductibles, and other details of your insurance. In addition, you may incur other charges from physicians and other providers separate from the hospital charges for the services identified in this pricing file. The other charges could include pathology, radiology, anesthesia, emergency care, and other physician or surgeon charges. Physician-related charges are billed directly by your physician, and other third-party charges (charges for services by providers other than the hospital and your physician) are billed directly by the third-party provider.

Prices Subject to Change

The prices in the pricing files are subject to change at any time without notice.

Subject to Medical Necessity

Nothing in the pricing file means the selected services are medically necessary or appropriate. Ascension may refuse to provide any services that are not medically necessary or appropriate or violate our Ethical and Religious Directives.

Prior Authorizations; Personal Financial Obligation

Ascension has not obtained any prior authorization or referral that may be required by your health insurance plan for any services identified in the pricing files, and Ascension has not contacted your health insurance provider to confirm the costs that will be covered by your insurance plan. You are responsible for

• getting any prior authorizations and referrals that your health insurance plan requires;
• contacting your health insurance plan to confirm the costs that will be covered by insurance and any costs for which you will be personally responsible for paying;
• any personal financial obligation for all charges for services performed by Ascension and any other provider whose services are related to or associated with those services; and
• promptly paying any costs not covered by your insurance company.

Definitions and Additional Information
If you have insurance coverage, your financial responsibility will be determined by the contract between the hospital and your insurance company, and the specific coinsurance, copay, and deductible obligations you have under your insurance policy. Below are brief descriptions of some of the key terms used in the pricing files.

1. “Gross Charge” is the charge for an individual item or service that is reflected on the hospital's chargemaster, absent any discounts.
2. “Discounted Cash Price” is the charge that applies to an individual who pays cash (or cash equivalent) for a hospital item or service.
3. “Insurance Plan Rate” is the rate the hospital has negotiated with the applicable health insurance plan.
4. “De-Identified Maximum Negotiated Charge” is the highest charge that a hospital has negotiated with all insurance providers for an item or service.
5. “De-Identified Minimum Negotiated Charge” is the lowest charge that a hospital has negotiated with all insurance providers for an item or service.

Compliance with Price Transparency Rules
All hospitals in the U.S. are required by law to publish their standard charges in both a machine-readable file and in a consumer-friendly manner. This machine-readable price transparency file is intended to comply with the CMS price transparency rules at 45 C.F.R. § 180.50.

Other Terms
Ascension’s Terms of Use apply to Ascension’s machine-readable pricing files and your use thereof, except to the extent prohibited by law. As noted in the Terms of Use, you may have a registered account with Ascension, but such an account is not required for you to use Ascension’s machine-readable pricing files, nor are you required to provide any personally identifiable information in order to use the pricing files.