Guest Estimate - Frequently Asked Questions

Guest Estimate FAQ

How can I tell which DRG applies to me?

The best way to find out which DRGs apply to you is to let your doctor know you’re trying to estimate pricing. Ask him or her for your exact treatment plan, including the DRG codes associated with it.

How will the hospital chargemaster rates differ from my actual costs?

The chargemaster rates in our spreadsheets only include hospital-related charges. You may also receive charges from the physicians providing you services related to your hospital visit. These may include:

  • Specialists
  • Anesthesiologists
  • Pathologists
  • Radiologists

You may also receive a separate bill from independent laboratory and radiology services. These services include having specialists read and interpret EKG's, X-rays, EEG's and lab work.

How does insurance coverage affect the chargemaster rates?

When reviewing charges, it is also important to note that actual payment rates for hospital care provided to insured patients are:

  • Negotiated with health plans,
  • Set by the federal government for Medicare, or
  • Set by state governments for Medicaid