Hospital Price Transparency

Standard Charges & Negotiated Rates

In compliance with federal law, Franciscan Health provides a machine-readable file containing its standard charges and the negotiated payer allowed rates for those charges. The charge master includes line item prices for room and board, supplies, diagnostics, surgical procedures, and other medical goods and services. You may search this file using the name of the procedure or item. You may also search for procedures by the Nationally assigned CPT code. We also provide a file of Diagnostic Related Groups (DRGs) payment levels for those payers that pay DRG for inpatient services. Please note that surgery and procedures costs are a combination of room, supplies, drugs, and it is difficult to estimate your payment rate by simply searching at the line item level. You can access our online payment estimate tool via the link below or if you have questions or need assistance, please call our Franciscan Price Quote Line at 855-477-1604.

Shoppable Services & Price Quotes

Good Faith Estimates

You have the right to receive a "Good Faith Estimate" explaining how much your medical care will cost.

Under the law, health care providers need to give patients who don't have insurance or who are not using insurance an estimate of the bill for medical items and services.

• You have the right to receive a Good Faith Estimate for the total expected cost of any non-emergency items or services. This includes related costs like medical tests, prescription drugs, equipment, and hospital fees.
• Make sure your health care provider gives you a Good Faith Estimate in writing at least 1 business day before your medical service or item. You can also ask your health care provider, and any other provider you choose, for a Good Faith Estimate before you schedule an item or service.
• If you receive a bill that is at least $400 more than your Good Faith Estimate, you can dispute the bill.
• Make sure to save a copy or picture of your Good Faith Estimate.

For questions or more information about your right to a Good Faith Estimate, visit www.cms.gov/nosurprises or call at 877-696-6775.

Notice to our patients regarding Good Faith Estimates

An individual for whom nonemergency health services have been ordered, scheduled or referred may at any time ask a health care provider for an estimate of the price the health care providers and health facility will charge for providing a nonemergency medical service. The law requires that the estimate be provided within 5 business days.

Your Rights and Protections Against Surprise Medical Bills

When you get emergency care or are treated by an out-of-network provider at an in-network hospital or ambulatory surgical center, you are protected from balance billing. In these cases, you shouldn't be charged more than your plan's copayments, coinsurance and/or deductibles.

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, like a copayment, coinsurance or a deductible. You may have additional 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" means providers and facilities that haven't signed a contract with your health plan to provide services. Out-of-network providers may be allowed 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 plan's deductible or 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. Surprise medical bills could cost thousands of dollars depending on the procedure.

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 they 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.

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 can 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 types of services at an in-network hospital or ambulatory surgical center, out-of-network providers can't balance bill you, unless you give written consent and give up your protections.

Estimate of Charges:

An out-of-network provider can’t balance bill you unless, at least 5 business days before the services are scheduled to be performed, they give you a good faith estimate of the expected charges for the scheduled services. Indiana law also requires a health care provider or facility to provide an estimate for non-emergency services within 5 business days of receiving a request for one.

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're 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 any additional costs to out-of-network providers and facilities directly.

• Generally, your health plan must:
  • Cover emergency services without requiring you to 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 in-network deductible and out-of-pocket limit.

If you believe you've been wrongly billed, contact the Indiana Department of Insurance at https://www.in.gov/idoi/consumer-services or 317-232-8582; or visit https://www.cms.gov/nosurprises/consumers or call 800-985-3095 for more information about your rights under federal law.